Colitis proximal to obstructing colonic carcinoma.

Nonspecific colitis proximal to an obstructing colonic carcinoma has appeared in the surgical literature for over 20 years, but it remains an uncommon and difficult clinical problem. This report details the case histories of five patients with this entity who have been admitted to the surgical service of Presbyterian Hospital since 1967. The colitis described is clearly related to the obstructive lesion and does not represent chronic inflammatory colitis in association with a carcinoma. The patients may initially have symptoms secondary to the obstructing lesion or fulminant peritoneal signs secondary to the colitis. The roentgenographic appearance is typical and closely resembles that seen in colonic ischemia. The pathologic process varies from fibrosis and stricture formation to transmural necrosis and perforation.