[Comparative study of radiographic and colonoscopic diagnosis of colonic diseases].
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For the patient with a single gallstone obstructing the colon, this technique offers nonoperative relief of the obstruction, allowing definitive operative therapy to be accomplished at a later time on a more elective basis. The patient should be carefully observed during the interval for intervening recurrent gallstone ileus.
An elderly man was admitted to hospital with dull abdominal pain and marked weight loss. Ileocolic intussusception was shown on colonoscopy and later confirmed at laparotomy. The main feature was a caecal lipoma. A review of the subject and comparison with two other cases is included in the report. If the colonoscopy reveals a coil-spring polypoid mass, intussusception must be considered as a diagnosis in patients with abdominal pain.
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The authors examined 204 patients after a two-year interval following endoscopic and surgical polypectomy resp. of an adenoma of the large intestine. The group comprised 67 patients (32.8%) with a metachronous adenomatous polyp. In none of these patients carcinoma was diagnosed. In patients where originally a solitary adenoma was diagnosed a metachronous adenoma developed in 14%. In the group with originally synchronous polyps a metachronous polyp developed in 85.2%. The male:female ratio during the original examination and after two years in relation to an adenoma of the large intestine did not change significantly. The test for occult blood in the faeces made by the Haemoccult test gave in 3% falsely positive results and in 27% falsely negative results. According to the results of the examination the two-year interval is sufficient for repeated coloscopy within the framework of dispensarization of patients after polypectomy. In exceptional cases the interval of the check-up must be adjusted to the patient's condition with regard to the follow up by and collaboration with the general practitioner.
For a two year period 79 patients were examined by fiber colonoscopy and X-ray examination of the colon. The purpose of the study is to find out the sensitivity, specificity and accuracy of the methods for the diagnosis of the most frequent diseases of the colon. The results allow the conclusion that fiber colonoscopy is the method of choice in the diagnosis of the neoplasms and the inflammatory diseases of the colon. When all segments of the colon cannot be examined by fiber colonoscopy a double-contrast barium enema is advised. Fiber colonoscopy should be performed to all patients with clinical data suspicious for a colonic disease and a negative X-ray examination of the colon.
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1. The possibilities of diagnostics and treatment of an intestinal invagination in children by the help of a colonileoscopy are discussed. 2. Clinico-endoscopical comparisons of ileocaecal invaginations in children and their connections with the sphincteric function of the Bauhin's ileocaecal valve are made.
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The purpose of this report was to review the authors' experience with colonoscopy as a method of treating patients with acute colonic distention. For the period 1981-1987, 19 patients at two teaching hospitals met the selection criteria for this study. In terms of measurable decompression of a colon distention, colonoscopy was successful in 89 per cent of patients, although 41 per cent required repeat endoscopic decompression during their hospital stay. The procedure failed in two patients (11%) and operative decompression was necessary. The authors have found that colonoscopy is a useful procedure for determining the cause of progressive colon distention and for providing safe and effective treatment.
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Over the past 14 years 1,000 polyps were removed via colonscope and histologically examined. There were 869 neoplastic polyps including 125 carcinomas. Non-neoplastic polyps included 32 inflammatory polyps, 32 metaplastic polyps, 27 juvenile polyps and 17 Peutz-Jeghers type polyps. Ninety-eight focal carcinomas were adequately treated by polypectomy only, whereas 9 out of 26 invasive carcinoma required further operations with one residual carcinoma in the pararectal tissue and colonic wall respectively. The criteria requiring additional surgery in invasive carcinoma are 1) lymphatic permeation of the submucosa, 2) poorly differentiated carcinoma or 3) massive invasion close to the cut end. Not only polypoid adenomas but also flat adenomas were found to exist and seem to play an important role in the adenoma-carcinoma sequence. It became clear that colonscopic polypectomy was a useful tool for the management of colonic polyps.
One thousand five hundred and seventy six polyps were removed from 1190 patients. Polyp size ranged from 5 mm to 6 cm. Nineteen complications occurred, an incidence of 1.2 per cent. Bleeding was the most common complication, accounting for 53 per cent of all complications, followed by transmural burn (32%). Other complications included a "silent" free perforation, a snare-wire entrapment, and an ensnared bowel wall. Certain complications can be prevented provided the basic safety features are observed. Some complications require conservative management, others require an operation.