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[Obstructive colitis: analysis of 7 patients]

A Jover Sáenz1, L L Lorente Aroca, J M Reñe Espinet

  • 1Departamento de Medicina, Hospital Universitario Arnau de Vilanova, Lleida.

Revista Clinica Espanola
|May 20, 1998
PubMed
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Obstructive colitis, characterized by ulcero-inflammatory lesions proximal to a blockage, is often caused by rectal adenocarcinoma. This condition presents with abdominal pain and constipation, highlighting a distinct clinicopathological entity.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Oncology

Background:

  • Obstructive colitis is defined by ulcero-inflammatory lesions proximal to an obstructive lesion in the colon.
  • This retrospective study analyzes seven cases over a five-year period to illustrate the clinicopathological spectrum of obstructive colitis.

Observation:

  • The study identified obstructive colitis in predominantly female patients (mean age 66) with pre-existing conditions like diabetes and hypertension.
  • Clinical symptoms included abdominal distension, pain, and acute constipation.
  • Adenocarcinoma in the rectosigmoid region was the cause of obstruction in all cases.

Findings:

  • Macroscopically, the colitis area showed moderate dilation with single or confluent ulcers, and a transitional preserved zone between the obstruction and colitis.

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  • Microscopic examination revealed granulation tissue replacing the mucosa with inflammation extending to the muscularis propria.
  • Cytometric analysis indicated increased cell cycle (S-phase) and proliferation index at the obstructive lesion, with aneuploidy in advanced cases.

    • Implications:

    • The findings suggest mural hypoperfusion and localized ischemia may play a role in the pathogenesis of obstructive colitis.
    • Understanding obstructive colitis is crucial for differentiating it from other colonic inflammatory diseases.
    • This study contributes to the clinicopathological understanding of obstructive colitis, aiding in diagnosis and management.