BENIGN EXTRINSIC STRICTURE OF THE SIGMOID COLON

Abstract

Benign extrinsic stricture of the rectosigmoid and sigmoid colon, caused by pelvic perito-nitis and pelvic abscess, is discussed in this paper. There are nine cases in the Prefectural Nishinomiya Hospital from Sep. 1976 to June 1978. Duration of clinical symptoms which are acute inflammatory features, fever and ab-dominal pain, is relatively short. The examinations discussed in the paper are Ba-enema, colonofiberscopy, angiography and colonofiberscopy infusing the dye, Indigocarmine, into the feeding artery_??_ On the Ba-enema, extrinsic stricture of the colon that margin is featherlike is visible But the stricture recures progressively. So follow-up study is im-portant. By the colonofiberscopy many hemorrhagic spots of the intestinal mucosa are visible. If infusing the Indigocarmine into the feeding artery, it can be observed that the colour of intestinal mucosa changes into blue uniformly. On the angiography hypervascularity of peripheral feeding vessels are visible. There are neither encasement nor obstruction. But these findings are not distinctive for pelvic abscess. There are many diseases have to be differ-entiated e.g., primary and metastated cancer, Crohn's disease, tuberculosis, ischemic colitis, radiation colitis, endometriosis and so on. Primary focus of pelvic abscess is caused by appendicitis, diverticulitis of the colon, cholangitis, pancreatic cyst and perforated peptic ulcer. In our nine cases four are caused by appendicitis but the primary focus was not confirmed in the rest of the cases. It is important to seek the primary focus, although it is not aways possible to discover the focus.