5. Colon Syndrome and its Surgical Treatment

Abstract

The Number of out-patients having gastric symptoms has in recent years remarkably increased. Many of them, though free from pathological findings when examined by upper 'G-I X-ray series including the biliary tract and by gastrofiberscope, were found, on illness, to have abnormal habit of defecation, full sensation of the lower abdomen, or other various :subjective symptoms all of long duration.A total of 1335 such cases have been subjected to barium enema examination of the colon (Aoyama's method). With the exception of 27 cases having organic diseases of the colon, organic in the narrow sense of the word such as its tumors. 1308 cases were further investigated.As a result, a close correlation has been found between the X-ray findings such as abnormal location, course and so-called membraneous lifting-up of the colon, together withits traction or stenosis due to mesocolitis, and the patient's subjective symptoms and defecation habits. Based on this study, the authors attempted to designate those symptoms and radiological sighs, including kinking of the splenic flexure or the descending colon, the socalled detour sign, cicatric mesocolitis of the splenic flexure or cicatric mesosigmoiditis, as"colon syndrome" for the purpose of differentiatiating it from the" irritable colon."One of the authors, Hayashida, attempted to remedy this syndrome by surgical intervention: one stage modification of abnormal course kinking, cicatrices and so no of the colon together with left hemi-colectomy. In 150 cases thus treated, 84.9 percent have been free from any subjective symptoms six months after operation.