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At least 595 records · Page 33Linked to original sources
PubMed2001

Percutaneous colonoscopic cecostomy for management of chronic constipation in children.

BACKGROUND: Chronic constipation and encopresis are common problems in children with spina bifida and anorectal anomalies. Commonly used therapies include complicated bowel regimens and antegrade continence enemas delivered via surgically placed appendicostomies and radiologically placed cecostomies. METHODS: A technique is described for percutaneous placement of cecostomies for the delivery of continence enemas or venting. RESULTS: Percutaneous cecostomies were placed in 12 patients. Improvement in bowel management occurred in all patients. CONCLUSIONS: Percutaneous endoscopic cecostomy is a safe and effective method for the treatment of intractable constipation.

Adolescent↗
PubMed2005

Colonoscopic removal of inguinal hernia mesh: report of a case and literature review.

The transabdominal preperitoneal (TAPP) procedure for laparoscopic inguinal hernia mesh repair is being applied with increasing frequency. This technique has an acceptable recurrence rate (0.4-3.9%), but has varying complication rates (1.3-17.4%).1,2 We report the first case of mesh penetration of the colon following laparoscopic TAPP repair, treated with colonoscopy.

Colonoscopy↗
PubMed1984

Distribution and spread of colonic lesions in shigellosis: a colonoscopic study.

In a study of the distribution and severity of colonic lesions in patients with shigellosis, colonoscopy was performed for 33 men with this disease. All 33 patients had inflammatory lesions in the rectosigmoid area; in 18 (55%) the lesions extended to the splenic flexure, in 14 (42%) the disease extended to the distal transverse colon, in nine (27%) the area of involvement included the proximal transverse colon, and in five (15%) pancolitis was evident. In most patients lesions were continuous and diffuse, with the intensity of inflammation decreasing in a proximal direction. Biopsied samples from proximal lesions usually showed less severe inflammation than did those from more distal lesions. Aphthoid erosions, which have not previously been described in shigellosis, were observed in five patients. Proximal colitis was associated with diarrhea of four or more days' duration (P less than .01, Fisher's exact test). These findings indicate that the rectosigmoid is the most frequently and most severely affected area of the colon in shigellosis and suggest that during the course of shigella infection, colonic lesions extend in a proximal direction.

Adult↗
PubMed1988

Colonoscopic detection of early colorectal cancers. Impact of a surgical endoscopy service.

The Surgical Endoscopy Service has been aggressively evaluating gastrointestinal symptoms with colonoscopy and screening asymptomatic patients with flexible sigmoidoscopy in hopes of finding early curable colorectal cancers. The purpose of this study was to compare the stages of colorectal cancers resected during the 18-month period prior to (Pre-SES) and during the first 18 months (Post-SES) after the creation of the Surgical Endoscopy Service. In addition, the yield of lesions that would have been obtained by depending upon patient symptoms or occult blood testing were determined. A total of 361 colonoscopies were performed Pre-SES and 874 colonoscopies Post-SES; 26 patients underwent resection of colorectal cancers Pre-SES and 32 Post-SES. Whereas early colorectal cancers (Dukes' A and B1) were found in only three patients (12%) Pre-SES period, early cancers were found in 13 (41%) Post-SES. Doubling the number of colonoscopies produced a fourfold increase in the number of early lesions. Furthermore, disseminated cancers (D lesions) dropped from 19% Pre-SES to 3% Post-SES. Among the total 58 patients, 43% of the A lesions and 40% of the B1 lesions were asymptomatic. Even more alarming, 86% of the A lesions, 50% of the B1 lesions, 31% of the B2 lesions, and 14% of the C2 lesions were occult blood negative. Indeed, only the D lesions were uniformly occult blood positive. This study demonstrates that aggressive colonoscopy detects early colorectal cancers. Moreover, patient symptoms or occult blood testing will fail to indicate the majority of early colorectal cancers.

Aged↗
PubMed1994

Benefits of colonoscopic surveillance after curative resection of colorectal cancer.

OBJECTIVE: The authors determined the usefulness of routine colonoscopy after colorectal cancer surgery. SUMMARY BACKGROUND DATA: Some studies suggest benefit to colonoscopy in the routine follow-up of patients with colorectal cancer who are resected for cure, whereas other studies show no benefit. METHODS: Chart review was conducted for 290 patients who underwent curative resection for colorectal cancer between 1967 and 1991 at a colorectal surgeon's practice. Colonoscopy was performed every 6 months during the first year, then every 1 to 2 years, or when intercurrent symptoms appeared. RESULTS: Overall, 31 patients (10.7%) developed recurrent disease, which increased as a function of stage (C2 > B2 > A), with a median time to diagnosis of 20 months. Of these 31 recurrences, 14 (45.2%) were solely local (of whom 12 were asymptomatic); 17 (54.8%) involved distant disease. Nine locally recurrent patients were able to undergo curative resection. Of 19 symptomatic patients, only 3 (15.8%) were amenable to curative resection. Six patients (2.1%) developed a metachronous second primary colorectal cancer, of whom four (66.7%) were asymptomatic, and five (83.3%) were able to undergo curative resection. Overall, because of surveillance colonoscopies, 13 asymptomatic patients (4.5%) had curative resection for localized recurrent disease or a metachronous second primary cancer. CONCLUSIONS: Colonoscopy is a useful modality in the early detection of recurrent and metachronous disease after colorectal cancer, increasing the potential for curative resection and improved survival.

Aged↗
PubMed1980

Vascular ectasia of the colon: clinical, colonoscopic, and radiographic features.

We report a retrospective review of the pertinent clinical, endoscopic, and radiologic findings of 15 patients with vascular ectasia of the colon. Although the majority of the patients were over 60 years old, 40% were older than 50 but younger than 60. Vascular ectasia can occur without associated aortic stenosis or chronic obstructing pulmonary disease. Twenty-seven percent of the patients had multiple lesions involving the transverse or descending colon or both, as well as the cecal-ascending colon area. Colonoscopy and angiography were able to detect the vascular ectasia, but both diagnostic methods missing some lesions. Watchful waiting appears to offer a reasonable approach toward patients with vascular ectasia of the colon unless the lesions cause significant or recurrent bleeding.

Aged↗
PubMed2001

The effects of gender and age on the colonoscopic examination.

The data concerning the influence of gender and age on a patient's toleration of and the technical difficulty of colonoscopy are conflicting. One hundred eighty patients (108 women and 72 men) undergoing colonoscopy were categorized into three age groups: the young (aged 2040 years), the middle-aged (aged 41-60 years), and the old (aged 61-75 years). The endoscopists assessed the examination immediately after the procedure. The patients completed a questionnaire before leaving the endoscopy unit and again 2 weeks later. The women rated colonoscopy after the procedure more painful (p < 0.01) and in the repeat questionnaire more painful (p < 0.05) and more difficult (p < 0.05) than men. Also, the endoscopists judged colonoscopy to be more difficult (p < 0.001) and the time taken to reach cecum longer (p < 0.01) for women. The young experienced more discomfort than the middle-aged or the old, as evaluated after the procedure (p < 0.05). In the repeat questionnaire, the young reported more discomfort and pain than the middle-aged (p < 0.05). The endoscopists also judged the examination to be more difficult and the time taken to intubate cecum longer for the old than for the middle-aged (p < 0.05) or the young (p < 0.01). Correspondingly, the examination time was shorter among the young when compared with the middle-aged (p < 0.05) or the old (p < 0.001). The young were least willing to repeat the examination (p < 0.05). Colonoscopy is less tolerable and more difficult for women. Although colonoscopy among the old patients was technically more difficult, they tolerated the procedure better than the young.

Age Factors↗
PubMed2003

Colonoscopic identification of a foreign body causing an hepatic abscess.

BACKGROUND: Hepatic abscesses often result from a perforation of the gastrointestinal tract. Although rare, this may occur via puncture by a foreign body. The object may directly extend from the stomach or duodenum into the liver, or rarely, the object may perforate the bowel distal to the duodenum and indirectly extend to the liver leading to the formation of an abscess. CASE REPORT: A 44-year-old man developed an hepatic abscess. Although the abscess was identified on computed tomography, various imaging studies were unable to identify the cause of the infection. After an extended ICU course, the patient was deemed stable enough to undergo a colonoscopy that demonstrated a foreign body penetrating through the wall of the sigmoid colon. CONCLUSIONS: Here we describe the first report of a foreign body leading to a hepatic abscess where the object was identified by colonoscopy. In addition, we present a comprehensive literature review examining the method of identification of gastrointestinal foreign bodies that led to liver abscesses. These findings emphasize that in cases of hepatic abscesses of unknown etiology, direct visualization by colonoscopy may be a useful tool to elucidate the cause of the abscess.

Adult↗