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PubMed2003

[Uncommon case of incomplete left paraduodenal hernia].

Internal hernias are very rare. The hernial orifice, sac and content are situated inside the abdomen. Paraduodenal hernias are relatively rare congenital malformations and account about 50 per cent of all internal hernias. The cause of this malformation is the incomplete rotation of the mid-gut. Right and left paraduodenal hernias are different, varying in anatomic structure and embryological origin. In right paraduodenal hernia the small bowel is partially or completely localised behind the mesocolon of the ascending colon, in left paraduodenal hernia behind the mesocolon of the descending colon. That is why the widely used name "mesocolic" hernia is more convenient, because it refers on the pathogenesis of the disorder. The complaints can vary from recurrent atypical abdominal pains to the complete small bowel obstruction, but often there are no complaints. Abdominal CT scan and the barium meal provide the best diagnostic approach for paraduodenal hernias, but it will be recognised very often only at an emergency operation. A case of small bowel obstruction caused by incomplete left paraduodenal hernia discovered after swallowing a foreign body is described with pathogenesis, diagnosis and possible treatments for the disease.

Aged↗
PubMed2004

Colonic lipoma intussusception: a case report.

Lipomas are the most common mesenchymal benign tumor of the colon. They are usually asymptomatic but may cause bleeding, obstruction, intussusception, or abdominal pain. The diagnosis can be made by colonoscopy, barium enema examination, and by computed tomography (CT). We have reported a case of large submucosal lipoma of the ascending colon with intestinal obstruction. At laparotomy there was an intussusception descending colon, and subtotal colectomy was performed.

Adult↗
PubMedDate not supplied

Unusual blast colonic injury due to a fall.

Civilian colonic injuries are usually due to penetrating injuries like gun shots, stab wounds and blunt trauma especially following road traffic accidents. Blast injuries are caused by bomb blasts, intracolonic explosion of gases after diathermy, over-enthusiastic bowel insufflation at sigmoidoscopy or by pressure hose applied to the anus. We report the case of a 28-year old man with an unusual blast injury of the colon following a fall from a colanut tree. The transverse colon was sheared off at its two ends while the descending colon was split open along its entire length. There was a delay of 14 hours before the man was discovered in the remote bush and brought to hospital. The mode of injury, its severity and the ultimate favourable outcome are quite unique considering the gross faecal soilage of the peritoneal cavity and the inevitable time lapse before the institution of medical care.

Accidental Falls↗
PubMed1979

Anastomoses of intestinal tract as a sequela to rectal stricture in swine.

Rectal stricture with anastomoses of colon and/or small intestine to a spherical dilatation of the descending colon proximal to the stricture was observed in six swine. In three of these swine, feces bypassed most of the colon in passage from the small intestine to the dilated colon. Rectal stricture with an anastomosis of a loop of colon to the rectal stricture was observed in one pig where feces bypassed much of the stricture.

Animals↗
PubMed1987

Malignant teratoma of the left colon associated with chronic ulcerative colitis.

An autopsy case of a malignant teratoma of the descending colon is presented, the first observed in this site. A 41-year-old woman had suffered from chronic ulcerative colitis and was operated because of an abscess forming a mass in the left colon. However, the tumour proved to be inoperable and the patient died from septicaemia. Histologically, the tumour was a highly metastasizing malignant teratoma containing mature tissue elements (hair, cartilage, adipose tissue, squamous epithelium, bronchial, endometrial and cervical tissues). The relationship between the ulcerative colitis and the teratoma is obscure.

Adult↗
PubMed1980

Study of kinetics of epithelial cell populations in normal tissues of the rat's intestines and in carcinogenesis. I. A comparison of enterocyte population kinetics in different segments of the small intestine and colon.

The peculiarities of enterocyte proliferation in the duodenum, jejunum, ileum, caecum, ascending, transverse and descending colon in the rat were studied by different methods of analysis of cell population kinetics (percentage-labelled mitosis curves, cumulative labelling curves, distribution of labelling index curves, etc.). The majority of proliferating cells in the small intestine are homogenous, as far as mitotic cycle mean duration (11-12 hrs) is concerned. All proliferating cells in all the zones of the colonic crypts and the bottom of the small intestine crypts are divided into subpopulations, having different mean durations of the mitotic cycle. It is suggested that, in the crypt bottom in all intestines as well as the crypt's maximum proliferation zones in most of the colonic segments, a considerable fraction of cells has a very long mitotic cycle or enters resting phase R1. The average value of the mean durations of the mitotic cycle of all colonic enterocyte subpopulations is 18-22 hours. On the basis of the authors' findings and literature data, a model for the enterocyte life cycle is proposed, according to which the cell flux is branched during the mitotic cycle and the crypt develops from a stem enterocyte population located at its bottom.

Animals↗
PubMedDate not supplied

Quantification of the sulphomucin-producing cell population of the colonic mucosa during protracted stress in rats.

The sulphomucins contained in goblet cells of the descending colon of 55 Sprague-Dawley rats were histochemically labelled by High Iron Diamine (HID) and quantified in an image analyzer (Cortex controller). After transportation to the stress laboratory, 25 rats were compelled to swim for two consecutive hours/day either only once (5 rats), for one week (5 rats), two weeks (5 rats), four weeks (5 rats) or eight weeks (5 rats). 25 additional rats were only transported to the stress laboratory (i.e. "sham-handled" control), either once (5 rats), for one week (5 rats), two weeks (5 rats), four weeks (5 rats) or eight weeks (5 rats). The remaining 5 rats were "untransported", resting control rats (i.e. day zero). The results were expressed in percent of HID-staining/total mucosa analyzed. When various time intervals were compared with those of day zero (i.e. horizontal study), it was found that one day swimming rats had a significantly lower percentage (p less than 0.001) of HID stained material. The fluctuations at other time intervals were non-significant. On the other hand, for transported rats, a significant increase (p less than 0.001) in the percentage of HID positive areas was found for rats swimming for eight weeks. When compared to day one, the percentage of HID positive areas increased from day one to one-eight weeks, the differences being significant (p less than 0.001) at four and (p less than 0.01) eight weeks. Similar results were found for transported rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1980

Colonic perforation following neurosurgical procedures and corticosteroid therapy in four dogs.

Perforation of the proximal descending colon occurred in four Dachshund dogs, each of which died 5 to 10 days following neurosurgical procedures. The complication was believed to be associated with parenteral use of dexamethasone. Correct antemortem diagnosis was made in only one of the four cases, probably because signs of a perforated viscus were so modified by the antiphlogistic effects of corticosteroids as to prevent early detection of the complication.

Animals↗
PubMed1987

Tissue oxygen tension as a predictor of colonic anastomotic healing.

Inadequate blood flow causing tissue hypoxia can result in failure of anastomotic healing. Tissue oxygen tension (ptO2) measurement has been used to predict anastomotic leakage in animals, but its use in humans has not been described previously. A Clark-type oxygen electrode was used to measure ptO2 on the colon of 50 patients undergoing colonic resection and anastomosis. Baseline ptO2 levels were lowest on the descending colon (31.8 +/- 7.4 mmHg, mean +/- SD) and tended to increase at all sites with increasing arterial paO2 (r greater than .76, P less than .001). Perianastomotic ptO2 levels were predictive of subsequent anastomotic leakage when they were less than either 20 mmHg; 50 percent of the preresection ptO2; 15 percent of the arterial paO2; or 40 percent of the ptO2 at a control site (ileum). It is concluded that perioperative ptO2 measurements are of value in the prediction of anastomotic leakage.

Adult↗
PubMed2006

True smooth muscle neoplasms of the gastrointestinal tract: morphological spectrum and classification in a series of 85 cases from a single institute.

BACKGROUND AND AIM: True smooth-muscle neoplasms of the GI tract have been only rarely studied in the KIT era. Their incidence among other GI mesenchymal tumours and their clinicopathological spectrum have not been sufficiently analysed. MATERIALS AND METHODS: We reviewed all GI mesenchymal lesions at the Pathology Institute of the Nuremberg Clinic Centre from 1994 through 2005. RESULTS: Among 262 lesions, there were 142 GISTs (54%) and 85 true smooth muscle neoplasms (32%). Smooth muscle neoplasms comprised 72 polypoid leiomyomas (78%, 5 oesophageal and 67 colorectal), 10 intramural leiomyomas (11%, 5 oesophageal, 4 gastric and one ileal), two intramural leiomyosarcomas in the sigmoid colon and ileum (2%) and one polypoid leiomyosarcoma involving the stomach, descending colon and the retroperitoneum concurrently. None of the leiomyomas with available follow-up have recurred or metastasised. CONCLUSION: Smooth muscle neoplasms are the second most common mesenchymal neoplasms in the GI tract after GISTs. They may arise either from the muscularis mucosae or proper muscle layer forming polypoid and intramural lesions, respectively. Polypoid leiomyomas are more common in the rectosigmoid, while intramural ones mainly arise in the vicinity of the oesophagogastric junction. Polypoid leiomyomas are sufficiently treated by endoscopic resection, and local surgical excision is the treatment of choice for intramural leiomyomas. Intramural leiomyosarcomas are rare high-grade sarcomas that commonly have infiltrated into the surrounding tissue or metastasised by the time of diagnosis.

Adult↗
PubMed1992

Flaxseed supplementation and early markers of colon carcinogenesis.

Since flaxseed ingestion produces potentially anticarcinogenic lignans in the colon, this study determined whether flaxseed decreases the risk for colon carcinogenesis. Following a single injection of azoxymethane (15 mg/kg body wt.), five groups of male Sprague-Dawley rats were fed a high-fat (20% corn oil) basal diet with or without supplementation with 5% or 10% flaxseed meal (FM) or flaxseed flour (FF) for four weeks. Upon sacrifice, colons were examined for aberrant morphology and cell proliferation. In the descending colon of supplemented groups, the total number of aberrant crypts and foci were significantly reduced by 41-53% and 48-57%, respectively. The labeling index (LI) was also 10-22% lower in these groups, except for the 5% FM group. While these effects are not linearly related to the level of flaxseed fed, it suggests that flaxseed feeding may reduce the risk for colon carcinogenesis.

Animals↗
PubMed1997

Colonic spread of three rectally administered mesalazine (Pentasa) dosage forms in healthy volunteers as assessed by gamma scintigraphy.

BACKGROUND: Rectal administration of enemas, foams and suppositories is the most efficient method of delivering locally-acting drugs to the distal colon, sigmoid colon and rectum. Healthy volunteers provide an effective population to compare different formulations for rectal drug delivery. However, there is still only limited comparative information available on the dispersion of such dosage forms in human subjects. Therefore, the objective of this scintigraphic study was to compare colonic spread of an enema, a rectal foam and a suppository formulation in healthy volunteers. METHODS: This was a randomized, crossover study in eight healthy male volunteers. Each received Pentasa rectal formulations as either a 100 mL suspension enema (1 g mesalazine), one actuation of a non-CFC propellant rectal foam (1 g mesalazine in 5 mL concentrate, expanding to 40 mL on actuation), or one suppository (1 g mesalazine) on three separate occasions. The spread of the radiolabelled formulations was assessed over a 4-h period by gamma scintigraphy. RESULTS: The formulations were retained by all subjects for the whole of the 4-h imaging period. The enema spread to the splenic flexure in 7 out of 8 subjects, but was retained in the rectum and sigmoid colon in one individual. The foam spread as far as the descending colon in four subjects. In the remaining individuals the foam was retained in the rectum and sigmoid colon. The spread of the suppository was limited and confined to the rectum. CONCLUSIONS: The findings of this study are consistent with previous research and support the intended clinical uses of the enema, foam and suppository formulations to treat distal ulcerative colitis, proctosigmoiditis and proctitis, respectively. The results highlight the potential of gamma scintigraphy in providing in vivo 'proof of concept' data to help verify the targeting of pharmaceutical products to their intended site of delivery.

Administration, Rectal↗
PubMed2002

[Colonic diverticulosis: A comparison between sonography and endoscopy].

AIM: To investigate the ability of sonography to diagnose diverticulosis and to demonstrate the typical appearance of normal diverticula. PATIENTS AND METHODS: Sixty consecutive patients underwent sonography for prospective evaluation of the presence of diverticulosis of the left hemicolon. Diverticula were assessed for number, diameter, echogenicity, and wall thickness. Sonographic results were compared with those of endoscopy. RESULTS: Sonography yielded positive results in 28/33 patients (85 %) with endoscopically proven diverticulosis. Sonography on average could demonstrate less diverticula per patient than endoscopy. Two sonographic results were false positive. Diverticula had a maximum average diameter of 8.7 mm and the diverticular wall measured 1 mm at most. In many cases the diverticular wall could not be demonstrated by sonography. All diverticula except for one were hyperechoic. In 39 % of patients with diverticulosis one or more diverticula showed clear acoustic shadowing indicative of a faecalith. The maximum diameter of the colonic wall was 3.3 mm on average. Sonography could demonstrate the descending colon in all cases. The sigmoid colon was not visible in 3 cases and could rarely be evaluated in its entire length. CONCLUSION: Sonography can diagnose diverticulosis of the left hemicolon in most cases. Normal diverticula present as hyperechoic protuberances of the colonic wall with acoustic shadowing of varying intensity. The diverticular wall is thin and often not demonstrable at sonography.

Adolescent↗
PubMed1993

Mid-colon oesophagocoloplasty for corrosive oesophageal strictures.

Corrosive strictures of the oesophagus are common and being long and dense frequently require surgical replacement of the oesophagus. Presently available techniques of oesophagocoloplasty are associated with a significant mortality and major morbidity, such as a high rate of ischaemic necrosis of the colon, cervical salivary fistula or oesophagocolic stenosis. A method of mid-colon oesophagocoloplasty using an isoperistaltic colonic segment from the mid-ascending to the mid-descending colon is reported. The procedure was carried out in 33 patients. The conduit was placed retrosternally in 27 patients and subcutaneously in the rest. The essential steps of the procedure are simultaneous neck and abdominal dissection, near-total mobilization of the colon from the ileocaecal segment to the sigmoid colon and sequential clamping of ileocolic, right colic and usually the middle colic vessels leaving the left colic vessels as the major vascular pedicle. The divided ileum is used to pull the colon into position thus avoiding traumatization of the colon and leaving the whole length of the mobilized colon available for anastomosis. A wide side to side oesophagocolic anastomosis in the neck, resection and discarding of the bulky terminal ileocaecal segment after completion of the cervical anastomosis, closure of the terminal end of the colon and its placement adjacent to the hypopharynx and end to side cologastric anastomosis complete the procedure. There was no mortality and there was no instance of colonic necrosis. The procedure restored an ability to eat normal food in 93.9% of patients compared to only 39.2% of patients with bougienage.(ABSTRACT TRUNCATED AT 250 WORDS)

Anastomosis, Surgical↗
PubMed1990

Treatment of postoperative paralytic ileus by intravenous lidocaine infusion.

The effects of continuous intravenous infusion of lidocaine on postoperative paralytic ileus in cholecystectomized patients was investigated in this double-blind study. An infusion of lidocaine (3 mg/min, n = 15) or an infusion of an equal volume of saline (n = 15) was started 30 min before induction of anesthesia and continued for 24 h after surgery. Postoperative colonic motility was evaluated by radiopaque markers and serial abdominal radiographs. A record was kept of the first passage of gas and feces. Results showed significantly earlier return of propulsive motility in the colon of lidocaine-treated patients. Radiopaque markers in the lidocaine group were propelled significantly earlier from the cecum/ascending colon to the transverse colon (P less than 0.05) and appeared significantly earlier in the descending colon (P less than 0.05) and the rectosigmoid colon (P less than 0.05) than in saline-treated patients. Despite the fact that the mean time for postoperative defecation occurred 17 h earlier in lidocaine-treated patients, differences between the groups were not statistically significant--a fact due, perhaps, to great individual variations in defecation habits. The time to first passage of gas, a variable representative of changes in anorectal or colonic tone rather than propagative motility, also did not differ significantly between the groups. No adverse reactions to lidocaine were reported. The results suggest that continuous intravenous infusion of lidocaine during the first postoperative day shortens the duration of paralytic ileus in the colon after abdominal surgery. Suppression of inhibitory gastrointestinal reflexes by reduction of postoperative peritoneal irritation is suggested as the mechanism of action.

Cholecystectomy↗
PubMed1989

[Results of abdominal surgery in patients over 90 years old].

During a year period (1978-1987), 105 cases of abdominal surgery were performed at Sasebo Chuo Hospital on patients over 80 years of age. This study discusses 4 patients who were over 90 years old at time of their surgery. Emergency surgery had been required for 2 patients (a 91-year-old male with a sigmoid colon ca., and a 91-year-old female with a descending colon ca.), and elective surgery had been performed on the other two patients (a 95-year-old male with a caecum ca., and a 97-year-old female with a leiomyosarcoma of stomach). The patients who underwent elective surgery had a uniformly smoother hospital course and an overall better prognosis then the patients who underwent emergency surgery, whose prognosis was poor. We have concluded that early diagnosis and elective surgery is the necessary procedure in the elderly patient.

Adenocarcinoma↗
PubMed1989

Postpromotional effects of dietary marine or safflower oils on large bowel or pulmonary implants of CT-26 in mice.

Marine oils containing n-3 fatty acids exhibit variable antineoplastic effects. Diets containing low (11.6% of kcal) or high (46.5% of kcal) levels of marine oils as the exclusive fat source were compared to diets containing identical amounts of safflower oil (n-6) in weanling, male BALB/c ByJ mice. All diets provided approximately 90 kcal/100 g body weight/day, and contained identical quantities of vitamins, minerals, protein, and fiber. The growth of transplantable colon carcinoma, CT-26, (10(6) cells/animal) implanted, subserosally, into the descending colon via laparotomy, was observed weekly over 28 days by necropsy in all dietary groups. At each time period animals fed safflower oil had larger tumors than those fed marine oil. Tumor volumes at 21 days postimplantation were as follows: low fat marine, 55 mm3 (5-196 mm3) [median (range)]; high fat marine, 70 (26-194); low fat safflower, 216 (32-800); high fat safflower, 247 (70-1352). Marine oil tumors were smaller than safflower oil tumors (P less than 0.005 by analysis of variance; P less than 0.01 by Scheffe test). Metastatic potential was assessed by pulmonary colonization. CT-26 was injected i.v. in tail veins (10(5) cells/animal). Mice were sacrificed and colonies were counted after 21 days. Mice fed low fat marine, high fat marine, and low fat safflower oil diets, 10-14 colonies; high fat safflower, 55 colonies (P less than 0.001 by analysis of variance). Hence, dietary marine oil significantly suppressed growth of this colon carcinoma at all intake levels studied and inhibited pulmonary colonization at higher intakes relative to safflower oil.

Animals↗
PubMed1978

Pneumatosis coli secondary to colonic obstruction. A case report.

A case of pneumatosis coli of the caecum and ascending colon with a closed loop obstruction secondary to carcinoma of the descending colon is presented. The caecum was grossly distended and impending rupture was diagnosed. It is postulated that complete transmural rupture of the caecum was prevented by partial decompression of caecal air into the bowel wall.

Aged↗