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Nephrol Dial Transplant (1995) 10: 2281-2285
© 1995 European Renal Association-European Dialysis and Transplant Association

research-article

Segmental necrosis of ascending colon in haemodialysis patients

B. Charra1,, M. Cuche2, M. Ruffet1, J.-C. Terrat1, J. Beurlet3, H. Labrosse2, T. Vanel1, E. Calemard1, C. Chazot1, G. Vovan1, G. Jean1 and G. Laurent1

1Centre de Rein Artificiel de Tassin 42 Avenue du 8 Mai 1945, 69160 Tassin 2Infirmerie Protestante, Cours General Giraud 69006 Lyon 3Centre d'Anatomie Pathologique et de Cytologie 35 r M. Bloch, 69007 Lyon, France

Correspondence and offprint requests to: Correspondence and offprint requests to: B. Charra, Centre de Rein Artificiel de Tassin, 42 Avenue du 8 Mai 1945, 69160 Tassin, France

A segmental necrosis of the ascending colon sometimes affecting the terminal ileum was observed 13 times in 12 end-stage renal disease patients over a 5400 patient-years observation period. In all but three cases the patient was operated within 24 h of onset of the abdominal pain. Three patients had a bowel perforation; nine had a limited intestinal necrosis. All underwent a partial resection or colectomy. Two died within 1 month. In all cases the mucosa was necrotic, the submucosa small vessels were congested and the mesenteric vessels were normal. Ischaemic bowel disease has been previously reported in uraemic patients, but our cases do not fit with the usual reported features of this complication. The absence of typical mesenteric infarction, vascular thrombosis, stenosis or major atherosclerotic lesions is surprising. The ascending colon topography of the lesions is very unusual. Ischaemia, constipation and other factors may play a role.

Keywords: ascending colon; haemodialysis; necrosis


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