[Colonic occlusion. Apropos of a surgical series of 63 cases]

63 colonic occlusions were operated on from 1975 to 1988. Cancer and stenotic diverticular sigmoiditis were found to be the main causes of colonic obstruction in respectively 36 cases (55%) and 8 cases (13%). Other etiologies were represented by neoplasic gynecologic diseases (9.5%). The rectosigmoid was involved in 50% of the cases (31) while transverse colon and caecum were respectively concerned in 25% and 17%. The 2 main therapeutical procedures used were colic resection (35 cases-55%) with immediate anastomosis in 1 case out of 3 and derivation (26 cases 41%) mostly in the proper from of a colostomy (20 cases). Operation was undertaken during the first 48 hours in 65% of the cases. Death occurred in 8 patients (12.5%). Related to etiology the death rate was 11% in cancers and 25% in stenotic diverticulitis. Where linked to treatment this mortality rate reached 27% in derivations and 3% in colic resections. 38% of non lethal complications were recorded, two-third being due to the bad general conditions of the patients. Several times operations, such as first colostomy or resection without anastomosis, should remain the basic rule one should not depart from without great carefulness. However a new interesting trend toward one time surgery with intraoperative colonic lavage is taking shape.