Ischemic stricture of the rectosigmoid colon caused by division of the superior rectal artery below Sudeck's point during sigmoidectomy: report of a case.
Despite Sudeck's cautionary report regarding the risk of colon necrosis following a pull-through procedure, published in 1907, most colorectal surgeons do not pay close attention to Sudeck's critical point when operating in the rectosigmoid region. We report herein the case of a patient who developed an ischemic stricture, 6 cm in length, in the rectosigmoid colon distal to the anastomosis following a radical sigmoidectomy with division of the superior rectal artery immediately distal to Sudeck's point. This is the first documentation of a patient developing an ischemic stricture attributable to sigmoidectomy. Division of the artery distal to Sudeck's point most probably impaired the blood supply to the rectosigmoid colon, which subsequently resulted in occlusive ischemic colitis. Thus, there is a risk that division of the superior rectal artery distal to Sudeck's point may lead to colonic ischemia in the remaining rectosigmoid region following sigmoidectomy.
Yamazaki
T
T
First Department of Surgery, Niigata University School of Medicine, Japan.
Shirai
Y
Y
Sakai
Y
Y
Hatakeyama
K
K
D000368:Aged; D000714:Anastomosis, Surgical; D001158:Arteries; D003082:Colectomy / Q000009:adverse effects*; D017091:Colitis, Ischemic / Q000209:etiology*; D012809:Colon, Sigmoid / Q000098:blood supply* / Q000601:surgery; D006801:Humans; D008297:Male; D012810:Sigmoid Diseases / Q000601:surgery*