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PubMedDate not supplied

Intestinal atresia and stenosis: a retrospective analysis of presentation, morbidity and mortality in Zaria, Nigeria.

Over a period of 19 years 22 children with intestinal atresia and stenosis were managed at the Ahmadu Bello University Teaching Hospital Zaria. The condition ranks as the fourth most common cause of neonatal intestinal obstruction after anorectal malformation, Hirschsprung's disease and strangulated inguinal hernia at the hospital. Three patients had duodenal atresia, 18 had jejunoileal involvement (atresia 15, stenosis 3) and one colonic atresia. The median age at presentation to the surgeon was 6 days (range 1 day-2 years). The common features were bilious vomiting and abdominal distension, the latter being more common in patients with lower atresia. Non-passage of meconium in the first 24 hours of birth occurred in 11 patients; mostly in those with lower jejunal, ileal and colonic involvement. Eight patients had associated anomalies, 5 of them with ileal atresia or stenosis. Diagnostic investigation was mainly plain abdominal radiography showing double-bubble shadow in duodenal atresia and varying degrees of air-fluid levels in other atresias. Contrast studies were not employed for diagnosis in any patient. The patients with duodenal atresia and had duodenoduodenostomy and duodenojejunostomy respectively while the jejunoileal atresia and stenosis were treated by resection and anastomosis. One patient with ileal atresia associated with total colonic Hirschsprung's disease and extensive atresia from terminal ileum down to descending colon had ileostomy. Postoperatively, 7 patients had infections of varying degrees and 3 anastomotic dehiscence. Mortality was 9 (41%) due mostly to septic complications and prematurity. While the survival of children with intestinal atresia and stenosis has improved over the years in developed countries, ours is still low (59%) due to late presentation and lack of neonatal intensive care facilities.

Child, Preschool↗

PubMed2002

Use of an introducer sheath for colonic stent placement.

We describe a technical modification of Wallstent implantation for the treatment of malignant rectosigmoid and descending colonic obstructions. The modification is the routine placement of an introducer sheath via the rectum before stent implantation in order to straighten the rectosigmoid region. This device facilitates catheter and guide wire manipulations and obtaining specimen biopsies for histopathological studies. The introducer sheath has been used without complications in 21 consecutive patients.

Colonic Diseases↗

PubMed2004

Longitudinal colonic torsion as a cause of tenesmus in an adult Irish Water Spaniel.

CASE HISTORY: Torsion of the descending colon was diagnosed by barium enema radiography in an adult Irish Water Spaniel which had presented with tenesmus of 24 h duration. Treatment involved exploratory laparotomy, repositioning of the colon, colopexy and repair of a mesenteric rent. No definitive cause of the torsion could be established. The dog made an uneventful recovery from surgery. CLINICAL RELEVANCE: Animals presenting with constipation of undetermined cause should have large intestinal obstruction ruled out prior to administering bowel cleansing solutions per os and/or colonic enemas. Colonic obstruction by torsion should be considered as a possible differential diagnosis in all cases of tenesmus.

Journal Article↗

PubMed1986

Effects of phorbol esters on sodium and chloride transport in rat colon.

To determine the role of protein kinase C in the regulation of active electrolyte transport in rat descending colon, the effects of phorbol dibutyrate (PDB) were studied using the Ussing chamber/voltage-clamp technique. PDB added to the serosal surface increased the short-circuit current in a concentration dependent manner with a EC50 of 3 X 10(-8) M and a maximal effect at 10(-7) M PDB. The effect was not seen with the inactive alpha-phorbol analogue but was reproduced with 1-oleoyl-2-acetylglycerol, a more permeable analogue of diacylglycerol. PDB caused a decrease in mucosal-to-serosal and net fluxes of Na and Cl and an increase in serosal-to-mucosal Cl flux, indicating inhibition of Na and Cl absorption and stimulation of Cl secretion. The PDB-induced increase in Cl secretion was virtually abolished by both indomethacin and ibuprofen, indicating a dependence on arachidonic acid metabolism via the cyclooxygenase pathway. The Cl secretion was inhibited by verapamil and Ca2+-free bathing solution on the serosal surface but not by dantrolene, suggesting the importance of extracellular Ca2+ but not intracellular stored Ca2+ in the PDB-induced secretion. The Cl secretory effect was also inhibited by tetrodotoxin and atropine, suggesting involvement of cholinergic nerves. In contrast, the PDB-induced decrease in Na and Cl absorption was not dependent on metabolites of the cyclooxygenase pathway, not dependent on extracellular Ca2+, and not blocked by tetrodotoxin. It appears likely that protein kinase C is involved in the regulation of rat colonic active Na and Cl absorption and electrogenic Cl secretion but that the pathways involved are different in the two transport systems.

Animals↗

PubMed1996

Angiomyolipoma arising in the colon.

Extrarenal angiomyolipomas are very rare. Here we report the first case of surgically resected angiomyolipoma of the descending colon that developed in a 50-yr-old man. The patient had no signs of or family history of tuberous sclerosis. He underwent a partial colectomy because the tumor obstructed the colon. Histologically, the tumor consisted of three components: mature fat cells, blood vessels, and smooth muscle cells, and was thereby diagnosed as an angiomyolipoma. Immunohistochemically, the proliferating smooth muscle cells were positive for vimentin, alpha-smooth muscle actin, and desmin. The tumor cells were negative for HMB-45, which is consistently expressed in renal angiomyolipomas.

Angiomyolipoma↗

PubMed1976

[The small left colon syndrome. 3 cases].

In the light of three cases of neonatal obstruction related to a small calibre descending colon, the authors review the main clinical and radiological signs and compare them with the data in the literature. This functional disturbance is related to immaturity of the intrinsic innervation of the colon which is especially common in low birth weight neonates or of diabetic mothers. Diagnosis is dependent upon enema using diluted uroangiographic hydrosoluble iodine contrast medium, which shows a disparity in calibre at the left colic angle. The differential diagnosis lies with Hirschsprung's disease. Functional ileus in premature infants, meconium ileus and the "small left colon syndrome" are related to the same pathogenisis: functional immaturity of the colon.

Colon↗

PubMed1985

Diffuse hemangiomatosis of the colon.

We report extensive colonic hemangiomatosis in two young adults. In the first, the hemangioma contiguously involved the entire colon. In the second, a large venous angioma affected the bladder, rectosigmoid, and descending colon. Venous angioma, a variant of hemangioma, is frequently confused with cavernous hemangioma because of their similar histologic appearance. The angiographic features, however, may enable a more accurate preoperative diagnosis and prevent unwarranted biopsy. We review and put into perspective pertinent previous reports of cavernous and venous angioma.

Adult↗

PubMed2004

Evaluation of criteria for the activity of Crohn's disease by power Doppler sonography.

BACKGROUND/AIM: In recent years, power Doppler sonography has been proposed as a method to assess disease activity in patients with Crohn's disease. The aim of this prospective study was to evaluate diagnostic criteria for power Doppler sonography by blinded comparison with ileocolonoscopy. METHODS: Twenty-two patients with confirmed Crohn's disease were prospectively investigated with B-mode and power Doppler sonography (HDI 5000, Philips Ultrasound) as well as ileocolonoscopy. Sonography was performed within 3 days before endoscopy. All procedures were performed by experienced examiners who were blinded to the clinical data and other results. Defined ultrasound parameters (bowel wall thickness, vascularization pattern) were used to determine a sonographic score of the activity. The degree of activity was scored from 1 (none) to 4 (high) by both ultrasound and ileocolonoscopy (pattern, extent of typical lesions). For each patient all segments of the colon and the terminal ileum were evaluated by both ultrasound and endoscopy. The weighted kappa test was used (StatXact software) for statistical analysis. RESULTS: In total, 126 bowel segments were evaluated by both ultrasound and endoscopy. The study showed a high concordance of power Doppler sonography and ileocolonoscopy (weighted kappa by region: sigmoid colon: 0.81; transverse colon: 0.78; ascending colon: 0.75; cecum: 0.84; terminal ileum: 0.82). Highest concordance was found in the descending colon (weighted kappa: 0.91; 95% CI: 0.83-0.98). CONCLUSIONS: Combination of B-mode and power Doppler sonography has a high accuracy in the determination of disease activity in Crohn's disease when compared to ileocolonoscopy. The diagnostic criteria established in this study can be useful for the evaluation of inflammatory bowel diseases by ultrasound.

Adolescent↗

PubMed2003

[A case of psoriatic arthropathy complicated with HTLV-I carrier and secondary amyloidosis].

We report a case of psoriatic arthropathy complicated with HTLV-I carrier and secondary amyloidosis. She was a 45-year-old woman and was diagnosed as psoriatic arthropathy and HTLV-I carrier in December 1999. She was treated with combination therapy corticosteroid, salazosulfapyridine, methotrexate, cyclophosphamide, and gold sodium. However, her arthralgia and fever was not completely improved. In April in 2001, she was admitted to our hospital because of nausea, vomiting, and diarrhea. Her colon fiberscopic examination showed rubber, erosion, and multiple ulcers of the rectum through descending colon mucosa. Her biopsied specimens of the colon mucosa showed Congo Red dye stained amyloid deposits. Because the loss of stain for Congo Red dye after exposure to potassium permanganate, the deposits were amyloid A protein. This case is considered as a rare case of psoriatic arthropathy and HTLV-I carrier complicated with secondary amyloidosis in a relatively short period (approximately two years) after onset of psoriatic arthropathy.

Amyloidosis↗

PubMed1978

Induction of colonic adenocarcinoma in the rat by X-irradiation.

In work to determine whether X-radiation could be used to induce tumors of the colon in outbred Holtzman rats, a technique was devised so that only the descending colon could be irradiated with a collimated X-ray beam and tumorigenic exposures in the kilo-Roentgen range were delivered. Ninety male Holtzman rats were divided into 6 exposure groups of 15 animals each. In the first group only the colon was exposed to 2500 R; in the second group the colon was exposed to 3500 R and the exposures were increased by 1000-R increments up through 6500 R; the sixth group was sham irradiated. Animals in each of the irradited groups developed mucoid adenocarcinomas with the highest incidence (47%) obtained inthe 4500-R group. Histopathologically, the induced tumors bear a close resemblance to human colon adenocarcinoma, and the development of pulmonary metastases in one of the animals with multiple primary tumors demonstrated their malignancy. The usefulness of the animal model is discussed.

Adenocarcinoma, Mucinous↗

PubMed1984

Effect of Senokot on rat intestinal electrolyte transport. Evidence of Ca++ dependence.

The mechanism of action of Senokot, a widely used laxative, has not been established. Senokot was given orally to rats 8-14 h before intestinal water and electrolyte transport were studied. Senokot significantly decreased colonic and jejunal water absorption measured in vivo by the single-pass perfusion technique. The Senokot changes were not associated with changes in jejunal or colonic histology or adenylate cyclase activity or colonic cyclic adenosine monophosphate content. Senokot also altered active electrolyte transport in rat descending colon as measured by the Ussing chamber-voltage clamp technique. These changes consisted of an increase in short-circuit current and a decrease in active Na and Cl transport that was due to a decrease in the mucosal-to-serosal fluxes. The changes in active electrolyte transport were dependent on Ca++ in the serosal but not the mucosal bathing solution. In contrast, addition of 10(-4) M verapamil to the serosal surface did not alter the Senokot effect. In spite of a dependence on serosal Ca++, Senokot did not alter 45Ca++ entry across the colonic serosal surface. The phospholipase A2 inhibitor quinacrine (10(-4) M) also did not alter the effect of Senokot on colonic Na and Cl transport. Senokot alters active colonic Na and Cl transport via a presently unknown mechanism that is dependent on serosal Ca++.

Adenylyl Cyclases↗

PubMed1983

Different dose-response relationships in the induction of different types of colonic tumors in Wistar rats by 1,2-dimethylhydrazine.

Four groups of 21 male Wistar rats were given weekly subcutaneous injections of 1,2-dimethylhydrazine at a dose of 20 mg/kg body weight for 2, 4, 6 and 8 weeks, respectively, and 7 animals of each group were killed in weeks 24, 32 and 40. This treatment induced a clear dose-related increase in the total number of colonic carcinomas. The number of tubular adenocarcinomas, which were mostly located in the descending colon, was clearly dose-related, whereas the number of signet ring cell carcinomas, which developed in the ascending colon, was apparently dose-independent.

Adenocarcinoma↗

PubMedDate not supplied

Placement of a colonic stent by percutaneous colostomy in a case of malignant stenosis.

We present a patient with disseminated stomach cancer who presented with symptoms of acute obstruction of the splenic flexure of the colon caused by tumor spread. During a first attempt to insert a colon stent through the anus under endoscopic guidance as final palliative therapy, it was not possible to reach the region of the stricture, and iatrogenic perforation of the descending colon occurred, which resolved favorably under conservative management. A second attempt to insert a stent was made via percutaneous puncture of the transverse colon, approaching the region of the stricture by a descending route. The procedure was completed without complications and the patient's symptoms improved. Stent placement via percutaneous puncture of the colon has not previously been described in the literature. It may be an alternate route in cases of proximal strictures in which access through the anus has been unsuccessful even with the aid of endoscopic guidance.

Colonic Diseases↗

PubMed1979

Conditions affecting prolonged maintenance of mouse and rat colon in organ culture.

The effect of variations in culture conditions on survival of fragments of mouse and rat descending colon in organ culture was studied by morphological and functional criteria. A combination of conditions demonstrated to be beneficial permitted maintenance for at least 35 days. These included: a gaseous environment of 95% O2:5% CO2, an attachment matrix consisting of a Metricel GA-4 membrane (pore size, 0.8 mu), intermittent exposure to the gas and fluid phases by rocking in 5 ml medium and supplementation of the medium with 1.0 microM dexamethasone and 10% FBS. During this time, the crypt structure of the mucosal epithelium was well preserved, and DNA synthesis in the crypts and mucin production in the crypts and superficial epithelium continued. In addition, the synthetic trophic hormone, pentagastrin, stimulated DNA synthesis in the mucosal epithelium of mouse colon fragment in short-term organ culture.

Animals↗

PubMed1992

Inhibition of neuronally mediated secretion in rat colonic mucosa by prostaglandin D2.

The effect of prostaglandin D2 (PGD2) on ion transport across the mucosa of the descending colon was studied in rats. PGD2 dose-dependently decreased baseline short-circuit current of mucosa-submucosal preparations mounted either in the Ussing chamber or mounted as an everted sac. However, with the everted sac technique, the tissue was about 1000 times more sensitive to PGD2. Concomitant with the decrease in short-circuit current, PGD2 increased the mucosal-to-serosal fluxes of sodium and chloride and decreased the serosal-to-mucosal flux of chloride. PGD2 inhibited the secretory action of the PGI2 analogue iloprost, PGD2 alpha, and neurotensin. The action of these secretagogues was dependent on the presence of the submucosal plexus. In contrast, PGD2 had no effect on the increase in short-circuit current caused by PGD2, substance P, or serotonin, the actions of which were not dependent on the presence of the submucosal plexus. The results indicate that the action site of the antisecretory mechanism of PGD2 is localized in the secretomotor neurons.

Animals↗

PubMed1982

Uptake, conjugation and transport of laxative diphenols by everted sacs of the rat jejunum and stripped colon.

Phenolphthalein (PHEN), desacetylbisacodyl (DES) and oxyphenisatin (OXY) were incubated with everted sacs of the rat jejunum and stripped descending colon; the mucosal and serosal fluid were analysed with respect to free and conjugated diphenol by means of HPLC. Conjugates were measured as the amount of free diphenol in completely hydrolyzed samples less the amount before hydrolysis. A study with double-sided administration of PHEN revealed that diphenol uptake from and conjugate output to both sides followed a rectilinear course for 15-90 min. A standard incubation time of 60 min. was chosen for the subsequent experiments, in which the diphenols were administered at the mucosal side at a low and a high concentration. Diphenol uptake, i.e. the amount of free diphenol administered less the amount recovered at the mucosal side, varied in an order (PHEN greater than DES greater than OXY) which seems to be inversely related to the order of water solubility of the compounds. Tissue accumulation and conjugate output relative to uptake varied with the dose, and from one compound to another. At low initial concentration (20 nmol/ml), the compounds were transferred to the jejunal and colonic serosal fluid almost entirely as conjugates (greater than or equal to 95%); the transfer rates followed, qualitatively, the same order as above. In jejunum, more conjugates were released to the mucosal than to the serosal side; in colon the distribution was reversed. Increasing the dose to 100 nmol/ml caused a corresponding increase in uptake, but relative output decreased and tissue accumulation increased; thus demonstrating capacity limitation. With PHEN, the ratio of conjugated:free diphenol on the serosal side remained essentially unchanged; with DES in particular, but also with OXY the ratio decreased. These findings may be interpreted to mean that in case of PHEN capacity limitation is linked to conjugate efflux, while DES and OXY may be poor substrates for glucuronide formation as well. Experiments with serosal side administration like the double-sided PHEN experiments verified the dissimilar conjugate distribution in jejunal and colonic sacs; the phenomenon is to some extent discussed in the text. Identity tests gave evidence that the conjugates were mainly monoglucuronides.

Animals↗

PubMed1994

[Pneumatosis cystoides of the colon: knowing how to recognize it. Apropos of 8 cases].

Eight cases of pneumatosis cystoides intestinalis (PCI) affecting the descending colon at first misdiagnosed in seven of them, are reported. The mechanism of cyst formation remains unclear but certain specific endoscopic and X-ray findings should help in differentiating PCI from other intramural tumors, i.e. polyposis. Diagnostic investigations and management approaches are described. No treatment is necessary in most instances because of the benign nature of PCI.

Adenomatous Polyps↗

PubMed1993

Sex differences in the risks of hormone-dependent cancers.

There are marked variations in the risk of hormone-dependent cancers between males and females, and these are likely to reflect sex differences in endogenous hormone profiles. The authors examined sex differences in the risk of hormone-dependent cancers of sex-shared sites by using data from the England and Wales national cancer registry for 1962-1984. Both breast and thyroid cancers showed marked excesses in risk for women, but the female: male ratio peaked around menopause for breast cancer and a puberty for thyroid cancer, suggesting that although female sex hormones may influence the risk of these two cancers, the mechanisms involved are probably different. In the descending colon, the risk of cancer was greater in females than in males at ages under 60 years, but greatest in males at ages above this, whereas in the ascending colon there were no age-specific differences in risk between the sexes. This is consistent with the hypothesis that female reproductive events may decrease a woman's risk of cancer in the descending but not in the ascending colon. Sex differences in bone cancer risk at puberty, particularly for osteosarcomas and Ewing's sarcomas, paralleled known sex differences in skeletal growth; there was a peak in age-specific rates earlier and lower in girls than in boys. Rhabdomyosarcoma, a soft tissue cancer, also showed a rise in risk at puberty with age differences between boys and girls that correlated with sex differences in muscle growth patterns; this suggests that its etiology may be hormonally related as well.

Adolescent↗