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A segmental necrosis of the ascending colon sometimes affecting the terminal ileum was observed 13 times in 12 end-stage renal disease patients over a 5400 patient-years observation period. In all but three cases the patient was operated within 24 h of onset of the abdominal pain. Three patients had a bowel perforation; nine had a limited intestinal necrosis. All underwent a partial resection or colectomy. Two died within 1 month. In all cases the mucosa was necrotic, the submucosa small vessels were congested and the mesenteric vessels were normal. Ischaemic bowel disease has been previously reported in uraemic patients, but our cases do not fit with the usual reported features of this complication. The absence of typical mesenteric infarction, vascular thrombosis, stenosis or major atherosclerotic lesions is surprising. The ascending colon topography of the lesions is very unusual. Ischaemia, constipation and other factors may play a role.

In vivo, the normal regulation of embryo growth passes by a complex system of signals exchanged between the ovary (corpus luteum, CL), the genital tract, and embryo itself. So failure may result from various abnormalities in and between these three “partners.” Current knowledge regarding early embryo development, is only partial, and improvement techniques are limited if not nonexistent; in various species, viability quickly declines and cleavage stops around the so-called block stage.