On closer inspection, early ischemic enteritis involves the tips of the villi. A colonoscopic view of ischemic colitis with minimal overlying exudate is shown below. In general, bowel is hard to infarct from atherosclerotic vascular narrowing or thromboembolization because of the widely anastomosing blood supply. Thus, most cases of bowel ischemia and infarction result from generalized hypotension and decreased cardiac output.