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At least 1,189 records · Page 66Linked to original sources
PubMed1986

[Ogilvie's syndrome: results of endoscopic exsufflation in a series of 29 cases].

The aim of this study was to assess the value of endoscopic decompression of the colon in a series of 29 patients affected with Ogilvie's syndrome. During the first period (1980-1982), 14 patients were treated by colonoscopic decompression alone. During the second period (1982-1985), 15 endoscopic decompressions were systematically completed by intubation of the colon. The tube was removed after 2 to 13 days. Whatever the procedure, endoscopic decompression was successfully achieved in all cases. The death rate (8/29) and number of cecostomies (2/29) were similar in the two groups of patients. Only one death was directly related to Ogilvie's syndrome itself, whereas 7 patients died from other severe underlying diseases. However, colonic dilatation recurred in 6 patients in the first group and in one patient in the second group (p less than 0.05). No complications due to the endoscopic procedures occurred in this series. It may be concluded that endoscopic treatment of Ogilvie's syndrome is a safe and effective procedure. Our results also suggest that colonoscopic intubation should be used prophylactically in order to avoid recurrences, frequently observed after simple endoscopic decompression.

Acute Disease↗
PubMed1986

Establishing a flexible sigmoidoscopy/colonoscopy program for surgical residents. The University of Illinois experience.

The clinical value of lower gastrointestinal endoscopy and the requirement of the American Board of Surgery for endoscopic training mandate establishing a program in flexible sigmoidoscopy and colonoscopy for all surgical residents. In a 12-month period, the surgical residents at the authors' institution performed 599 flexible sigmoidoscopic and 116 total colonoscopic examinations under the supervision of two attending colorectal surgeons, with no mortality and a 0.03 per cent morbidity. There was an average of 42 endoscopic examinations per resident for the 3-week training period. Three hundred seventy (62%) of the flexible sigmoidoscopic examinations were for screening and 229 (38%) were for the evaluation of symptomatic patients. Colorectal polyps were identified in 68 patients (11.4%) and carcinoma in 14 patients (1.9%). Forty-nine per cent of the colonoscopic examinations were for endoscopic polypectomy. Sixty-four per cent of patients with more than one adenomatous polyp harbored polyps in different surgical segments of the colon. Every resident was able to perform flexible sigmoidoscopy safely by the end of the 3-week training period, and in addition, the residents rated their endoscopic experience as a valuable part of their surgical training.

Colonoscopy↗
PubMed1985

[A case report of early rectal carcinoma, IIa + IIc type, with no invasion of the submucosa].

A 66-year-old woman was admitted to the Hakodate Chuo Hospital because of abdominal discomfort. A barium enema study revealed a deformity of the middle Houston's valve of the rectum and granular lesions at the Rb region of the rectum. A colonoscopic examination showed the IIa + IIc type of early rectal carcinoma. A resected specimen also revealed IIa + IIc type early rectal carcinoma, 8 X 13 mm in diameter, and well-differentiated adenocarcinoma with no invasion of the submucosa. Infiltration into the lymphatic vessels and regional lymph node metastasis were not encountered. The deformity of the rectal Houston's valve was checked by a barium enema study. It should be emphasized that early detection of colorectal carcinoma with no invasion of the submucosa, requires careful barium enema studies and colonoscopic examination.

Adenocarcinoma↗
PubMed1985

[Colonic angiodysplasia--its treatment by endoscopic electrocoagulation].

Three patients older than sixty were found to have "lower" gastrointestinal bleeding from colonic angiodysplasia. One of them presented multiple lesions. Throughout five colonoscopic procedures all of them were treated by endoscopic monopolar electrocoagulation, without complications. At 3, 18 and 24 months they were asymptomatic, their hematocrits stabilized and multiple fecal examinations for occult blood remained negative. We emphasized here the diagnostic value of colonoscopic examination and the therapeutic implication of endoscopic electrocoagulation as positive approaches to the management of bleeding colonic angiodysplasia.

Aged↗
PubMed1980

Flexible fibreoptic sigmoidoscopy--an alternative to colonoscopy?

The results of 166 colonoscopic examinations are reported with particular reference to site and nature of the lesion identified. One hundred and fifty-five polyps and 13 colorectal cancers were found, 62 polyps and five cancers being beyond 50 cm from the anal verge. It is suggested that the number of lesions beyond the reach of a flexible fibreoptic sigmoidoscope would be unacceptably high and that there can be no justification for the purchase of such an instrument as an alternative to a full length colonoscope. Whilst the fibreoptic instrument does have advantages as a sigmoidoscope its cost will preclude its widespread use in New Zealand at the present time.

Carcinoma↗
PubMed1982

[Colonoscopy and "hot" biopsy. Its value in vascular ectasias of the colon].

According to Gerald Rogers et. al., we believe about the usefulness of colonoscopy and endoscopic biopsy using Williams' forcep (hot biopsy forcep) for the diagnosis and final treatment of colon vascular ectasias. This method should be used immediately after the hemorrhage has finished. Angiography is prescribed when: 1) endoscopy suggests or confirm the presence of vascular ectasias in order to establish the degree of lesions and the therapeutic management. 2) When the caecum cannot be reached by the colonoscope. 3) When endoscopy is negative and there is firm clinic assumption of ectasias but the colonoscopic study has been done to much later after the bleeding stopped. Selective angiography would be the first prescription in case of bleeding which doesn't stop quickly with the necessity of immediate therapeutic measures taking into account the difficulties of intrahemorrhagic colonoscopy. Five cases are presented to support this point of view concerning the diagnosis of vascular ectasias of the right colon and considerations are made about local treatment by mean of colonoscopy and hot biopsy forcep which, when it's possible, has less morbidity and mortality than surgery, specially in attention than this is an entity concerning elderly patients.

Aged↗
PubMed1981

Segmental tuberculosis of the colon diagnosed by colonoscopy.

Segmental tuberculosis of the colon is a rare clinical entity. In the absence of pulmonary or ileocecal involvement, colonic tuberculosis may be difficult to differentiate from neoplasm or Crohn's disease by symptomatic and radiological means. Colonoscopy and biopsy can, however, establish the diagnosis and prevent operative intervention, as indicated in the present report. A patient with a radiologically demonstrated strictured lesion of the sigmoid colon was found at colonoscopy to have several hemorrhagic transverse ulcers ranging in diameter between 1-4.5 cm. Multiple target colonoscopic biopsies, specifically from the ulcer beds, revealed necrotizing granulomas and acid-fast bacilli. Antituberculous chemotherapy produced remarkable symptomatic, radiographic and endoscopic improvements and averted exploratory laparotomy for the establishment of the diagnosis. This case report points out the importance of colonoscopic biopsy as a useful diagnostic modality in this disease.

Biopsy↗
PubMed1980

Campylobacter colitis presentin as inflammatory bowel disease with segmental colonic ulcerations.

Campylobacter fetus subspecies have recently been recognized as an important cause of diarrheal illness in humans. We report a case of culture positive C. fetus colitis with colonoscopic findings of segmental mucosal edema, loss of normal vascular pattern with ulceration, and patchy involvement of mucosa. These colonoscopic findings were similar to those seen in granulomatous colitis. However, these findings may be difficult to distinguish from a number of other colonic mucosal diseases such as antibiotic-associated colitis, amebiasis, shigellosis, salmonellosis, invasive E. coli colitis, and ischemic colitis. On histopathologic examination of the mucosa, acute and chronic colitis with crypt abscess formation, mucosal atrophy, and mucous depletion was found which suggested the diagnosis of chronic ulcerative colitis. Cryptitis and crypt abscess are not specific to chronic ulcerative colitis alone and can be seen in many nongranulomatous inflammations of the colonic mucosa. Therapy with erythromycin led to prompt clinical improvement, clearance of the pathogen, and normalization of the colon by repeat examination 11 days after the initiation of the therapy.

Campylobacter Infections↗
PubMed1980

Endoscopic surveillance for cancer in chronic ulcerative colitis.

Severe epithelial dysplasia in multiple colonscopic biopsy specimens may held identify those patients with chronic ulcerating colitis (CUC) at highest risk for developing colonic cancer. This retrospective analysis of 75 patients with longstanding CUC studied by colonoscopy and biopsy disclosed 11 patients with cancer. Four of these cancers were detected by surveillance colonoscopy and seven were detected by diagnostic colonoscopy. There was a high correlation between the presence of dysplasia and cancer in the patients. Cancer was found in five of seven patients who underwent operation after colonoscopic biopsies showed severe dysplasia. No cancers were found at operation in 15 patients whose colonoscopic biopsy specimens were free of dysplasia. Dysplasia can be consistently identified. A reviewing pathologist agreed with the initial biopsy diagnosis in 59 of 64 cases (92%) and with the colectomy diagnosis in 18 of 21 (86%). Colonscopy with multiple biopsy specimens is a valuable surveillance technic. Patients without dysplasia on biopsy should have continued surveillance.

Adult↗
PubMed1979

Malignant potential of chronic ulcerative colitis. Preliminary report.

Prior studies confirm the increased incidence of carcinoma of the colon in chronic ulcerative colitis. The authors reviewed clinical and histologic data retrospectively in 23 patients with colon carcinoma and chronic ulcerative colitis. Twenty-two of these patients had dysplasia of colonic epithelium remote from the cancer. The authors prospectively reviewed clinical data and rectal and colonoscopic biopsy specimens on 36 patients with chronic ulcerative colitis, 12 with Crohn's colitis, and 12 with miscellaneous disorders. Eight patients with chronic ulcerative colitis had dysplasia; 6 have had colectomy, and 2 of these had carcinoma. No patient without chronic ulcerative colitis had dysplasia. Patients with chronic ulcerative colitis should have periodic rectal and colonoscopic biopsies, and those with moderate to marked dysplasia require colectomy because of the increased risk of colon carcinoma.

Adolescent↗
PubMedDate not supplied

Intestinal polyps in children and adolescents--a review of 103 cases.

Juvenile polyps are the most common tumors of the gastrointestinal tract in children and are the principal cause of hematochezia. A total of 103 children and adolescents with intestinal polyps have been treated in Veterans General Hospital-Taipei from March 1961 to March 1994. The diagnosis included 87 cases (84.5%) of juvenile polyps, 2 cases of isolated adenomatous polyp and 14 cases of inherited polyposis syndrome. Juvenile polyps most often occur in children between 2 to 10 years old, with a male-to-female ratio of 1.4:1. Rectal bleeding was the main symptom (97.7%). Of the 87 patients, 82.8% had isolated polyps and 83.3% of those were located in rectosigmoid colon. After extensive use of colonoscopy, the reported incidence of multiple polyps substantially increased, and more polyps were found proximal to the rectosigmoid colon. Most juvenile polyps were removed by colonoscopic polypectomy. The recurrent rate was 10.2%. One of the two cases of juvenile polyposis coli suffered from intussusception demanding partial colectomy. Recurrent polyps were found in the remaining colon and were removed by colonoscopic polypectomy. Seven patients of Peutz-Jeghers syndrome came from five families. At initial diagnosis, one case had no polyps and two presented with intussusception. A 19-year-old girl was found to have bilateral ovarian cysts. One of the three familial adenomatous polyposis had adenocarcinoma at initial evaluation. Two cases of Gardner's syndrome received sulindac treatment, and no evidence of malignancy was found after three years of follow-up.

Adenomatous Polyposis Coli↗
PubMed1995

Raised carcinoembryonic antigen level as an indicator of recurrent disease in follow up of patients with colorectal cancer.

BACKGROUND: Serum carcinoembryonic antigen level is raised in 80% of patients undergoing colonic resection for cancer. Subsequent elevation in the follow-up period may precede signs and symptoms as an indicator of recurrent disease. there is little evidence that "classical" follow up of patients in the general surgical outpatient clinic improves either survival or quality of life. Regular carcinoembryonic antigen level estimation requested by the general practitioner, allied to day-case colonoscopic surveillance may be a more rational approach. AIM: A study was undertaken to investigate the relationship between raised carcinoembryonic antigen level and the recurrence of colorectal cancer in patients following a curative primary resection. METHOD: Retrospective analysis was carried out on the notes of 125 patients who had attended a dedicated hospital colorectal follow-up clinic between 1988 and 1992. Carcinoembryonic antigen level data were obtained by subsequent examination of the University of Edinburgh Department of Clinical Chemistry (immunoassay section) carcinoembryonic antigen database. RESULTS: A single carcinoembryonic level result of more than 100 ul-1 (normal range less than 60 ul-1) was found to be a highly sensitive (87%), specific (89%), and accurate (88%) indicator of recurrent disease. Raised carcinoembryonic antigen level preceded symptoms in 72% of patients with recurrence of colorectal cancer. CONCLUSION: Sequential laboratory estimation of carcinoembryonic antigen level organized by the general practitioner may represent an accurate method of detecting recurrent colorectal disease. Hospital review could be limited to colonoscopic surveillance and restaging of patients referred with evidence of recurrent disease.

Adult↗
PubMedDate not supplied

Colonoscopy for unexplained lower gastrointestinal bleeding in a tropical country.

Two hundred and forty consecutive patients with recurrent lower gastrointestinal bleeding were studied by colonoscopic examination. These included 187 adults and 53 children. The procedure was successful either in identifying the lesion or in excluding it up to the cecum in 216 (90% patients). The source of bleeding was identified in 138 (74%) adults and 43 (81%) Children. Predominant lesions in adults were nonspecific colitis and ulcers (58%), polyps (19%), cancer (10%), rectal varices (4%) and tuberculosis (3%). Juvenile polyps (77%) and nonspecific colitis and ulcers (23%) were the cause of bleeding in children. Both in adults and children, 92% of these lesions involved the left colon. Rectum and sigmoid colon were mainly involved. Diffuse lesions were seen when nonspecific colitis and ulcers were the source of bleeding. Thus colonoscopic examination was useful in localizing the cause of rectal bleeding and the predominant lesions were different from those reported in the Western hemisphere.

Adult↗
PubMed1995

Diagnostic yield of routine ileoscopy.

Intubation of the ileum during colonoscopy, although well described, is not routinely performed. It can establish the completeness of colonoscopic examinations and is useful in the diagnosis of inflammatory bowel disease. However, the diagnostic utility of routine ileoscopy during all colonoscopic procedures has not been well studied. We prospectively evaluated ileal intubations in 138 patients undergoing colonoscopy. The incidence of a positive diagnosis from ileoscopy was 2.7% in asymptomatic patients undergoing surveillance colonoscopy, and 29% of patients complained of diarrhea (18% in non-HIV patients, 67% in HIV-positive patients). We feel ileal intubation is an important adjunct to colonoscopy, especially in patients with diarrhea.

Colonoscopy↗
PubMed1995

Effects of thromboxane synthase inhibition on in vivo release of inflammatory mediators in chronic ulcerative colitis.

OBJECTIVE: To evaluate the effects of a thromboxane inhibitor on the production of eicosanoids by the colonic mucosa of patients with chronic ulcerative colitis. PATIENTS AND METHODS: Fourteen patients with active left-sided ulcerative colitis were divided into in two treatment groups. Seven patients received oral ridogrel (300 mg twice daily) and seven 5-aminosalicylic acid (5-ASA; 1 g twice daily) for 4 weeks. Intracolonic eicosanoid and elastase release were measured using a colonic double-lumen perfusion technique. An isotonic solution was infused 50 cm from the anal verge at the rate of 5 ml/min, and recovered by siphonage 30 cm distally. Effluents were assayed for thromboxane B2 (TXB2), prostaglandin E2 (PGE2), and leukotriene B4 (LTB4) by radioimmunoassay (RIA), and for polymorphonuclear elastase by immunoactivation. Clinical and colonoscopic criteria were used to determine activity before and after treatment. RESULTS: Four of the seven patients in the ridogrel group and five of the seven in the 5-ASA group showed clinical and colonoscopic improvement. Intraluminal elastase release decreased in every responding patient in the 5-ASA group (P < 0.05) and in three out of seven responders in the ridogrel group. Basal eicosanoid release was similar in both groups. In the responders, 5-ASA significantly reduced the release of the three eicosanoids (P < 0.05). Ridogrel reduced the release of TXB2 to 31% of basal levels (P < 0.01) but the release of PGE2 and LTB4 was not affected. CONCLUSIONS: These results suggest that ridogrel is an oral active selective inhibitor of thromboxane synthetase, which modifies the pattern of colonic eicosanoid generation in patients with chronic ulcerative colitis. Oral ridogrel may be a useful treatment for patients with non-severe ulcerative colitis, although specific indications require further studies.

Adult↗
PubMed1994

[Colonoscopy monitoring intervals after polypectomy of adenomas of the large intestine in patients younger than 40 years of age].

A group of patients younger than 40 years of age, who had been subdued to endoscopic large intestine adenoma polypectomy were compared with the rest of the patients regarding the adenoma occurrence according to sex, localisation, histologic character, frequency of recurrence, and carcinoma formation in the large intestine in the site of previous polypectomy. The compared groups of patients differed merely in time of recurrence. In patients over 40 years of age the adenomas reoccurred most frequently in the first and fifth years following the primary polypectomy. In patients after primary polypectomy regular colonoscopic controls were suggested, namely after the first year and subsequently after every two years. This scheme is appropriate also for patients under the age of 40 years. Therefore the recommended intervals of colonoscopic controls at this age category do not require to be subdued to alteration. (Tab. 14, Ref. 5.)

Adenoma↗
PubMedDate not supplied

Perendoscopic manometry of the distal ileum and ileocecal junction: technique, normal patterns, and comparison with transileostomy manometry.

The technique of perendoscopic manometry was used to study the motor patterns of the ileocecal junction and distal ileum. An expert endoscopist cannulated the distal ileum of 20 unsedated subjects in 260 +/- 252 (mean +/- SD) seconds, causing no discomfort beyond that of an ordinary colonoscopic examination. No sphincter-like motor activity was detected at the ileocecal junction, and four distinct motility patterns were identified in the distal ileum: (1) tone variations, (2) slow phasic contractions, (3) regular rapid phasic contractions, and (4) prolonged rapid phasic contractions. Previous appendectomy and insertion of the colonoscope into the distal ileum to position the manometric catheter did not affect the manometric recordings. Perendoscopic manometry of the distal ileum was compared with transileostomy manometry in 9 subjects. Perendoscopic and transileostomy manometric recordings showed the same motor patterns except for a longer occurrence of tone variations with perendoscopic manometry. In conclusion, this study shows that perendoscopic manometry of the distal ileum and ileocecal junction is feasible; recorded motor patterns are not affected.

Adolescent↗
PubMedDate not supplied

[Colonoscopy and digital cytometry in the clinical assessment of prolonged non-specific ulcerative rectocolitis].

UNLABELLED: Twenty-one patients having ulcerative colitis (U.C.) for a period of seven or more years, and considered as being in the risk group for developing large bowel neoplasia, were studied according to the following procedures: 1) colonoscopic examination for macroscopic identification of mucosal alterations and obtainment of multiple biopsies; 2) histologic examination of mucosal biopsies; 3) quantification of mucosal-cell DNA using digital cytometry. The duration of disease in these patients ranged from seven to 33 years, with an average of 14 years. In three patients colonoscopic images showed vegetant lesions suggestive of malignancy. The association of UC with cancer occurred in 14% of cases. Colonoscopy was efficient in providing accurate diagnosis in all cases and also allowed a successful endoscopic resection of an aneuploid neoplastic lesion. Digital cytometry revealed diploid DNA histogram in all phases of U.C. and aneuploid in cases with association of UC and neoplastic development. CONCLUSION: these three methods together should be utilized in the follow-up of patients with long standing ulcerative colitis.

Adult↗