LOCAL HEMOSIDEROSIS OF THE COLON IN SURGICAL PRACTICE: CLINICAL CASE

Hemosiderosis can lead to the development of pigment dystrophies characterized by excessive accumulation of iron-containing pigment hemosiderin in the tissues of the body. There are local forms of the disease (cutaneous and pulmonary hemosiderosis) and generalized ones (with the deposition of hemosiderin in the organs of the thorax, abdomen and retroperitoneum). The literature describes clinical observations of hemosiderosis of these organs, but there is no data on hemosiderosis of the colon. Therefore, the authors in the article present a clinical case of colon hemosiderosis in a 47-year-old surgical patient operated for acute constrictive intestinal obstruction in combination with a mobile caecum inversion complicated by gangrene of the right flank of the colon and peritonitis. Emergency surgical treatment was performed – diagnostic laparoscopy, conversion to laparotomy, also right-sided hemicolectomy and ileostomy were performed. The postoperative period was smooth sailing, without complications. The patient underwent planned surgery after 2 months: restoration of intestinal continuity by applying a term-lateral ileotransverse anastomosis. When applying an inter-intestial anastomosis, surgeons paid attention to the dark black color throughout the colon mucosa, and assumed hemosiderosis. Mucous membrane biopsy was taken. At the same time, the color of the mucosa of the small intestine was normal, not changed. An inter-intestinal anastomosis was imposed, despite the presence of these mucosal changes, and in the postoperative period the insolvency did not develop. The course of the postoperative period was normal, without complications. The patient was discharged with recovery. Pathologic and anatomical examination of the biopsy material confirmed the presence of a rare pathology – hemosiderosis of the colon.

The authors conclude that intestinal hemosiderosis in this case was an accidental finding, and the diagnosis was made on the basis of morphological investigation of organ bioptate. It can be assumed that intestinal hemosiderosis is more common, but in most cases it is not diagnosed during clinical and pathomorphological studies, due to the inflammatory and ischemic changes of an organ.

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