[Acute colonic necrosis without vascular obstruction. Apropos of 2 cases]

The authors report 2 new cases of acute necrosis of the colon without vascular obstruction and reviewed them in the light of 94 similar cases collected in the literature. Such lesions of colonic necrosis are believed to be the final outcome of a variable combination of functional circulatory disturbances and of infections starting in the colonic mucosa. Total excision of lesions offers the best chance of recovery. It would seem that the extent of lesions of the mucosa can be determined only by per-operative colonoscopy, findings being used to determine the limits of the resection carried out. There otherwise arises the question of the legitimacy of extensive colonic incision (sub-total or total colectomy with sometimes resection of the rectum) because of the constant possibility of secondary progression of mucosa lesions left in place. The prognosis in this condition is very serious since mortality of cases having undergone potentially curative surgery remains at 56%.