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A D V E R T I S E M E N T
A D V E R T I S E M E N T
When the colonic vessels reach the colon wall, they send branches to either side of the mesenteric taenia. From the serosal surface, branches penetrate the muscular layers on either side of the mesenteric taenia and on the mesenteric side of the two other taenia. At these points, the potential for dilatation of the muscular defect and protrusion of the submucosa and mucosa under chronic increased intraluminal pressure predisposes to diverticula formation.
A D V E R T I S E M E N T
The proximity of the penetrating vessel to the diverticulum poses the risk of pressure necrosis on the vessel by inspissated stool in the diverticulum leading to diverticular bleeding. Most diverticular bleeds are from a single source and the natural history in the majority of cases is spontaneous cessation. If intervention is necessary, colonoscopic or interventional radiological control is often successful because of the isolated nature of the bleeding source.
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A D V E R T I S E M E N T
The IMA distribution is shown. There are several sigmoidal branches to be divided in sigmoid resection. Left colon resection for cancer requires division of the IMA close to its origin for adequate mesenteric lymph node clearance.
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This page was last modified on 9/15/2009.
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