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At least 1,081 records · Page 60Linked to original sources
PubMed1982

Esophageal replacement in infants and children bv colon interposition.

Colon replacement for the esophagus was used successfully in 20 of 21 pediatric patients. Intrathoracic placement of the colon segment was done in 18. Careful preparation and operative experience combined to reduce operative morbidity and mortality in an unfortunate group of patients. Satisfactory long-term results have been achieved. Careful technique, attention to detail, and perfection of a single technique may be more important than performing new surgical techniques when they are reported. Colon interposition performed by the Waterston technique utilizing the transverse colon is an effective means of substitution for a diseases esophagus in children.

Body Weight↗
PubMed1992

Management of blunt and penetrating colon injuries.

The records of 28 patients with traumatic colon injuries (TCI) were retrospectively reviewed. Sixteen patients (57%) with 17 TCI had blunt trauma, whereas 8 patients (29%) experienced penetrating trauma. Four TCI were from intraluminal injury. Blunt trauma commonly involved the left colon, whereas penetrating trauma usually involved the right or transverse colon. Fifty-nine percent of the blunt TCI were treated with primary repair, including resection and primary anastomosis, as were 88% of the penetrating TCI. Shock, transfusion requirement of more than 4 units, contamination, and associated injuries did not necessarily preclude primary repair. One of 16 patients (6%) who underwent primary repair developed morbidity related to the colon injury. The morbidity rate for the colostomy group was 13% (1 of 8). The mortality rate was 13% in the patients who experienced external trauma (3 of 24). Two of these deaths were related to severe head injury and chest injury, respectively. These data represent a much higher proportion of blunt injuries to the colon than is reported in the literature. The low rate of morbidity for all patients treated by primary repair tends to support the more liberal trend toward this technique for both blunt and penetrating TCI.

Adult↗
PubMed1986

Colonic obstruction in a child with von Recklinghausen's neurofibromatosis.

A child is reported who developed partial colonic obstruction from an intussuscepting polypoid mass in the transverse colon. A 5 cm plexiform ganglioneurofibroma was found at laparotomy. Examination of the entire gastrointestinal tract revealed no other neurogenic tumors. Gastrointestinal involvement by neurofibromatosis in children is rare; however, children with von Recklinghausen's disease who complain of vague abdominal symptoms should be evaluated for gastrointestinal tumors.

Child↗
PubMed1998

Milking action: a new functional concept of a different orthotopic neobladder: 4-year followup.

PURPOSE: We demonstrate how the combined use of detubularized and remodeled intestine with intact cecum in the construction of an orthotopic colonic neobladder determines different functioning. MATERIALS AND METHODS: Since February 1993, 11 men who underwent radical cystectomy due to invasive bladder carcinoma have received a new bladder substitute consisting of an upper component of ascending colon and a detubularized and remodeled right half of transverse colon, and a lower component with intact cecum. During postoperative years 1 and 4 all patients were evaluated with urodynamics and cystography. RESULTS: The detubularized upper component of the neobladder acts as a large capacity, low pressure filling reservoir, while the intact cecum with its haustral contractions (inverted milking action) contributes as an additional continence mechanism. The mass contractions (milking action) with abdominal wall tension actively collaborate to evacuate the reservoir completely. CONCLUSIONS: This new structural concept of a neobladder constructed from detubularized and intact intestine has a different functional behavior than neobladders described in literature. This neobladder enables complete evacuation and total continence in the immediate postoperative period.

Cecum↗
PubMed2002

Patient pain during colonoscopy: an analysis using real-time magnetic endoscope imaging.

BACKGROUND AND STUDY AIMS: Colonoscopy is generally perceived as being a painful procedure. Contributory factors are: stretching of the colonic wall and mesenteric attachments from looping of the instrument shaft, overinsufflation, the degree of torque or force applied to the colonoscope shaft, and patient pain threshold. The aim of this study was to determine the frequency of pain episodes experienced during diagnostic colonoscopy and the corresponding colonoscope configuration, utilizing real-time magnetic endoscope imaging (MEI). PATIENTS AND METHODS: Consecutive outpatients undergoing colonoscopy were studied. Patients with previous colonic resections were excluded. Procedures were commenced with antispasmodics only, and patient sedation was self-administered whenever significant discomfort was experienced, using a patient-controlled analgesia (PCA) syringe pump. All "demands" were correlated with the MEI record, which was subsequently analysed. RESULTS: A total of 650 demands were recorded in 102 patients. Seventy-seven percent of all demands occurred with the colonoscope tip in the sigmoid colon, 7 % in the descending colon, 6 % at the splenic flexure, 5 % in the transverse colon, and 4 % in the proximal colon. Ninety percent of all pain episodes coincided with either looping (79 %) or straightening of the colonoscope shaft (11 %); presumed overinsufflation being an infrequent cause of pain (9 %). Of the loops encountered during colonoscopy, the N-sigmoid spiral loop was associated with the majority of pain episodes (56 %). Looping was both more frequent ( P = 0.0002) and less well tolerated in women than in men ( P = 0.0140). CONCLUSIONS: This study is the first to document pain at colonoscopy accurately. Looping, particularly in the variable anatomy of the sigmoid colon, is the major cause of pain, especially in women. Use of MEI may improve pain control by facilitating the straightening of loops within the sigmoid colon, and by enabling the endoscopist to target patient analgesia.

Analgesics↗
PubMedDate not supplied

CT features of primary colorectal signet-ring cell carcinoma.

PURPOSE: The purpose of this work was to evaluate the CT features of 15 patients with primary colorectal signet-ring cell carcinomas. METHOD: We retrospectively reviewed the CT scans of 15 patients (mean age 44 years) with pathologically proved colorectal signet-ring cell carcinoma. On CT, we evaluated the site and length of the tumor, bowel wall thickening patterns, perirectal or pericolic infiltration, the presence or absence of colonic obstruction, and metastasis to other organs. RESULTS: The tumors were located in the rectum in nine patients, the sigmoid colon in one, the hepatic flexure in one, the transverse colon in one, the ascending colon in two, and the cecum in one. The tumor length ranged from 4.0 to 10.0 cm (mean 6.1 cm) with mean thickness of 2.1 cm. CT showed concentric bowel wall thickening in all patients ("even" in 8 and "uneven" in 7), target appearance was noted in 4, perirectal or pericolic infiltrations were moderate to severe in 12, and colorectal obstruction was seen in 6. In the tumor spread patterns, lymphadenopathy was noted in 13, invasion to adjacent pelvic organs in 5, peritoneal carcinomatosis in 4, liver metastasis in 2, and periureteric metastasis in 1. CONCLUSION: Primary signet-ring cell colorectal carcinoma should be included for differential consideration when CT shows a long length of concentric bowel wall thickening and target sign, especially when such findings occur in the rectum and in young patients.

Adolescent↗
PubMed1996

Alcohol dehydrogenase in the human colon and rectum.

Alcohol dehydrogenase (ADH) activities were measured in rectal biopsies from 55 patients (28 males, 27 females aged 22-81 years), in colonic biopsies from 19 patients (10 males, 9 females aged 21-81 years) and in three surgical specimens. All patients had normal mucosa as determined by light microscopy. The activity of rectal ADH was comparable to gastric ADH activity and did not exhibit any significant gender effect (5.5 +/- 1.1 vs. 6.7 +/- 1.0 nmol/mg protein x min; nonsignificant). No significant correlation was found between age and rectal ADH activity. Compared to ADH activities in other colonic segments, rectal ADH activity was found to be significantly increased (ascending colon: 3.9 +/- 0.7 nmol/mg protein x min; p < 0.05; transversal colon: 3.4 +/- 1.1 nmol/mg protein x min; p < 0.05; descending colon 2.3 +/- 0.4 nmol/mg protein x min; p < 0.001; rectum 6.1 +/- 0.8 nmol/mg protein x min). This higher activity of ADH in the rectum could result in increased acetaldehyde levels after alcohol administration and could therefore play a role, at least in part, in the ethanol-associated rectal cocarcinogenesis.

Adult↗
PubMed1975

[Bursa omentalis hernia through Winslow's foramen].

The case of a 61 year old female patient suffering from an incarerated hernia through the foramen of Winslow into the lesser sac is discussed. The hernia contained the terminal ileum (20 cm) with caecum, part of the appendix, the ascending colon, hepatic flexure and the first third of the transverse colon. This type of hernia is one of the rarer forms which may occur. After surgical reposition of the hernia contents and closure of the foramen of Winslow, the patient recovered completely and was discharged.

Aged↗
PubMed2006

[Meta analysis of 2025 cases with multiple primary colorectal carcinoma].

OBJECTIVE: To summarize the clinicopathological characteristics of multiple primary colorectal carcinoma. METHOD: With "multiple primary colorectal carcinoma" as search words,and with the same inclusion and exclusion criteria, related Chinese literatures published were retrieved. A meta analysis was carried out. RESULTS: The incidence of multiple primary colorectal carcinoma was 2.9%; and the average age was 53 years. 55.2% of the cases with synchronous multiple primary colorectal carcinoma were diagnosed by fiberoptic colonoscopy before operation,37.5% by intraoperative exploration, 15.7% by postoperative pathology. 94.8% of the cases with metachronous multiple primary colorectal carcinoma were diagnosed by fiberoptic colonoscopy before operation,and the average interval was 5.2 years. 30.9% of the lesions were located in the rectum, 19.9% in the sigmoid, 9.0% in the descending colon, 5.2% the in splenic flexure, 9.1% in the transverse colon, 6.1% in the hepatic flexure, 11.8% in the ascending colon,and 8.1% in the caecum. 37.6% of the cases were complicated with extra- intestinal lesions,and 43.7% adenoma or polyps. 34.6% of the cases had lymph node metastasis. Histological type was the same in 60.6% of the cases,and adenocarcinoma accounted for 89.2% and cancerization of adenoma 8.4%. Radical resection was performed in 85.9% and palliative resection in 10.1% of the cases. The 3, 5, 10 and 15 year survival rates were 64.3%, 44.6%, 26.3% or 9.4% in synchronous multiple primary colorectal carcinoma respectively, and 69.6%, 59.2%, 45.0%, 36.7% in metachronous multiple primary colorectal carcinoma. CONCLUSIONS: Multiple primary colorectal carcinoma is rare in clinic. The diagnosis mainly depends on colonoscopy and intra-operative exploration. The resection rate is high and the prognosis is better. The prognosis of metachronous multiple primary carcinoma is better than that of synchronous multiple primary colorectal carcinoma.

Adolescent↗
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↗
PubMed1984

Morphology and distribution of 1,2-dimethylhydrazine dihydrochloride-induced colon tumors and their relationship to gut-associated lymphoid tissue in the rat.

The histopathology and relationship of sym-dimethylhydrazine dihydrochloride [(DMH) CAS: 306-37-6; 1,2-dimethylhydrazine dihydrochloride]-induced colon tumors to colonic lymphoid aggregates were examined in outbred male Sprague-Dawley rats treated with saline or DMH and sacrificed at three intervals after treatment. The ratio of polypoid:sessile tumors was 71:29 four months after DMH treatment and 62:38 when tumors were fully developed. Colonic lymphoid aggregates were found 3-5 cm from the cecal-colonic junction, near the flexure of the ascending and transverse colon, and 3-5 cm from the rectum. There were no significant differences between saline-treated and DMH-treated rats regarding the size, cellularity, and number of lymphoid aggregates per rat. A significant association (P less than .001) was seen between tumor development and the presence of a lymphoid aggregate in a given segment of the colon. Sessile adenocarcinomas, but not polypoid tumors, were significantly associated (P less than .001) with lymphoid aggregates and usually presented as mucinous tumors adjacent to or intermixed with the lymphoid tissue.

1,2-Dimethylhydrazine↗
PubMed1982

[New prospective trends in the diagnosis and treatment of gastrointestinal cancer].

The report deals with a 15-year long experience gained by the clinical staff of the Institute in treating more than 3,500 patients with gastro-intestinal tumors. In recent years, the research conducted by the staff has been focused on further improvement procedures for malignant tumors of this localization. Both surgical procedures and methods of combination and complex therapy have been improved. For example, since 1967 all operations for rectal tumors have been performed by two teams of surgeons working simultaneously. Most perineal wounds have been closed by sutures and vacuum-drained. Extraperitonization of enterstomy is considered to be an indispensable component of colon resection procedure. Lienal angle and distal third of transverse colon are being used on a large scale in performing abdominoanal resections. The results of treatment of more than 250 patients have demonstrated the advantages of preoperative radiation therapy application for rectal tumors. Extensive use has been made of endolymphatic chemotherapy in cases of stomach neoplasms and regional endovascular chemotherapy for malignant rectal tumors.

Drug Therapy, Combination↗
PubMedDate not supplied

[The results of the diversion of urine into a large-intestine reservoir].

Cystectomy for bladder cancer with derivation of the urine into the colon was performed in 35 patients (30 males and 5 females). Postoperative lethality was 11.4% (4 patients). The best outcomes in cases of partial and/or complete failure of the ileocecal valve were obtained when forming the invaginate in the stomal ileum. Examination following the surgery was conducted in 31 patients. Of them, preoperative passage from the upper urinary tracts was impaired in 22 (71%) because of the tumor spread into the ostium urethritis. Postoperative defect from the upper urinary tracts was recorded in 7 (22.6%) patients, while normal function of the kidney was registered in 24 out of 31 patients (77.4%). A complete retention of the urine was achieved in 27 of 31 patients (87.1%). With time, the capacity of the colon reservoir increased up to 750 +/- 57.9 ml to the end of the second postoperative year. The right part of the colon, cecum or ascending colon as well as the proximal third of the transverse colon as the reservoir served satisfactorily.

Adult↗
PubMed1995

Continent colonic conduit for the treatment of faecal incontinence associated with disordered evacuation.

A transverse colonic conduit incorporating an intussusception valve and skin-flapped cutaneous aperture was constructed in nine patients with combined faecal incontinence and disordered evacuation. Intestinal continuity was restored with a colocolonic anastomosis. Median follow-up was 4 (range 2-15) months and daily irrigation with a median of 1.2 (range 0.3-2.0) litres of water resulted in evacuation in less than 1 h. At 1 month after operation there was no leakage of solid or liquid faeces from the anus between irrigations. The valve was continent to faeces and irrigation fluid, and no stoma appliances were required.

Adolescent↗
PubMed2003

Cholinergic transmission to colonic circular muscle of children with slow-transit constipation is unimpaired, but transmission via NK2 receptors is lacking.

Tachykinins (TKs) colocalize with acetylcholine in excitatory motor neurones supplying human colonic circular muscle (CCM). Some children with slow-transit constipation (STC) have reduced TK-immunoreactivity in nerve terminals in CCM suggesting a deficit in neuromuscular transmission. This study aimed to test this possibility. Seromuscular biopsies of transverse colon were obtained laparoscopically from STC children (37, 17 with low density of TK-immunoreactivity). Specimens of transverse (17) and sigmoid colon (20) were obtained from adults undergoing colonic resection for cancer. CCM contractions were measured isotonically and responses to carbachol, neurokinin A (NKA) and electrical field stimulation (EFS) recorded. Carbachol and NKA-evoked contractions in adult and STC colon. Hyoscine (2 micromol L-1) significantly depressed responses to EFS in all preparations. Blockade of NK2 receptors (SR 48968, 2 micromol L-1) significantly depressed EFS-evoked contractions of adult transverse CCM, but had no effect on STC preparations. Thus, neuromuscular transmission in both adults and STC children is predominantly cholinergic and this component is unimpaired in the latter, indicating that reduced TK-immunoreactivity is not a marker for depressed cholinergic responses. Although pharmacologically responsive TK receptors are present in STC colon, we did not detect neuromuscular transmission mediated by release of TKs in these preparations.

Adolescent↗
PubMed1991

Squamous carcinoma of the colon: primary or metastatic?

A patient is reported who developed a tumour of the transverse colon, which at presentation appeared histologically and clinically to be a primary squamous cell keratinizing carcinoma, arising from an area of in situ carcinoma in the colonic epithelium. However, she had had a stage 1 cervical carcinoma treated by Wertheim's hysterectomy 7 years previously and although there were no other signs of recurrence, this raised the possibility that the lesion might be metastatic. Thirty-seven previously reported cases of primary squamous carcinoma of the colon and those of squamous carcinoma metastasizing to the colon and mimicking primary lesions are reviewed.

Carcinoma in Situ↗
PubMed1979

Colonic tuberculosis diagnosed by colonoscopic biopsy.

A patient with pulmonary tuberculosis and a constricting transverse colon lesion on barium enema was found at colonoscopy to have a 1.5 X 3.0 cm ulcer with irregular, edematous borders. Multiple colonoscopic biopsies of the ulcer revealed acid-fast bacilli with absence of granulomas. Previously, the diagnosis of colonic tuberculosis had been thought to require laparotomy for confirmation. The authors now suggest that colonoscopic biopsy may be a desirable alternative in selected cases.

Biopsy↗
PubMed1995

The association of reproductive and menstrual characteristics and colon and rectal cancer risk in Wisconsin women.

Reproductive and menstrual characteristics were ascertained by telephone interview from Wisconsin women with newly reported diagnoses of carcinoma of the colon (n = 536) and rectum (n = 243) and 2315 population control subjects. The relationships of parity, age at first full-term pregnancy, age at menarche, regularity and length of menstrual cycles, age at menopause, and type of menopause to colon and rectal cancer were examined. In our study population, no reproductive or menstrual characteristics were significantly associated with colon cancer, although subsite analyses suggested an increased risk for transverse colon cancer in women reporting irregular menstrual cycles. Only parity was associated with rectal cancer; women who had given birth five or more times were at significantly lower risk compared to those who were nulliparous (odds ratio: 0.60; confidence interval: 0.36, 0.99). The odds ratio per birth also suggested an inverse association. These data give little support to the hypothesis that female reproductive events modify colon and rectal cancer risk.

Adult↗