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Antimesenteric perforations of the colon during diverticular disease: possible pathogenetic role of ischemia.
Tagliacozzo, S; Tocchi, A.
Afiliación
  • Tagliacozzo S; Rome La Sapienza University Medical School, First Department of Surgery, Italy.
Dis Colon Rectum ; 40(11): 1358-61, 1997 Nov.
Article en En | MEDLINE | ID: mdl-9369113
UNLABELLED: The pathogenesis of free perforations occurring on the antimesenteric border of the pelvic colon during the course of diverticular disease has received little attention, with most being generically referred to as diverticular perforations. PURPOSE: This study was designed to identify the pathogenetic factors responsible for free perforations that may occur in the antimesenteric intertenial area during the course of diverticular disease. METHODS: Vascular alterations of the colonic wall associated with diverticula and open antimesenteric perforations were analyzed. RESULTS: Previous data on the site of diverticula formation and related intramural vascular alterations were confirmed. A subserosal vascular network developed in the antimesenteric intertenial area in instances of multiple bilateral diverticula. Free perforations occurred in the antimesenteric haustral area only with multiple bilateral diverticula. CONCLUSIONS: Alterations of the intramural vascular pattern secondary to the presence of multiple and bilateral diverticula may predispose the colonic wall to acute vascular injury. These changes may be enhanced by an episodic increase of intraluminal pressure and consequent distention of the colonic wall occurring in the course of diverticular disease.
Asunto(s)
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colon Sigmoide / Divertículo del Colon / Perforación Intestinal / Isquemia Tipo de estudio: Etiology_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Dis Colon Rectum Año: 1997 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colon Sigmoide / Divertículo del Colon / Perforación Intestinal / Isquemia Tipo de estudio: Etiology_studies / Prognostic_studies Límite: Humans Idioma: En Revista: Dis Colon Rectum Año: 1997 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos