The Colon and parts
THE HEIGHT IN dolichomegacolon
The Colon The final part of the digestive system:
The colon begins at the ileocecal valve and ends at the junction rectal sigmoid. The classic anatomy books Rouvière and Testud, considered average for a length of 153 colon and 155 cms., A width of 3 to 5 cm. and a sigmoid of 48 cms. Their portions are retroperitoneal ascending and descending, vertical and fixed on both sides of the peritoneal cavity. The transverse and sigmoid colon, due to the presence of the corresponding meso is more mobile.
dolichocolon the colon is called very elongated committed almost exclusively to the Megacolon Sigmoid and chronic dilatation of the colon, when the transverse diameter is greater than 6.5 cm.
can be congenital megacolon (Hirschsprung disease or aganglionic megacolon) and is caused by agenesis or hypogenesis parasympathetic ganglion cells of the myenteric (Auerbach) and submucosal (Meissner) in the large intestine. It was acquired in Latin America for Chagas Disease (by Trypanosoma cruzi) that leads to destruction of myenteric ganglion cells, following the same pathophysiology of Hirschsprung's disease and is associated with pathology of other organs such as myocarditis, megaesophagus, etc. . There are also other cases of anoxia, chemicals and avitaminosis B.
dolichomegacolon Andino:
Residents living above 3000 feet have the longest colon and diameter as the inhabitants of sea level, it is called acquired anatomical modification dolichomegacolon Andino. According to Oscar Frisancho the high fiber diet may inhibit the histological phenomenon known elastogenesis, "to over the years, the megacolon. Another important factor would be the lower atmospheric pressure at altitude, and the expansion of intraluminal gas could affect the growth of intestinal dimensions.
has several anatomical features, clinical, radiological, histological and serological features that differentiate it from chagasic megacolon.
CXR scheme, which is displayed dolichomegacolon gastric zone (below), known as mark-Frisancho Bouroncle
Since the 1950 Peruvian had reports of this disease as those of Delafield, Kurt Hellriegel and Maccagno (Chulec Hospital, La Oroya), David Frisancho (Puno), Fernando Delgado (Tarma), Rigoberto Zuniga (Huancayo), Darwin Salas, and José Serapio Martiarena Somocursio (Cusco).
plain abdominal radiograph demonstrating the Andean dolichomegacolon
Andean dolichomegacolon Alvarez Ruiz found in 50% of 208 X-rays reviewed and David Frisancho colon in 65.13% of 3000 workers examined. David and Oscar Frisancho found in populations of Puno to 3800 meters. a colon with 191 cms. long and 5 to 6 cms. in diameter, with a sigmoid of 68 cms. In Bolivia at the same altitude Oviedo found a colon of 191 cms. long by 6 to 8 cm. wide and 71 cms. for the sigmoid, while the Peruvian Andean groups Escudero found an average of 190 cms. for colon and 84 cms. for the sigmoid.
contrast colon radiography showed a large sigmoid dolichomegacolon Andean
This condition can be asymptomatic, or produce some manifestations clínicas como distensión abdominal, meteorismo, estreñimiento, o síntomas leves digestivos. Nuestros cirujanos en La Oroya como Krüger, Noli, Gonzales siempre repetían ese aforismo ante sus alumnos que “las tres principales causas de dolor abdominal en la altura son la úlcera péptica, la colecistopatía y el dolicomegacolon andino”. En la mayoría de los pacientes la patología se pone de manifiesto cuando se presenta el vólvulo de sigmoides, que es una de las emergencias quirúrgicas más frecuentes en los hospitales del área andina, donde representa más del 50% de todas las obstrucciones intestinales.
El Dolicomegacolon Andino y la Mesocolonitis Retráctil son the main predisposing factors for volvulus as Oscar Frisancho, the principal investigator of this subject. Mesocolonitis approximates the proximal and distal segment of the sigmoid loop, favoring torque. Copious intake of fermented foods is the precipitating factor for volvulus most patients are seen during times of harvest and planting periods in which increases consumption. In the Central Highlands after the famous pachamancas .
For the treatment of sigmoid volvulus can be tried not invasive emergency procedures such as endoscopic volvulus: the replacement of rotation is useful to decrease colonic la compresión abdominal y restaurar la circulación sanguínea enteral. El tratamiento quirúrgico de urgencia debe guiarse por la condición general del paciente y el estado del asa colónica en el acto quirúrgico.
SUMMARY
People, who live at altitudes above 3000 meters sea level, have a larger and thicker colon than coastal residents. Professor David Frisancho calls this acquired pathology the Andean dolichomegacolon DMCA A fiber-rich diet may inhibit the histological phenomenon known as elastogenesis, developing - over the years - the megacolon. Another important factor may be the lower atmospheric pressure in the altitude, the expansion of intraluminal gas may have an influence on intestinal enlargement.
The alteration in the colon can not be symptomatic or can only generate abdominal distension or a long period of time without defecation.
However sigmoid volvulus is a frequent cause of emergencies in hospitals in the Andean area, representing more than 50 per cent of all intestinal obstructions. Andean dolichomegacolon and retractile mesocolonitis are the main contribuiting factors for volvulus. Copious intake of fermentable food is the precipitating factor for volvulus. The patients are seen during sowing and harvest periods, in which the consumption of this type of food increases. DCMA has many special anatomic, clinical, radiological, histological and serological features which make it different from the chagasic megacolon.
The colon begins at the ileocecal valve and ends at the junction rectal sigmoid. The classic anatomy books Rouvière and Testud, considered average for a length of 153 colon and 155 cms., A width of 3 to 5 cm. and a sigmoid of 48 cms. Their portions are retroperitoneal ascending and descending, vertical and fixed on both sides of the peritoneal cavity. The transverse and sigmoid colon, due to the presence of the corresponding meso is more mobile.
dolichocolon the colon is called very elongated committed almost exclusively to the Megacolon Sigmoid and chronic dilatation of the colon, when the transverse diameter is greater than 6.5 cm.
can be congenital megacolon (Hirschsprung disease or aganglionic megacolon) and is caused by agenesis or hypogenesis parasympathetic ganglion cells of the myenteric (Auerbach) and submucosal (Meissner) in the large intestine. It was acquired in Latin America for Chagas Disease (by Trypanosoma cruzi) that leads to destruction of myenteric ganglion cells, following the same pathophysiology of Hirschsprung's disease and is associated with pathology of other organs such as myocarditis, megaesophagus, etc. . There are also other cases of anoxia, chemicals and avitaminosis B.
dolichomegacolon Andino:
Residents living above 3000 feet have the longest colon and diameter as the inhabitants of sea level, it is called acquired anatomical modification dolichomegacolon Andino. According to Oscar Frisancho the high fiber diet may inhibit the histological phenomenon known elastogenesis, "to over the years, the megacolon. Another important factor would be the lower atmospheric pressure at altitude, and the expansion of intraluminal gas could affect the growth of intestinal dimensions.
has several anatomical features, clinical, radiological, histological and serological features that differentiate it from chagasic megacolon.
CXR scheme, which is displayed dolichomegacolon gastric zone (below), known as mark-Frisancho Bouroncle Since the 1950 Peruvian had reports of this disease as those of Delafield, Kurt Hellriegel and Maccagno (Chulec Hospital, La Oroya), David Frisancho (Puno), Fernando Delgado (Tarma), Rigoberto Zuniga (Huancayo), Darwin Salas, and José Serapio Martiarena Somocursio (Cusco).
plain abdominal radiograph demonstrating the Andean dolichomegacolon Andean dolichomegacolon Alvarez Ruiz found in 50% of 208 X-rays reviewed and David Frisancho colon in 65.13% of 3000 workers examined. David and Oscar Frisancho found in populations of Puno to 3800 meters. a colon with 191 cms. long and 5 to 6 cms. in diameter, with a sigmoid of 68 cms. In Bolivia at the same altitude Oviedo found a colon of 191 cms. long by 6 to 8 cm. wide and 71 cms. for the sigmoid, while the Peruvian Andean groups Escudero found an average of 190 cms. for colon and 84 cms. for the sigmoid.
contrast colon radiography showed a large sigmoid dolichomegacolon Andean This condition can be asymptomatic, or produce some manifestations clínicas como distensión abdominal, meteorismo, estreñimiento, o síntomas leves digestivos. Nuestros cirujanos en La Oroya como Krüger, Noli, Gonzales siempre repetían ese aforismo ante sus alumnos que “las tres principales causas de dolor abdominal en la altura son la úlcera péptica, la colecistopatía y el dolicomegacolon andino”. En la mayoría de los pacientes la patología se pone de manifiesto cuando se presenta el vólvulo de sigmoides, que es una de las emergencias quirúrgicas más frecuentes en los hospitales del área andina, donde representa más del 50% de todas las obstrucciones intestinales.
El Dolicomegacolon Andino y la Mesocolonitis Retráctil son the main predisposing factors for volvulus as Oscar Frisancho, the principal investigator of this subject. Mesocolonitis approximates the proximal and distal segment of the sigmoid loop, favoring torque. Copious intake of fermented foods is the precipitating factor for volvulus most patients are seen during times of harvest and planting periods in which increases consumption. In the Central Highlands after the famous pachamancas .
For the treatment of sigmoid volvulus can be tried not invasive emergency procedures such as endoscopic volvulus: the replacement of rotation is useful to decrease colonic la compresión abdominal y restaurar la circulación sanguínea enteral. El tratamiento quirúrgico de urgencia debe guiarse por la condición general del paciente y el estado del asa colónica en el acto quirúrgico.
SUMMARY
People, who live at altitudes above 3000 meters sea level, have a larger and thicker colon than coastal residents. Professor David Frisancho calls this acquired pathology the Andean dolichomegacolon DMCA A fiber-rich diet may inhibit the histological phenomenon known as elastogenesis, developing - over the years - the megacolon. Another important factor may be the lower atmospheric pressure in the altitude, the expansion of intraluminal gas may have an influence on intestinal enlargement.
The alteration in the colon can not be symptomatic or can only generate abdominal distension or a long period of time without defecation.
However sigmoid volvulus is a frequent cause of emergencies in hospitals in the Andean area, representing more than 50 per cent of all intestinal obstructions. Andean dolichomegacolon and retractile mesocolonitis are the main contribuiting factors for volvulus. Copious intake of fermentable food is the precipitating factor for volvulus. The patients are seen during sowing and harvest periods, in which the consumption of this type of food increases. DCMA has many special anatomic, clinical, radiological, histological and serological features which make it different from the chagasic megacolon.
Dr. Achilles MONROY
