What condition is indicated by acute crampy abdominal pain with tenderness in one quadrant and hematochezia after myocardial infarction?

The scenario described—acute crampy abdominal pain with tenderness localized to one quadrant and the presence of hematochezia (blood in the stools)—is indicative of ischemic colitis, especially following a myocardial infarction.

Ischemic colitis occurs when there is a reduction in blood flow to part of the colon, often due to systemic hypoperfusion or occlusion of the mesenteric vessels, which can happen after a myocardial infarction. The heart’s compromised function during or after an MI can lead to decreased perfusion to various organs, including the intestines, causing ischemia. The resulting abdominal pain is typically crampy and may be accompanied by tenderness in the affected area, which aligns with the patient's symptoms.

Hematochezia is a key symptom here, as it reflects bleeding likely due to the ischemic injury to the colon's mucosa. In the context of a recent myocardial infarction, the likelihood of ischemic colitis increases, particularly in older patients and those with vascular risk factors.

In contrast, conditions such as appendicitis, diverticulitis, and cholecystitis may present with abdominal pain and tenderness but they usually do not primarily feature hematochezia as a symptom and have different clinical presentations