Ischemic colitis typically occurs in the watershed or borderzone territory of the colon, between the segments supplied by the superior and inferior mesenteric arteries. A period of hypotension leads to hypoperfusion within the watershed territory. With close monitoring, a conservative path may be followed but resection may be necessary if there is a deterioration in clinical status.

The particular segment of colon involved in this case makes other causes of colitis such as infection or inflammatory bowel disease less likely.