Segmental necrosis of ascending colon in haemodialysis patients

A segmental necrosis of the ascending colon sometimes affecting the terminal ileum was observed 13 times in 12 end-stage renal disease patients over a 5400 patient-years observation period. In all but three cases the patient was operated within 24 h of onset of the abdominal pain. Three patients had...

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Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 1995-12, Vol.10 (12), p.2281-2285
Main Authors: CHARRA, B, CUCHE, J, JEAN, G, LAURENT, G, RUFFET, M, TERRAT, J.-C, BEURLET, J, LABROSSE, H, VANEL, T, CALEMARD, E, CHAZOT, C, VOVAN, C
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Colon - pathology
Emergency and intensive care: renal failure. Dialysis management
Female
Humans
Intensive care medicine
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - therapy
Male
Medical sciences
Middle Aged
Necrosis
Renal Dialysis - adverse effects
Retrospective Studies
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Summary:A segmental necrosis of the ascending colon sometimes affecting the terminal ileum was observed 13 times in 12 end-stage renal disease patients over a 5400 patient-years observation period. In all but three cases the patient was operated within 24 h of onset of the abdominal pain. Three patients had a bowel perforation; nine had a limited intestinal necrosis. All underwent a partial resection or colectomy. Two died within 1 month. In all cases the mucosa was necrotic, the submucosa small vessels were congested and the mesenteric vessels were normal. Ischaemic bowel disease has been previously reported in uraemic patients, but our cases do not fit with the usual reported features of this complication. The absence of typical mesenteric infarction, vascular thrombosis, stenosis or major atherosclerotic lesions is surprising. The ascending colon topography of the lesions is very unusual. Ischaemia, constipation and other factors may play a role.
ISSN:0931-0509
1460-2385
DOI:10.1093/ndt/10.12.2281