Abstract
There are several weak points in the colonic blood supply, known as watershed areas, which result from incomplete anastomoses of the marginal arteries. These watershed areas are more vulnerable to ischemic injury than other parts of the colon. We report herein the cases of two patients who developed ischemic colitis well localized in the cecum, and in the rectosigmoid region at Sudeck's point, respectively. This report and our review of the literature suggest that watershed areas, including the splenic flexure, or Griffith's point, Sudeck's point, and the ileocecal region, are high-risk regions for the development of ischemic colitis.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Michels NA, Siddharth P, Kornblith PL, Parke WW (1963) The variant blood supply to the small and large intestine: Its import in regional resections. J Int Coll Surg 39:127–170
Michels NA, Siddharth P, Kornblith PL, Parke WW (1968) Routes of collateral circulation of the gastrointestinal tract as ascertained in a dissection of 500 bodies. Int Surg 49:8–28
Siddharth P, Ravo B (1988) Colorectal neurovasculature and anal sphincter. Surg Clin North Am 68:1185–1200
Griffiths JD (1956) Surgical anatomy of the blood supply of the distal colon. Ann R Coll Surg Engl 19:241–256
Sudeck P (1907) Über die Gefässversorgung des Mastdarmes in Hinsicht auf die operative Gangrän. München Med Wschr 54:1314–1317
Bower TC (1993) Ischemic colitis. Surg Clin North Am 73:1037–1053
Landreneau RJ, Fry WJ (1990) The right colon as a target organ of nonocclusive mesenteric ischemia. Arch Surg 125:591–594
Anonymous (1995) Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 9-1995. N Engl J Med 23:332(12):804–810
Farman J (1995) Ischemic colitis. Abdom Imaging 20:85–86
Halsted WS (1993) Vascular disease: Hemorrhage, mesenteric occlusive and nonocclusive disease, ischemia, radiation enteritis, volvulus. In: Corman ML (ed) Colon and rectal surgery, 3rd edn. Lipincott, Philadelphia, pp 860–900
Shoji BT, Becker JM (1994) Colorectal disease in the elderly patient. Surg Clin North Am 74:293–316
Marston A (1985) Ischaemia. Clin Gastroenterol 14:847–862
Guttormson NL, Bubrick MP (1989) Mortality from ischemic colitis. Dis Colon Rectum 32:469–472
Longo WE, Ballantyne GH, Gusberg RJ (1992) Ischemic colitis: Patterns and prognosis. Dis Colon Rectum 35:726–730
Bubrick MP, Guttormson N (1988) Ischemic colitis. Minn Med 71:603–607
Parish KL, Chapman WC, Williams LF Jr (1991) Ischemic colitis: An ever-changing spectrum? Am Surg 57:118–121
Reeders JW, Tytgat GN, Rosenbusch G, Gramata S (1984) Ischaemic colitis. Hijhoff, The Hague, pp 17–28
Rist CB, Watts JC, Lucas RJ (1984) Isolated ischemic necrosis of the cecum in patients with chronic heart disease. Dis Colon Rectum 27:548–551
Boley SJ (1990) Colonic ischemia — 25 years later. Am J Gastroenterol 85:931–934
Boley SJ, Schwartz S, Lash J, Sternhill V (1963) Reversible vascular occlusion of the colon. Surg Gynecol Obstet 116:53–60
Marston A, Pheils MT, Thomas ML, Morson BC (1966) Ischaemic colitis. Gut 7:1–15
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yamazaki, T., Shirai, Y., Tada, T. et al. Ischemic colitis arising in watershed areas of the colonic blood supply: A report of two cases. Surg Today 27, 460–462 (1997). https://doi.org/10.1007/BF02385714
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02385714