Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series
Abstract Background 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. Case presentation A total of 191 patien...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-07-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-020-00919-5 |
| _version_ | 1818145760234962944 |
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| author | Takatsugu Fujii Shigeo Toda Yuki Nishihara Yusuke Maeda Kosuke Hiramatsu Yutaka Hanaoka Rikiya Sato Shuichiro Matoba Masashi Ueno Hiroya Kuroyanagi |
| author_facet | Takatsugu Fujii Shigeo Toda Yuki Nishihara Yusuke Maeda Kosuke Hiramatsu Yutaka Hanaoka Rikiya Sato Shuichiro Matoba Masashi Ueno Hiroya Kuroyanagi |
| author_sort | Takatsugu Fujii |
| collection | DOAJ |
| description | Abstract Background 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. Case presentation 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. Conclusion Diagnoses were easy in these cases, but treatment was prolonged and surgery was necessary in 1 case. While this condition is rare, caution is warranted as it is difficult to treat. |
| first_indexed | 2024-12-11T12:08:34Z |
| format | Article |
| id | doaj.art-02622a16a62f45de8134f9b6f5eb6c15 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-12-11T12:08:34Z |
| publishDate | 2020-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-02622a16a62f45de8134f9b6f5eb6c152022-12-22T01:07:51ZengSpringerOpenSurgical Case Reports2198-77932020-07-01611510.1186/s40792-020-00919-5Congestive ischemic colitis occurring after resection of left colon cancer: 4 case seriesTakatsugu Fujii0Shigeo Toda1Yuki Nishihara2Yusuke Maeda3Kosuke Hiramatsu4Yutaka Hanaoka5Rikiya Sato6Shuichiro Matoba7Masashi Ueno8Hiroya Kuroyanagi9Department of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalDepartment of Gastrointestinal Surgery, Toranomon HospitalAbstract Background 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. Case presentation 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. Conclusion Diagnoses were easy in these cases, but treatment was prolonged and surgery was necessary in 1 case. While this condition is rare, caution is warranted as it is difficult to treat.http://link.springer.com/article/10.1186/s40792-020-00919-5Ischemic colitisColon cancerAnastomosisColectomy |
| spellingShingle | Takatsugu Fujii Shigeo Toda Yuki Nishihara Yusuke Maeda Kosuke Hiramatsu Yutaka Hanaoka Rikiya Sato Shuichiro Matoba Masashi Ueno Hiroya Kuroyanagi Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series Surgical Case Reports Ischemic colitis Colon cancer Anastomosis Colectomy |
| title | Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series |
| title_full | Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series |
| title_fullStr | Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series |
| title_full_unstemmed | Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series |
| title_short | Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series |
| title_sort | congestive ischemic colitis occurring after resection of left colon cancer 4 case series |
| topic | Ischemic colitis Colon cancer Anastomosis Colectomy |
| url | http://link.springer.com/article/10.1186/s40792-020-00919-5 |
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