Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series

Surgical Case Reports
Takatsugu FujiiHiroya Kuroyanagi

Abstract

Ischemic colitis can occur after colectomy and is sometimes difficult to treat. We report 4 cases of refractory, delayed onset, regional congestive colitis occurring on the anal side of the anastomosis after laparoscopic left hemicolectomy. A total of 191 patients underwent surgery for left colon cancer (transverse, descending, and sigmoid colon cancer) at our hospital from January 2012 to December 2017. During the procedures, the left colic artery (LCA) or sigmoid colic artery (SA) was dissected, the superior rectal artery (SRA) was preserved, and the inferior mesenteric vein (IMV) was dissected at the inferior margin of the pancreas. Congestive ischemic colitis due to venous return dysfunction occurred in 4 cases (2.1%), 5 to 34 months postoperatively. The patients had diarrhea and blood in the stool. On computed tomography (CT), the patients exhibited continuous intestinal edema and high-density adipose tissue from the anastomosis site to the rectum. Contrast enhancement showed dilation of the vasa recti and arteries from the inferior mesenteric artery (IMA) to the SRA. Three patients improved with long-term intestinal rest; in 1 case, the stenosis did not improve and required colorectal resection. Diagnoses were easy in the...Continue Reading

References

Dec 22, 1999·The American Journal of Gastroenterology·P DraganovG Portwood
Apr 15, 2008·World Journal of Gastroenterology : WJG·Seong-Su HwangJin-Mo Yang
Nov 30, 2011·International Journal of Colorectal Disease·Min Geun ParkNam Kyu Kim
Nov 11, 2017·ANZ Journal of Surgery·Amanda L Nikolic, James O Keck

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Methods Mentioned

BETA
dissection
surgical resection

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