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Coloanal anastomosis: indications and surgical technique.

The coloanal anastomosis has evolved from the older "sleeve" pull through techniques and is used as a sphincter-saving procedure in those patients requiring excision of the rectum where adequate removal of all disease necessitates transection of the rectum close to the dentate line. For very low rectal carcinomas, however, abdominoperineal resection remains the procedure of choice for curative treatment. The appropriate choice of low anterior resection, coloanal pull through anastomosis, or abdominoperineal resection depends on many other variables besides the location of the tumor, and the correct choice may not be apparent until the rectum has been mobilized at surgery. The coloanal procedure requires wide excision of the lesion; full mobilization of the splenic flexure, distal transverse colon, and descending colon; precise transanal removal of the rectum; accurate suturing of the descending colon to the anus; and a temporary defunctioning colostomy. With careful technique, longterm results are good in most patients.

Anal Canal↗

Esophageal conduit in nearly hopeless corrosive esophageal stricture patient.

The case report of a 28 year old woman with strictured esophagus from corrosive esophagitis for 4 months is presented. Barium swallowing showed a strictured esophagus extending from T2 to the aortic knob and needed frequent dilatations. The patient had a perforated thoracic esophagus and mediastinitis on last dilatation. Cervical esophagostomy, transabdominal esophageal bandaging and jejunostomy feeding were done along with intravenous broad spectrum antibiotics. On esophagoscopy, there was complete stenosis of the cervical esophagus 2 cm from the postcricoid area. The large intestine from the caecum, transverse colon and descending colon was chosen as the esophageal conduit because of adequate length to pass subcutaneously. The caecum was anastomosed to the cervical esophagus and descending colon to the stomach. Seven days postoperatively, the patient could take liquids and soft porridge orally. There was a small leakage from the cervical anastomosed, spontaneous closure was achieved 3 weeks postoperatively. We chose the right side colon as the esophageal conduit because of adequate length to pass subcutaneously. Mediastinal and transhiatal routes could not be passed because of previous mediastinitis from thoracic esophageal perforation. This may be an alternative choice of operation for high cervical esophageal stenosis with previous mediastinitis.

Adult↗

Normal colon of Sprague-Dawley rats. An immunohistochemical study.

The patterns of expression of the human-tumor-associated antigens, CO17-1A, GA73-3, BR55-2, GICA19-9, CA50 and carcino-embryonic antigen (CEA) were studied in the normal colonic mucosa (the last three also in the serum) of Sprague-Dawley rats. Four immunohistochemically different segments were identified: caecum, ascending colon, transverse colon and descending colon. The immunohistochemical reactions of the cells at the lower part of the crypt were essential for the distinction of the four segments. In the caecum, the MAbs 17-1A, 73-3 and 19-9 stained the glycocalyx of the cells of the lower part of the crypts and the Golgi apparatus of the intercalated cells (IC). MAb55-2 stained very weakly the goblet-like cells (GLC) of the lower part of the crypt of transverse colon, in addition to a nearly complete lack of reaction in the upper part of the crypts. In the ascending colon, the lower part of the crypts showed a characteristic diffuse staining of the intercalated cells with MAb55-2. The perinuclear and mucosal staining observed in the GLC of the transverse colon with MAbs 17-1A, 73-3 and 19-9 as against the supranuclear and Golgi zone staining observed in the GLC/goblet cells (GC)/columnar cells (CC) of the lower part of crypts of the descending colon with the same MAbs, distinguished the former segment from the latter. The IC demonstrated by immunohistochemistry in the lower parts of the crypts of caecum and ascending colon appear to correspond to the replicating cells of the colonic crypts.

Animals↗

Scintigraphic assessment of retrograde colonic washout in fecal incontinence and constipation.

PURPOSE: This study aimed to evaluate the colorectal luminal transport obtained by retrograde colonic washout with a new scintigraphic technique. METHODS: Nineteen patients (5 with spinal cord lesion, 6 with idiopathic fecal incontinence, and 8 with idiopathic constipation) treated with retrograde colonic washout took indium-111-labeled polystyrene pellets to label the bowel contents. Technetium-99m-diethylene-triamine-pentaacetic acid was mixed with the irrigation fluid to assess its extent within the colorectum. Scintigraphy was performed before and after a standardized washout procedure. The colorectum was divided into four segments: the cecum and ascending colon, the transverse colon, the descending colon, and the rectosigmoid. Assuming ordered evacuation of the colorectum, the contribution of each colonic segment to the total evacuation was expressed in percent of the original segmental counts. The contributions of each segment were summed to reach a total defecation score (range, 0-400), and directional segmental transports were estimated. RESULTS: The defecation score in patients with idiopathic constipation (median, 59; range, 21-130) differed significantly (P < 0.05) from the scores in those with spinal cord lesions (median, 204; range, 108-323) and idiopathic fecal incontinence (median, 188; range, 155-234). Thus, patients with spinal cord lesion or idiopathic fecal incontinence were able to empty most of the rectosigmoid and most of the descending colon, but those with idiopathic constipation could only empty 59 percent of the rectosigmoid. The irrigation fluid on average reached a point just beyond the right colic flexure that correlated with the defecation score (r(2) = 0.58, P < 0.001). CONCLUSION: The effect of retrograde colonic washout was significantly better in spinal cord lesion and idiopathic fecal incontinence than in idiopathic constipation, and its effect correlated with the extent to which the irrigation fluid had entered the colorectum.

Adolescent↗

Abnormal conditions of the equine descending (small) colon: 102 cases (1979-1989).

The signalment, clinical and laboratory findings of surgical conditions, treatment, and outcome of 102 cases of descending colon disease in horses were reviewed. Abnormal conditions were categorized as enteroliths, impactions, strangulating lipomas, fecaliths, foreign body obstruction, volvulus, nephrosplenic entrapment, and other conditions. Eleven breed categories of horses were seen during this period. Arabians, ponies, and American miniature horses were more predisposed to descending colon disease than other breeds (P less than 0.05). Female horses and animals greater than 15 years old were more likely to be affected with descending colon disease, whereas horses less than 5 years old were less likely to be affected (P less than 0.05). More specifically, Arabians, Quarter Horses, and Thoroughbreds greater than 10 years old were breeds that were overrepresented when compared with the hospital population (P less than 0.05). Enteroliths were most commonly seen in horses between 5 and 10 years old (P less than 0.05) and were not seen in horses less than 2 years old. Enteroliths had a tendency to develop more commonly in Arabians and in female horses. Impactions affected horses greater than 15 years old (P less than 0.05) and had a greater tendency to affect ponies and American miniature horses. Female horses were more commonly affected by impaction than were males. Strangulating lipomas were commonly seen in horses greater than 15 years old (P less than 0.05) and more specifically female Quarter Horses (P less than 0.05). Fecaliths tended to be a disease of horses less than 1 year old or greater than 15 years old and affected males more commonly than females.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗

[Carcinoma of colostomies. Investigation on Wistar rats and clinical observations (author's transl)].

48 surviving male Wistar rats, which achieved a double loop colostomy at the descending colon, developed spontaneous adeno-cardinomas at the proximal orifice of the stoma within 120-200 days. To differentiate the importance of fecal passage and eversion of the colon, the descending colon was separated from the fecal stream by a colostomy at the ascending colon, splitted longitudinally and inserted in the abdominal wall. Adeno-carcinoma arose in both positions, mainly within 120 days. Colonic mucosa, thus exposed, predominates to maligne transformation. The preferred development of cancer at colostomies, as seen systemically induced colonic cancer, is therefore explained to be of syncarcinogenic type. Similar lesions were found at human colostomies. The rareness of original carcinoma at human colostomies is caused by a more-years time of induction in relation to the high average age of patients getting a colostomy. In fact we regard this type of cancer as a biological phenomena comparable to the cancer of the gastric stump.

Adenocarcinoma↗

[A case of peritoneal dissemination disappeared by CPT-11 + TS-1 combination chemotherapy].

A patient is a 35-year-old man. By a diagnosis of descending colon cancer, descending colon ablative operation and D1 lymph node dissection were performed on April 22, 2004. It was P3H0N1SE, Stage IV in perioperative findings. Abdominal CT showed peritoneal dissemination of 1.7 cm at the right under the abdominal wall wound and 1.2 cm in the rectovesical pouch on May 18, 2004. CPT-11 + TS-1 combination chemotherapy was started on June 22nd. In the five weeks of the combination chemotherapy, continuous infusion of CPT-11 (150 mg/body day 1 and 15) was twice administered, and oral administration of TS-1 (120 mg/body/day) was given for 3 weeks (day 1-21). Peritoneal dissemination disappeared after the two-course end, and we judged it as CR. Furthermore, we were certain that we obtained CR after the three course end. The adverse event was only neutropenia of grade 1. The fourth course was not administered, but recurrence has not been observed. Abdominal CT showed no recurrence on March 3, 2005 since the combination chemotherapy ended 6 months ago.

Administration, Oral↗

Extensive resection and anastomosis of the descending (small) colon in a mare following strangulation by a mesenteric lipoma.

A 17-year-old Quarter Horse, Arabian crossbred mare presented with a history of having had abdominal pain for 2 d. At surgery there was 2.6 m of descending colon strangulated within the pedicle of a mesenteric lipoma. The lipoma was resected and the descending colon appeared viable so was replaced, and the mare recovered from anaesthesia. Post-operatively, the mare failed to stabilise so was taken back to surgery. There was 2 m of infarcted descending colon which was resected and anastomosed. A drain and stainless steel stay sutures were incorporated into the ventral suture line. Post-operatively the ventral wound became infected but was resolved with therapy. The diagnosis, surgical and post-operative management and outcome are discussed.

Anastomosis, Surgical↗

Mesenteric tears of the descending (small) colon as a postpartum complication in two mares.

Segmental ischemic necrosis of the descending colon associated with discrete tears of the mesocolon were diagnosed in 2 mares following foaling. After foaling, both mares had a slow onset of signs of abdominal pain and gradual deterioration of clinical status. Increases in peritoneal fluid total protein concentration and WBC count and a palpable impaction of the descending colon on examination per rectum were useful diagnostic aids. Surgical intervention was successful in one mare, but not in the other.

Anastomosis, Surgical↗

Calcium intake and colorectal adenoma in a US colorectal cancer early detection program.

BACKGROUND: Calcium can reduce the risk of colorectal tumors by binding secondary bile and fatty acids, which leads to antiproliferative effects in the bowel, or by acting directly on the colonic epithelium, which affects differentiation and apoptosis. OBJECTIVE: We investigated calcium intake and risk of colon adenoma to evaluate the association of calcium intake with early stages of colorectal tumor development. DESIGN: We compared the supplemental and dietary calcium intakes of 3696 participants with histologically verified adenoma of the distal colon (ie, descending colon, sigmoid colon, or rectum) with the calcium intakes of 34 817 sigmoidoscopy-negative control participants in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial. Calcium intake was assessed at study entry with a 137-item food-frequency questionnaire and additional questions on the amount and duration of calcium supplement use. RESULTS: After adjustment for known risk factors, adenoma risk was lower by 12% for participants in the highest quintile of total calcium intake (>1767 mg/d) than for participants in the lowest quintile (<731 mg/d) (odds ratio: 0.88; 95% CI: 0.76, 1.02; P for trend = 0.04). The protective association between total calcium and colorectal adenoma was largely due to calcium supplement use, with a 27% decrease in adenoma risk for participants taking >1200 mg/d than for nonusers of supplements (odds ratio: 0.73; 95% CI: 0.56, 0.91; P for trend = 0.005). The protective associations of total and supplemental calcium were strongest for colon adenoma (descending and sigmoid colon). CONCLUSION: High calcium intake, particularly from supplements, is associated with a reduced risk of distal colorectal adenoma.

Adenoma↗

Neuropeptide Y in submucosal ganglia: regional differences in the innervation of guinea-pig large intestine.

Since information about possible regional differences in the innervation of the guinea-pig large intestine is incomplete, a comparative study was made of the occurrence of neurones and nerve fibres of the submucosa showing immunoreactivity (IR) to neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP). In addition, a quantitative analysis was made of submucosal neurones in regions of guinea-pig large intestine selected for probable differences in their function. There were two principal findings: First, the density of NPY-IR neurone somata was high in the ascending colon (mean +/- SEM 3148 +/- 464 neurones/cm2; n = 5 animals) and progressively declined in an anal direction, the descending colon having 348 +/- 125 neurones/cm2 (in the same 5 animals); immunoreactive cell bodies were rare in the rectum. The reduced density was also reflected in a fall in the number of NPY-IR neurones/ganglion from 3.0 +/- 0.3 in the ascending colon to 0.5 +/- 0.2 in the descending colon. Second, varicose NPY-IR intraganglionic fibres were a conspicuous feature of the duodenum, caecum, transverse colon, descending colon and rectum, but not of the ileum, ascending colon or distal spiral. Moreover, in the descending colon and rectum the fibres were arranged in a loose 'cobweb' structure around non-NPY-IR neurone somata; in the caecum, there was an apparent paucity of NPY-IR somata but the exceptionally dense intraganglionic varicose fibre network may have obscured NPY-IR somata. In all regions, fibre baskets were rare. In the ascending colon, only 25 +/- 5% of ganglia (compared to 92 +/- 2% of ganglia in the descending colon) showed any intraganglionic nerve fibres; furthermore, when they occurred, these were not of the 'cobweb' type but, rather, they gave the ganglia a speckled appearance. In very immature fetuses at a stage of development when no neuropeptide somata could be found in either the myenteric or submucosal plexuses, many NPY-IR nerve fibres were present in the submucosa with a distribution similar to that of adult guinea pigs. With respect to the density of VIP-IR neurones in the large intestine, there was only a 40% reduction in the number of neurones/cm2 from proximal to distal colon, in contrast to the corresponding 90% reduction in the density of NPY-IR neurones. The number of VIP-IR neurones/ganglion (6.4) and the proportion of ganglia with VIP-IR fibres (> 90%) were constant. It is concluded that the striking regional dissimilarities in (i) the occurrence of NPY-IR neurone somata and (ii) in the disposition of intraganglionic NPY-IR nerve fibres indicate potentially important regional differences in the functions of neuropeptide Y as an antisecretory peptide in the local regulation of chloride transport in the mucosa and as a modulator of ganglionic transmission, respectively.

Animals↗

[Arterial supply in the left colonic flexure].

The authors study the behaviour of the middle colic, left colic superior, middle and inferior and the first sigmoidal arteries in the territory of the terminal portion of the transverse colon, the left colonic flexure and the descending colon. The study was carried out on 1200 angiographies of the superior and inferior mesenteric aa. and on 150 anatomical specimens, surgically extirpated in the course of left emicolectomy operations. Contrary to what is believed by most authors, the left flexure is a colonic tract very well supplied by blood while the descending colon results to be poorly supplied, being served only by one artery (the left sup. colic a.) often of limited caliber and with branches (the middle and the inf. left colic aa.) sometimes totally or partially lacking. In this last colonic tract the vascular continuity, represented by the arterial arcades, is often interrupted. The Riolan's arcade, variously shaped, is to be considered a constant vascular structure (only once it was lacking in this study). Sometimes it is doubled by a second more internal arcade which must not be confused with the intermesenteric arcade. In four of the observed cases, the Riolan's arcade resulted strengthened by a second retroperitoneal arcade, derived from a branching of the middle colic a., whose branches of division went to the two colonic flexures and descended along the postero-lateral walls of the ascending and descending colon, often parallel to the regular abdominal branches. Exceptionally the colonic flexure is supplied by the only left colic a., which behaves as a specific artery, by us called "dominant artery". The central branches of the artery go to the flexure while the lateral ones join the branches of the middle colic and the first sigmoidal aa., effecting tenuous connections, surgically unreliable. In this case the arterial continuity of the Riolan's arcade can be considered interrupted, at least for the surgical practice. The intermesenteric arcade, in its three forms (direct, mixed and indirect), was observed in 20% of the cases. The colic marginal a. is considered by the authors a tier of arches formed by the colic aa. The left colonic flexure is also supplied by particular vessels originated from the middle colic and the left colic aa. (angular branches and arcades and bridge-branches) or from the superior mesenteric a. (angular artery of Donati) and from other sources, particularly from the splenic a. These vessels then join the colic "vasa recta" through the phrenocolic ligament and the marginal omental vessels. This research shows that the vascular continuity of the left colon is not a constant element, able to reassure the surgeon, for possible interruptions that may occur in its composition.

Colon↗

Regional differences in the sympathetic innervation of the guinea pig large intestine by neuropeptide Y- and tyrosine hydroxylase-immunoreactive nerves of divergent extrinsic origin.

Region-specific patterns of nerves with immunoreactivity to neuropeptide Y (NPY) have been described previously in the submucous plexus of guinea pig large intestine. Because these may have functional significance, the possibility of similar, characteristic variations of NPY-like immunoreactivity (NPY-ir) in the myenteric plexus was explored. Regional differences were found in the occurrence and pattern of distribution of NPY-ir in the myenteric plexus of the guinea pig large intestine. NPY-ir was present rarely within neuron somata in any region of the large intestine, and NPY-ir nerve fibers were present only within the distal large intestine, increasing progressively in density from the distal spiral to the rectum. Lesion of the colonic nerves, but not the hypogastric, intermesenteric, or lumbar splanchnic nerves, resulted in a loss of NPY-ir in the distal spiral and transverse colon but not in the descending colon or rectum. Ring myotomies in the descending colon resulted in a loss of NPY-ir proximal to the lesion. Dual-labeling immunohistochemical studies revealed that the NPY-ir nerve fibers rarely contained immunoreactivity for tyrosine hydroxylase (TH). Extrinsic nerve lesions resulted in an unequivocal reduction in NPY-ir in intraganglionic fibers of the submucosal plexuses of the transverse colon and a partial loss in the distal spiral and descending colon: the rectum was unaffected; in only a minority of guinea pigs, however, was any decrease in the NPY-ir innervation of submucosal blood vessels detected. The principal projections of NPY-ir nerves were from and through the inferior mesenteric ganglion; however, NPY-ir was not colocalized with TH-ir. It is proposed that nonnoradrenergic, NPY-containing neurons located in the inferior mesenteric ganglion project through the colonic nerves and that these proximally directed fibers innervate the transverse colon and the distal spiral. Nonnoradrenergic, NPY-ir neurons lying in the pelvic ganglia or sacral sympathetic chain may make an important contribution to the innervation of the myenteric plexus of the rectum and the descending colon.

Animals↗

MRI-guided percutaneous cryoablation of renal tumors: use of external manual displacement of adjacent bowel loops.

PURPOSE: We sought to investigate retrospectively the safety and effectiveness of using external hand compression to displace adjacent bowel loops during MRI-guided percutaneous cryoablation of renal tumors. MATERIALS AND METHODS: Fourteen patients (six women, eight men; mean age: 72 years) with 15 renal tumors (mean diameter: 2.4 cm; range: 1.4-4.6 cm) adjacent to bowel were treated with MRI-guided percutaneous cryoablation during which bowel was displaced manually. Bowel loop of concern was ascending colon (n=5), descending colon (n=8), descending colon and small bowel (n=1), ascending colon and small bowel (n=1). To analyze effectiveness of the maneuver, mean distance between tumor margin and bowel before and after the maneuver were compared and analyzed using paired Student's t-test. Minimum distance between iceball edge and adjacent bowel with external manual displacement during freezing was also measured. Safety was assessed by analyzing post-procedural MR imaging for adjacent bowel wall thickening and focal fluid collections as well as patients' clinical and imaging follow-up. RESULTS: Mean distance between tumor margin and closest adjacent bowel increased from 0.8 cm (range: 0-2 cm) before external manual compression to 2.6 cm (range: 1.6-4.1 cm) with manual displacement (p<0.01). Mean minimum distance between iceball edge and closest adjacent bowel during the procedures was 1.6 cm (range: 0.5-3.5 cm). No evidence of bowel injury was encountered. Twelve of 15 tumors had follow-up (mean: 10 months) that showed no tumor recurrence. CONCLUSION: MRI-guided percutaneous cryoablation of renal tumors adjacent to bowel can be done safely and effectively using external hand compression to displace bowel loops.

Aged↗

[Visualization and quantification of large bowel motility with functional cine-MRI].

PURPOSE: To develop and evaluate a method to visualize and quantify large bowel motility using functional cine MRI. METHODS: Fifteen healthy individuals (8 males, 7 females, 20 to 45 years old) with no history or present symptoms of bowel disorders were enrolled in a functional cine MRI examination at 6 a. m. after a starving phase for at least eight hours before and after oral administration of Senna tea (mild stimulating purgative). Two consecutive sets of repeated measurements of the entire abdomen were performed using a 1.5 T MRI system with coronal T2-weighted HASTE sequences anatomically adjusted to the course of the large bowel. A navigator technique was used for respiratory gating at the level of the right dorsal diaphragm. The changes in diameter (given in cm) were measured at 5 different locations of the ascending (AC), transverse (TC) and descending colon (DC), and assessed as parameters for the bowel motility. RESULTS: The mean values as a statistical measure for large bowel relaxation were determined. Before ingestion of Senna tea, the mean diameter measured 3.41 cm (ascending colon), 3 cm (transverse colon) and 2.67 cm (descending colon). After the ingestion of Senna tea, the mean diameter increased to 3.69 cm (ascending colon) to 3.4 cm (transverse colon) and to 2.9 cm (descending colon). A statistically significant difference was demonstrated with the Wilcoxon test (level of confidence 0.05). For the determination of dynamic increase, the changes of the statistical scatter amplitude to the mean value were expressed as percentage before and after the ingestion of Senna tea. Thereby, an increase in variation and dynamic range was detected for the AC (112.9 %) and DC (100 %), but a decrease in the dynamics for the TC (69 %). CONCLUSION: A non-invasive method for the assessment of bowel motility was developed for the first time. The use of functional cine MRI utilizing a prokinetic stimulus allowed visualisation and quantification of large bowel motility. Further studies have to determine whether this technique is clinically relevant.

Adult↗

[Cancer of the colon in the National Institute of Nutrition. II. Synchronous and metachronous tumors].

OBJECTIVE: To review the frequency localization, latency and clinical staging of synchronic and methachronic tumors in patients with resected carcinoma of the colon during the period 1979-1989. SETTING: A third level hospital in Mexico City. RESULTS: Synchronic tumors. Nine individuals (7.2%) of 123 patients reviewed had synchronic tumors. Their mean age was 63 years (26-78); 4 were men and 5 women. Localization and staging were: transverse colon + sigmoid (B1 + A); both ascendant colon (C2 + A); transverse colon + rectum(B3 + A); both descendent colon (B2 + A); sigmoid + descendent colon (A + A); transverse + descendent colon (B2 + B2); ascendant + sigmoid colon (D + B2); both sigmoid (B1 + A); ascendant + transverse colon (B1 + B2). In four patients, the presence of the synchronic tumors modified the surgical procedure. Methachronic tumors. Two cases (3.2%) were detected in 61 patients followed more than one year after colonic cancer surgery; the latency times were 16 and 23 months. In one case staging was A and the other was an in situ carcinoma. CONCLUSIONS: The frequency of synchronic and methachronic tumors in similar to that reported in the English literature. We emphasize the need to perform routine control colonoscopies preparatively and during the followup of these patients.

Adult↗

Ion transport and electrophysiology of the early proximal colon of rabbit.

The ion transport properties of the mammalian descending colon have been the subject of numerous investigations during the last decade. In contrast, relatively few studies have investigated proximal segments of this organ. In the present study, we assessed transepithelial transport of Na+, K+ and Cl- in the isolated initial segment (P1) of rabbit colon in vitro using radioisotopic tracer fluxes and electrophysiological techniques. Like the rabbit descending colon, the proximal colon actively absorbs sodium and chloride, however, its transport systems are markedly different. In vivo, this segment absorbs potassium, however in vitro active potassium secretion was observed. Unlike the descending colon, Na+ absorption is relatively insensitive to amiloride and only a slight inhibition was obtained even at 1 mM concentrations of this drug. Na+ and Cl- absorption appeared to be coupled (directly or indirectly) since the absorption of each ion was inhibited by the removal of the other. Serosal ouabain also inhibited Na+ and Cl- absorption and net K+ secretion. Unlike the descending colon, the proximal P1 segment did not have a net absorptive K+ transport system that was detectable in the presence of ouabain. Electrically, the early proximal colon has a low transepithelial resistance compared to descending colon (RT = 133 +/- 7 omega cm2) but a larger short-circuit current (Isc = 178 +/- 12 microA/cm2). The transepithelial potential averaged -21 +/- 1 mV, in excellent agreement with values measured in vivo. The apical and basolateral membrane potentials averaged -21 +/- 1 mV and -42 +/- 1 mV and intracellular potassium activity was 70 +/- 2 mM.(ABSTRACT TRUNCATED AT 250 WORDS)

Amiloride↗

Pneumatosis cystoides intestinalis: imaging findings with colonoscopy correlation.

We report on a case of pneumatosis cystoides intestinalis in a 32-year-old woman affected by coeliac disease with stool cultures positive for salmonella. After plain film of the abdomen, patient underwent computed tomography and magnetic resonance colonography studies that demonstrated numerous, diffuse bubblelike intramural gas collections into the ascending, transverse and descending colonic wall. CT and MR findings were correlated with colonoscopy.

Adult↗