ischemic colitis

Q: Which areas of the colon are more prone to ischemia due to hypo-perfusion?



Answer: Splenic flexure and rectosigmoid junction

The blood supply of large intestine and rectum comes from the superior mesenteric artery, inferior mesenteric artery, and internal iliac arteries. Fortunately, there is an extensive collateral circulation to protect the bowel from compromised perfusion, except in the "watershed" areas i.e.,  splenic flexure and rectosigmoid junction.

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References:

Brandt LJ, Feuerstadt P, Blaszka MC. Anatomic patterns, patient characteristics, and clinical outcomes in ischemic colitis: a study of 313 cases supported by histology. Am J Gastroenterol 2010; 105:2245. 

Greenwald DA, Brandt LJ, Reinus JF. Ischemic bowel disease in the elderly. Gastroenterol Clin North Am 2001; 30:445.