Ischemic lesions of the distended colon
1975; Elsevier BV; Volume: 129; Issue: 3 Linguagem: Inglês
10.1016/0002-9610(75)90247-0
ISSN1879-1883
Autores Tópico(s)Esophageal and GI Pathology
ResumoSlight, moderate, or severe ischemic lesions caused by insufficient perfusion frequently occur in the colon above obstructing carcinoma, due to distention. Since the mucosa and submucosa are the layers that are most sensitive to hypoxia, the lesions may remain localized to them for a long time. Any weakening of the viability of the mucosa will encourage infection from the intracolic flora. The healthy appearance of the serosa will make it difficult to appreciate the extent and significance of these lesions at laparotomy. This is evidently the reason that these ischemic lesions so often remain unrecognized. It is important to understand the variety of ischemic lesions of the distended colon, because gangrenous as well as nongangrenous ischemic colitis due to distention, whether perforated or not, calls for a type of therapy different from that applied to obstructive complications of colorectal cancer in which there is no ischemic damage. An awareness of ischemic damage to the distended colonic segment in the treatment of obstructive and perforative complications of colorectal cancer decreased the mortality to 11 per cent with extensive resection compared with 73 per cent in the earlier cases which were treated by simple exteriorization of the cecum only or by suture repair and colostomy.
Referência(s)