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Anatomic Problems of Large Intestine

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Anatomic problems of the large intestine are problems with the structure of the lower gastrointestinal (GI) tract. These problems can occur before birth called as congenital abnormalities. Anatomic problems of the large intestine can also occur any time after birth into adulthood.

Structure of the Large Intestine

The large intestine is also called as the colon. Structurally, the first part of the large intestine, that is, cecum is connected to the ileum (last part of the small bowel). The large intestine is made up of the cecum, colon, rectum and the anal canal. There are four sections of the large intestine:

  • The ascending colon
  • The transverse colon
  • The descending colon
  • The sigmoid colon

The large intestine is 5 feet long in adults. It absorbs water and any remaining nutrients that come along with partially digested food from the small intestine. The waste is then converted into solid matter called as stool. This stool passes from the colon to the rectum that is about 6 to 8 inches long in adults. Till the bowel underdoes a movement, the stool is stored in the rectum. When there is a bowel movement, the muscles of rectal wall contracts and the stool moves to the anus. The anus is one inch long, through which the stool leaves the body.

Problems with the Anatomy of the Large Intestine

During the gestation period of 4 weeks, the intestines in the fetus tend to be thin, straight and tube-like. It helps connect the stomach and the rectum. In the next 2 weeks, the intestines develop quickly and outgrow the abdomen. The abdomen is large enough to hold the intestines at 10 to 12 weeks of gestation.A tissue called as mesentery helps hold the intestines in place.

When the organs or parts of the intestine are placed wrongly, have an abnormal shape or incorrectly connected, it leads to structural defects. There are manyanatomic problems of the large intestine that include:

  • Malrotation – when the bowel does not rotate fully during the fetaldevelopment, it leads to malrotation. This condition is a medical emergency that requires treatment within a month from birth. Symptoms include abdominal tenderness, bloating, swelling, constipation, dehydration, paleness, confusion, weight loss. A surgery is usually required to correct malrotation and it is usually successful.
  • Volvulus – Volvulus is the condition that occurs when the intestine twists around the mesentery and itself. This causes the formation of obstruction that gets filled up with food, fluid and gas. The mesentery may get twisted so badly, that the blood flow to the affected intestine gets cut off. This leads to death of the tissue and in turn it tears off from the intestinal wall. This can be caused due to malroatation or other conditions such as Hirschsprung disease. There are different types of voluvus that includes:
  • Sigmoid volvulus – Symptoms include abdominal cramping, bloody stools, constipation, nausea, vomiting, shock.
  • Cecal volvulus – Symptoms include abdominal cramping, swelling, nausea and vomiting

Treatment usually involves surgery to reposition the intestine and restore blood flow.

  • Intussusception: This condition occurs when one section of the large or small intestine gets folded into itself. This leads to obstruction and disruption of blood supply to the affected part. Malrotation increases the risk of developing intussusception later on in life. Symptoms include abdominal pain, diarrhea, fever, stools mixed with mucus, vomiting with or without bile, lump in the abdomen, etc. Intussusception is a temporary condition and may get corrected on its own. If it does not resolve on its own, the doctor may push barium or air into the affected part and bring it back into position.

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  • Fistula: When an abnormal passage or tunnel is developed between two organs it leads to internal fistula. When the same thing happens between an internal organ and the outside of the body, it is called as external fistula. These fistulas can occur during gestation or even after birth. There are many causes of fistulas such as surgery, diverticulitis, childbirth, Chron’s disease, etc. Symptoms of fistula include dehydration, diarrhea, fatigue, abdominal pain, slow growth, fever, etc. The fistula may close on its own with time. If it does not, then the doctor may perform intestinal resection surgery.
  • Imperforate anus: During gestation when the rectum and anus develop abnormally, it leads to blocked or missing anus. This is called as imperforate anus. The condition causes inability to pass little or no stool from the rectum. This is a very uncommon condition that affects boys more than girls. Symptoms include observing imperforate anus after birth, incorrectly placed anus, abdominal swelling, complete absence of bowel movements, etc. The treatment usually involves surgery that depends on the location and severity of the defect.
  • Colonic atresia–When a section of colon closes before birth it is called as colonic atresia. The symptoms include vomiting, abdominal swelling, absence of bowel movement, etc. The only way to treat colonic atresia is resectional surgery.

This was all about anatomic problems of the large intestine. These problems are usually structural malformations or obstructions. They occur congenitally or due to another underlying condition after birth. One should seek immediate medical advice and get the problem corrected as some of the conditions are medical emergencies and may prove to be fatal.

Written by: healthplus24.com team

Date last updated: January 20, 2015

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