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Also, patients may be too embarrassed to discuss their exact problems, especially with regards symptoms like digitation. [12] The two key features of obstructed defecation are: An inability to voluntarily evacuate rectal contents. [34] Normal colonic transit time, but delayed transit in the rectum and sigmoid colon. [2]
Computed tomography of the abdomen is not routinely necessary, but may show thickening or inflammation in the distal colon (sigmoid colon) with associated diverticulosis. Treatment may consist of antibiotics, aminosalicylates (mesalamine), or prednisone. In rare cases, surgery with segmental resection may be considered.
A proctosigmoidectomy, Hartmann's operation or Hartmann's procedure is the surgical resection of the rectosigmoid colon with closure of the anorectal stump and formation of an end colostomy. It was used to treat colon cancer or inflammation (proctosigmoiditis, proctitis, diverticulitis, volvulus, etc.).
Diverticulitis; Other names: Colonic diverticulitis: Section of the large bowel (sigmoid colon) showing multiple pouches (diverticula).The diverticula appear on either side of the longitudinal muscle bundle (taenium), which runs horizontally across the specimen in an arc.
Sigmoidectomy is a resection of the last part of the colon, known as the sigmoid colon, and can include part or all of the rectum (proctosigmoidectomy). Precancerous polyps and sigmoid colon cancer are common indications for sigmoidectomy.
The colon is then mobilized from the retroperitoneum. Care is taken to avoid injury to the ureters and duodenum. The surgery then follows the same steps as small bowel resection. However, due to the colon's placement in the retroperitoneum, more dissection is often required to allow for tension free anastomosis. [5] [6]
CT scan showing extensive diverticulosis of the sigmoid colon Diverticular disease Whole slide of a transverse section of the left colon with diverticulosis. Diverticulosis is defined by the presence of multiple pouches (diverticula) in the colon. [22] In people without symptoms, these are usually found incidentally during other investigations.
Blue - supply from inferior mesenteric artery (IMA) and its branches: left colic, sigmoid, superior rectal artery. 7 is for so-called Cannon-Böhm point (the border between the areas of SMA and IMA supplies), which lies at the splenic flexure. The colon receives blood from both the superior and inferior mesenteric arteries.