NONNEOPLASTIC ulceration occurring within the large intestine is usually produced by pathogenic bacteria or parasites or occurs in association with a well-defined inflammatory disorder such as ulcerative colitis. Occasionally, however, patients with isolated colon ulcers are encountered in whom no etiologic agent can be found. Because these patients are often seen initially in the midst of an abdominal catastrophe with perforation, hemorrhage, or partial large bowel obstruction, the surgeon may be forced to deal with them on an urgent basis. Under these conditions an erroneous diagnosis of carcinoma may lead to the performance of a more extensive procedure than is actually required.
Nonspecific ulceration of the colon, with no obvious etiologic agent, has been recognized as a discrete clinical entity for many years.1 Since the diagnosis is usually made by excluding specific causes of ulceration of the colon, it is seldom made preoperatively and, at best, can