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PubMedDate not supplied

Refractory proctosigmoiditis probably caused by inferior mesenteric vein ligation at sigmoidectomy.

A case of refractory proctosigmoiditis is reported in a 65-year-old female post-sigmoidectomy patient. She had bloody diarrhea and abdominal pain 2 years after sigmoidectomy, in which the inferior mesenteric vein was ligated close to the inferior mesenteric artery root during the lymph node dissection, while the inferior mesenteric artery trunk and the last branch of the sigmoid arteries was preserved. The biopsied specimen obtained by a fiber optic colonoscopy was diagnosed as proctitis. Antidiarrheals, 5-aminosalicylic acid and steroid enemas showed only limited therapeutic effects. An angiography revealed a mild degree of rectal artery dilatation and tiny venous angiogenesis detected on the delayed phase images. Because the inferior mesenteric vein had been ligated, collateral veins developed to drain the blood on the distal side of the anastomosis to bilateral internal iliac veins. The venous blood of the descending colon (oral side of anastomosis) drained to left colic vein. The cause of rectosigmoiditis was considered to be venous congestion due to the inferior mesenteric vein ligation. A rectosigmoidectomy with reanastomosis using a double-stapling technique was performed, and the patient was discharged without symptoms.

Aged↗
PubMed1992

[5-aminosalicylic acid enema (Pentasa) versus hydrocortisone acetate foam (Proctocort) for the treatment of outbreaks of proctitis and cryptogenetic proctosigmoiditis. A comparative randomized multicenter trial].

The therapeutic efficacy of 1 g 5-aminosalicylic acid enema was compared with that of 90 mg hydrocortisone acetate foam following daily rectal administration to patients with idiopathic proctitis or proctosigmoiditis during two weeks. A total of 199 patients (103 5-aminosalicylic acid, 96 hydrocortisone acetate) were included in a randomized, multicenter trial. Endoscopic and clinical remission was seen in 67 and 69 percent of the 5-aminosalicylic acid-treated and in 50 and 45 percent of the hydrocortisone acetate-treated patients (P less than 0.05), respectively. Mild side effects were seen in 10.7 percent of the 5-aminosalicylic acid-treated patients and in 3.1 percent of the hydrocortisone acetate-treated patients (P = 0.05). After 2 weeks, 5-aminosalicylic acid enemas are more effective than hydrocortisone foam for topical treatment of patients with idiopathic proctitis or proctosigmoiditis.

Adolescent↗