SHOCK-ASSOCIATED RIGHT COLON ISCHEMIA AND NECROSIS

Ischemic complications associated with hemorrhagic shock after blunt o r penetrating trauma can result in acute renal, pulmonary, or hepatic failure, Less well described is the association between hemorrhagic sh ock and ischemic necrosis of the right colon, with only 14 cases repor ted in the literature. Herein, we report three previously healthy youn g trauma victims with shock-associated right colon necrosis, Each pati ent suffered a period of hypotension after injury, Diagnosis and opera tion took place within 2 days of initial injury in all three cases, In each patient, a right colectomy and primary anastomosis was performed without complication, Pathologic examination of the resected specimen s showed ischemic necrosis, but no evidence of vascular thrombosis or embolic occlusion of the mesenteric vessels, The etiology of this type of ischemic colitis is not clear, but seems to represent a form of no nocclusive mesenteric ischemia, Knowledge of this disease process will lead to early recognition, prompt treatment, and a satisfactory outco me.