Acute gangrenous colitis proximal to obstructive cancer of the sigmoid colon

Harada, Tetsuo; Umezawa, I.; Mogami, Kenji; Itoh, Zen

doi:10.1007/bf02469468

Cited by 18 publications

(2 citation statements)

References 6 publications

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“…The term “necrotizing colitis” was apparently introduced 3 in 1960 and Kremer 4 was the first to report a case of NC. It has different names such as ulcero–inflammatory colitis, 5 ischemic colitis, 6 , 7 ulcerative 5 , 8 or pseudo-ulcerative colitis, 9 gangrenous colitis, 10 obstructive colitis, 11 , 12 and idiopathic colitis. 13 …”

Section: Discussionmentioning

confidence: 99%

Necrotizing Colitis with Perforation Proximal to Obstructive Ascending Colon Cancer: A Case Report

Pradhan¹,

Satyam²,

Jain³

2023

Euroasian Journal of Hepato-Gastroenterology

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A bstract Background Necrotizing colitis (NC) with perforation is a rare complication of the obstructive cancer of the right colon. Case description We report here a case of a 45-year-old female patient of mucinous adenocarcinoma of ascending colon, which presented as acute NC with perforation proximal to obstructing colonic carcinoma with their imaging features on computed tomography (CT). The purpose of this article is to highlight the role of CT in distinguishing an ischemic and a tumoral segment in the carcinomas complicated by proximal bowel ischemia. Conclusion Imaging plays a great role in distinguishing an ischemic and a tumoral segment in carcinomas complicated by proximal bowel ischemia. The identification of NC will help to accurately stage colonic cancer. How to cite this article Satyam S, Jain K, Pradhan G. Necrotizing Colitis with Perforation Proximal to Obstructive Ascending Colon Cancer: A Case Report. Euroasian J Hepato-Gastroenterol 2022;12(2):95–97.

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Section: Discussionmentioning

confidence: 99%

Necrotizing Colitis with Perforation Proximal to Obstructive Ascending Colon Cancer: A Case Report

Pradhan¹,

Satyam²,

Jain³

2023

Euroasian Journal of Hepato-Gastroenterology

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“…Obstructive ileocolitis is an ulcero-inflammatory lesion proximal to an obstructive colorectal lesion [ 1 ]. As the name implies, both the ileum and colon can be involved in this condition.…”

Section: Introductionmentioning

confidence: 99%

Obstructive Ileocolitis in Patients With Obstructed Colorectal Cancer – A Matched Case Control Study

et al. 2018

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PurposeObstructive ileocolitis is an ulcero-inflammatory condition which typically occurs in the ileum or colon proximal to an obstructing colorectal lesion. If left unresolved, it often leads to intestinal perforation. We present a matched case control study of patients with obstructive ileocolitis caused by colorectal cancer to determine if any factors can predict this condition.MethodsThis is a retrospective review of 21 patients with obstructive colorectal cancer and histologically proven obstructive ileocolitis from 2005 to 2015 matched for age and sex with 21 controls with obstructing colorectal cancer without obstructive ileocolitis.ResultsThe 21 patients with obstructive ileocolitis had a median age of 71 years (range, 52–86 years). The most common presenting symptom was abdominal pain (n = 16, 76.2%), followed by vomiting/nausea (n = 14, 66.7%) and abdominal distension (n = 12, 57.1%). Interestingly, the radiological feature of pneumatosis intestinalis was noted in only 1 case. No significant differences were observed in baseline comorbidities, clinical presentations, or tumor characteristics between the 2 groups. Patients with obstructive ileocolitis were found to have a significantly higher total leucocyte count (17.1 ± 9.4×109/L vs. 12.0 ± 6.8×109/L, P = 0.016), lower pCO2 (32.3 ± 8.2 mmHg vs. 34.8 ± 4.9 mmHg, P = 0.013), lower HCO3 (18.8 ± 4.5 mmol/L vs. 23.6 ± 2.7 mmol/L, P < 0.001), lower base excess (-6.53 ± 5.32 mmol/L vs. -0.57 ± 2.99 mmol/L, P < 0.001) and higher serum lactate levels (3.14 ± 2.19 mmol/L vs. 1.19 ± 0.91 mmol/L, P = 0.007) compared to controls. No radiological features were predictive of obstructive ileocolitis.ConclusionPatients with obstructive ileocolitis tend to present with metabolic acidosis with respiratory compensation, raised lactate, and worse leucocytosis. Radiological features are not useful for predicting this condition.

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Ischaemic colitis and colorectal cancer: some problems and pitfalls

1993

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Four cases out of 204 new cases of colorectal carcinoma seen in a 24 month period were proven to have concomitant proximal ischaemic colitis. Ischaemic colitis associated with obstructing carcinoma of the colorectum may present dramatically with gangrene or colonic perforation if the acute vascular insufficiency is severe. Less severe degrees of ischaemic insult must be recognised intra-operatively as the incorporation of ischaemic colon in a colonic anastomosis may result in an anastomotic leak. Two other patients with ischaemic colitis were wrongly diagnosed as colorectal carcinoma on colonoscopy. Endoscopic features of ischaemic colitis may mimic colonic carcinoma and endoscopic biopsy is essential where any doubt exist as to the possibility of ischaemic colitis so that unnecessary surgery may be avoided.

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Acute gangrenous colitis proximal to obstructive cancer of the sigmoid colon

Cited by 18 publications

References 6 publications

Necrotizing Colitis with Perforation Proximal to Obstructive Ascending Colon Cancer: A Case Report

Necrotizing Colitis with Perforation Proximal to Obstructive Ascending Colon Cancer: A Case Report

Obstructive Ileocolitis in Patients With Obstructed Colorectal Cancer – A Matched Case Control Study

Ischaemic colitis and colorectal cancer: some problems and pitfalls

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