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Shock-associated right colon ischemia and necrosis
K A Ludwig1, E J Quebbeman, J M Bergstein
1Department of Colorectal Surgery, Cleveland Clinic Foundation, Ohio, USA.
The Journal of Trauma
|December 1, 1995
Summary
Hemorrhagic shock from trauma can cause right colon necrosis, a rare condition. Early recognition and surgical intervention, like right colectomy, lead to good outcomes in these nonocclusive mesenteric ischemia cases.
Area of Science:
- Trauma Surgery
- Gastrointestinal Surgery
- Critical Care Medicine
Background:
- Hemorrhagic shock following trauma can lead to multi-organ failure.
- Ischemic necrosis of the right colon is an underreported complication of hemorrhagic shock.
Observation:
- Three young, previously healthy trauma patients presented with hypotension and right colon necrosis.
- Diagnosis and surgical intervention, including right colectomy, were performed within 48 hours of injury.
Findings:
- Pathologic examination confirmed ischemic necrosis without vascular thrombosis or embolism.
- The condition appears to be a form of nonocclusive mesenteric ischemia.
Implications:
- Increased awareness of shock-associated right colon necrosis is crucial for early diagnosis.
- Prompt surgical treatment can lead to favorable patient outcomes.
- Further research is needed to clarify the etiology of this nonocclusive ischemic colitis.