Obstructive lesions of the descending colon and rectum.

Abstract

Since all lesions of the descending colon and rectum may become obstructive, they are of interest not only to the proctologist but to the general surgeon, to the internist and sometimes to the urologist and gynecologist. The term rectosigmoid has been discarded, because of variations of interpretations of its boundaries. The movable portion above the pelvic peritoneal reflection is designated as sigmoid, and the fixed portion below as the rectum, which in this discussion will also include the anus. The signs and symptoms of obstructive lesions usually have a mild onset and a gradual increase in severity. As the lesion becomes more and more constricted, the vague abdominal uneasiness progresses to definite discomfort and, later, pain. In some instances the pain may be more intense in the right lower quadrant of the abdomen. Definite changes in bowel movements become more pronounced, until there are real colicky pains and palpable or