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Cited by 68Abdominal vascular conditions and treatmentsInflammatory Bowel DiseaseDiverticular Disease and Complications

Obstructive Colitis: Ulceroinflammatory Lesions Occurring Proximal to Colonic Obstruction

Toner, Mary, Condell, Deborah, OʼBriain, D. Sean·1990·The American Journal of Surgical Pathology
DOI 10.1097/00000478-199008000-00003
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Abstract

The term "obstructive colitis" refers to ulceroinflammatory lesions occurring in the colon proximal to an obstructing or potentially obstructing lesion. We studied nine cases identified over a 9-month period. The patients were predominantly female (only one was male), elderly (mean age, 73), and usually had hypertension, diabetes, or other prior chronic illness. The colonic obstruction was due to adenocarcinoma in seven cases and to diverticular disease in two cases. Areas of colitis occurred either as circumscribed ulcers 0.5-2 cm in diameter (three cases) or as confluent circumferential lesions 8-25 cm in length; they were always separated from the more distal obstructing lesions by a segment of normal colon measuring 2.5-35 cm (mean, 14.6 cm). The involved area of colon was usually only mildly dilated; it exhibited moderate thickening of the wall and had a granular luminal surface accentuated in areas by deeper longitudinal or transverse ulcers. Often there were scattered pseudopolyps, and the margin separating the lesion from normal mucosa was well demarcated and irregular. In one case, two distinct separate areas of colitis were present; in another, the appendix was acutely inflamed. Microscopically, the lesions were composed of granulation tissue with a mixed acute and chronic inflammatory infiltrate that replaced the mucosa and often the submucosa; sometimes it extended into the muscularis propria, with associated peritonitis and perforation. Many of the features of obstructive colitis suggest an ischemic origin, probably mainly due to hypoperfusion following raised intramural pressure, but altered fecal flora may have a synergistic effect. The features of the disease are usually sufficiently characteristic to distinguish it from Crohn's disease and other forms of colitis. Complications include peritonitis, perforation and breakdown of anastomoses made through involved segments of colon that may appear externally normal at surgery.

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Crossref · 10.1097/00000478-199008000-00003

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  • Colon ischemia usually occurs proximal to the obstruction.

    “The CI usually occurs proximal to the obstruction[10].”

    From Ischemic bowel disease in 2021. (2021) · cites this paper as [10]

  • Colonic obstruction due to neoplasm, diverticular disease, adhesion, volvulus, intussusception, internal hernia with obstruction or fecal impaction may contribute to colon ischemia, although in most cases the precipitating cause remains unidentified.

    “Colonic obstruction due to neoplasm, diverticular disease, adhesion, volvulus, intussusception, internal hernia with obstruction or fecal impaction may also contribute to CI although in most cases the precipitating cause remains unidentified.”

    From Ischemic bowel disease in 2021. (2021) · cites this paper as [10]

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Authors
Toner, M., Condell, D., & OʼBriain, D. S.
Affiliations
St. James's Hospital (IE)
ORCID
Toner, Mary
Venue
The American Journal of Surgical Pathology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1990-08
Volume
14
Issue
8
Pages
719-736
ISSN
0147-5185 (ISSN-L)
DOI
10.1097/00000478-199008000-00003
OpenAlex
W2068453778
Cited by
68
References
0
Citations by year
2025: 3 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 2 · 2015: 1 · 2013: 3 · 2012: 5
FWCI
2.16
Type
journal article
Language
en
Open access
closed
Locations
  • The American Journal of Surgical Pathology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Health Sciences › Medicine › Surgery › Diverticular Disease and Complications
Keywords
obstructive colitis, colonic obstruction, colon adenocarcinoma, diverticular disease, granulation tissue, ischemic colitis, pseudopolyps, peritonitis, perforation, Crohn's disease differential diagnosis, fecal microbiota
MeSH terms
Aged, Aged, 80 and over, Colitis, Colon, Female, Humans, Intestinal Obstruction, Male, Middle Aged

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