Infarction of the Descending Colon Due to Vascular Occlusion

Ischaemic colitis.

“…The site of the lesion is at the point where the superior and inferior mesenteric systems inosculate and the blood supply is precarious (Griffiths, 1956). In the past a similar bowel lesion has been demonstrated following arterial occlusion (Thomson, 1948;Engelhardt and Jacobson, 1956;Cooling and Protheroe, 1958;McCort, 1960;Marshak et al, 1965), and it has been produced in dogs by ligation of the inferior mesenteric artery . On these grounds, and from the additional clinical evidence discussed below, we conclude that this syndrome is the result of infarction.…”

“…Infarction (McCort, 1960) Anti-clostridial serun Necrotizing colitis (Killingback and Williams, 1961 (Brownlee, 1951) Resection and Episode otf -.+Stenosis (Corbett, 1957) -4 anastomosis hypotension C CoLIrtS StA-It.…”

“…GROUP 1: ISCHAEMIC COLITIS WITH GANGRENE (CASE 1) Gangrene of the colon has been described following ligation of a major colic artery (Lauenstein, 1882;Dzialoswynski, 1925), following a thrombosis (Ferguson, 1932;Gambee, 1937;Huggard and COURSE High mortality Low mortality Ischaemic colitis Herstein, 1948;Thomson, 1948;Johnson and Baggenstoss, 1949;McCort, 1960), or an embolus, (Brown and Dey, 1932), and as a complication of aortic reconstruction (Smith and Szilagyi, 1960;Young, Humphries, de Wolfe, and Lefevre, 1963). It presents as a fulminating abdominal catastrophe with gross depletion of the plasma volume and endotoxaemia, and is almost always fatal.…”

“…Boreham (1957) discusses the causation of the lesion in some detail but does not mention ischaemia as a possibility. Later authors, however (McCort, 1960;Hannan, Jackson, and Pipik, 1964), have used the term infarction.…”

“…Episodes of ischaemia involving the heart or brain are common enough, and it would be surprising if similar events did not occasionally take place in the intestine, particularly the large intestine, whose blood supply is comparatively precarious. Infarcts of the colon have been described from time to time (Thomson, 1948;Engelhardt and Jacobson, 1956;McCort, 1960;Marston, 1962a;Marshak, Maklansky, and Calem, 1965;Varga and Currie, 1965), usually as single case reports or in very small series. Because ischaemia of the bowel results in immediate bacterial invasion, these cases present as an attack of acute 'colitis' of unexplained origin.…”