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Before removal, the portion of the bowel to be resected must be freed or mobilized. This is done by dissection and removal of the mesentery and other peritoneal attachments. Resection of any part of the colon entails mobilization and the cutting and sealing, or ligation, of the blood vessels supplying the portion of the colon to be removed. [8]
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]
Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is the development of cancer from the colon or rectum (parts of the large intestine). [5] Signs and symptoms may include blood in the stool , a change in bowel movements , weight loss, abdominal pain and fatigue. [ 9 ]
The sigmoid colon (or pelvic colon) is the part of the large intestine that is closest to the rectum and anus. It forms a loop that averages about 35–40 centimetres (14–16 in) in length. It forms a loop that averages about 35–40 centimetres (14–16 in) in length.
Attempts at removal can have severe and even lethal effects, such as the rupture of the colon wall by catheter or an acute angle of the fecaloma (stercoral perforation), followed by sepsis. It may also lead to stercoral perforation, a condition characterized by bowel perforation due to pressure necrosis from a fecal mass or fecaloma. [14] [15]
[17] [18] If blood flow to the colon drops by more than about 50%, ischemia will develop. The arteries feeding the colon are very sensitive to vasoconstrictors; presumably this is an evolutionary adaptation to shunt blood away from the bowel and to the heart and brain in times of stress. [ 19 ]
Laboratory results are usually normal in SCAD, although the white blood cell count may be mildly elevated. Fecal calprotectin, a marker of colon inflammation, may be elevated. Computed tomography of the abdomen is not routinely necessary, but may show thickening or inflammation in the distal colon (sigmoid colon) with associated diverticulosis.
Pancolitis or universal colitis, in its most general sense, refers to inflammation of the entire large intestine comprising the cecum, ascending, transverse, descending, sigmoid colon and rectum. It can be caused by a variety of things such as inflammatory bowel disease , more specifically a severe form of ulcerative colitis .