Serhal S, Akl C, Karam T
Service de Chirurgie Générale et Vasculaire, Hôpital Dr S. Serhal, Rabié, Liban.
J Chir (Paris). 1988 Feb;125(2):107-13.
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%.
作者报告了2例无血管阻塞的急性结肠坏死新病例，并根据文献中收集的94例类似病例对其进行了回顾。这种结肠坏死病变被认为是结肠黏膜起始的功能性循环障碍和感染的多种组合的最终结果。病变的完全切除提供了最佳的康复机会。似乎只有通过术中结肠镜检查才能确定黏膜病变的范围，检查结果用于确定所进行切除的界限。否则，由于留在原位的黏膜病变有持续进展的可能性，就会出现广泛结肠切开术（次全或全结肠切除术，有时包括直肠切除术）是否合理的问题。这种情况下的预后非常严重，因为接受了可能治愈性手术的病例死亡率仍高达56%。
