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Electrical potential changes and contractile activity of the distal cecum of turkeys.

Bipolar electrodes and strain gauge transducers were implanted on the distal cecum, ileum, and colon of turkeys in order to describe 1) cecal motility, 2) relationships between cecal, ileal, and colonic motilities, 3) events occurring in these organs during cecal evacuation, and 4) cecal electric slow waves. Two types of contractions were recorded in the cecum: those with low amplitude occurring at 2.6/min (minor) and those with higher amplitude occurring at 1.2/min (major). About one-half of the time the former occurred in coordination with contractions in the colon and ileum at the same frequency but slightly out of phase. Major contractions appeared to be propagated, and aborad propagation was twice as common as orad. Accumulation of ingesta in the cecal tip was apparently prevented by contractions arising in the distal cecum and moving orad having a much greater amplitude than those moving aborad. As many as six or seven major contractions occurred during the last 2 min prior to cecal evacuation; one or two similar high amplitude contractions occurred in the ileum and colon at this time. Electric slow waves were rarely recorded in the ceca.

Animals↗

Population of Salmonella typhimurium in the cecum of gnotobiotic chickens.

To test the interaction of various species of bacteria with Salmonella typhimurium, levels of S. typhimurium were measured in the cecum of gnotobiotic chickens inoculated with various test bacteria and subsequently with S. typhimurium. The population of S. typhimurium was suppressed in the cecum of chickens previously inoculated with Escherichia coli. Populations of Bacteroides vulgatus, Clostridium perfringens, Bifidobacterium thermophilum, or Lactobacillus acidophilus were transiently, though not significantly, suppressed by S. typhimurium. Inoculation of chickens with C. perfringens caused a terminal increase in the population of S. typhimurium. Thus the effect of cecal contents on reducing the levels of S. typhimurium in the cecum may be due to the presence of E. coli in the cecal contents.

Animals↗

Fecal loading in the cecum as a new radiological sign of acute appendicitis.

AIM: Although the radiological features of acute appendicitis have been well documented, the value of plain radiography has not been fully appreciated. The aim of this study was to determine the frequency of the association of acute appendicitis with images of fecal loading in the cecum. METHODS: Plain abdominal radiographs of 400 patients operated upon for acute appendicitis (n = 100), acute cholecystitis (n = 100), right acute pelvic inflammatory disease (n = 100) and right nephrolithiasis (n = 100) were assessed. The presence of fecal loading was recorded and the sensitivity and specificity of this sign for acute appendicitis were calculated. RESULTS: The presence of fecal loading in the cecum occurred in 97 patients with acute appendicitis, 13 patients with acute cholecystitis, 12 patients with acute inflammatory pelvic disease and 19 patients with nephrolithiasis. The sensitivity of this sign for appendicitis was 97% and its specificity to this disease was 85.3%. Its positive predictive value for appendicitis was 68.7%; however, its negative predictive value for appendicitis was 98.8%. CONCLUSION: The present study suggests that the presence of radiological images of fecal loading in the cecum may be a useful sign of acute appendicitis, and the absence of this sign probably excludes this disease. This is the first description of fecal loading as a radiological sign for acute appendicitis.

Acute Disease↗

Entamoeba histolytica: electrophoretic isoenzyme patterns of strains and their virulence in the cecum of gerbils (Meriones unguiculatus).

Six strains of Entamoeba histolytica isolated from humans were characterized by their electrophoretic isoenzyme patterns and by virulence in the cecum of Mongolian gerbils (Meriones unguiculatus). Amebae from symptomatic cases of amebiasis were found to belong to zymodeme group II, whereas strains isolated from asymptomatic infections belonged to zymodeme groups I or V. Strains recently isolated from symptomatic cases of amebiasis were highly invasive in the cecum of gerbils. The most prominent pathologic changes present in these infections were the destruction of the interglandular epithelium, crypt hyperplasia and trophozoite invasion of the crypts and submucosa. Strains from asymptomatic carriers were of low or moderate invasiveness in the animal model. Two of the carrier strains expressing a zymodeme group I pattern caused diffuse or transient focal erosions of the interglandular epithelium in some animals. Trophozoites of carrier strains did not invade the crypts nor cause sloughing of the surface epithelium. Presence of colonic lesions was correlated with passage of motile trophozoites in the feces. The severity of histologically demonstrable lesions in the cecum of gerbils was positively correlated with the isoenzyme patterns characteristic of the more virulent amebic strains.

Animals↗

Microvascular circulation of the cecum in horses.

The microvascular circulation of the cecum was studied in 15 adult horses, using microangiography and light microscopy combined with gross studies and scanning electron microscopy of vascular replicas. After heparinization, the horses were euthanatized and the cecum was transected at the cecocolic junction. Blood was flushed free of the circulation with isotonic NaCl and the cecal lumen was slightly distended. In 6 horses, the vascular system was injected with a modified radiopaque medium and evaluated radiographically. Sections evaluated radiographically were also prepared for histologic examination by standard methods. Eight horses were injected with 1 of 2 types of plastics and studied grossly or by scanning electron microscopy. In 1 additional horse, the lateral and medial arteries were injected with different colored plastic for gross studies. The lateral and medial cecal arteries appear to supply the respective areas of the cecum with minimal mixing of the 2 circulations. The major vascular supply to the cecal apex appeared to be through the medial cecal artery. Both the lateral and medial cecal arteries gave rise to cecal retia, which formed a mesh-like network around the respective veins. Vessels from these retia supplied the cecal tissue and the cecal lymph nodes. The continuation of the retia was through long terminal arteries that coursed around the circumference in the submucosa, forming an extensive submucosal plexus. This plexus supplied both the mucosa, and the tunica muscularis and serosa. Vessels within the longitudinal and circular muscle layers of the muscularis externa ran parallel to the muscle fibers, and consequently, perpendicular to each other.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗

Grain overload in cattle and sheep: changes in microbial populations in the cecum and rumen.

Samples from the rumen and cecum of cattle and sheep were cultured to determine changes in microbial populations resulting from overfeeding with grain. Before the animals were overfed, the predominant organisms from both sides were those that grew anaerobically on a relatively nonselective ruminal fluid medium and would not grow on selective mediums designed to culture lactobacilli, streptococci, coliforms, or Clostridium perfringens. By 24 hours after overfeeding, lactic acid bacteria had increased in numbers so that they were the most numerous organisms in both the rumen and the cecum. The concentrations of coliforms and C perfringens also increased after overfeeding and were generally higher in the cecum than in the rumen.

Animal Feed↗

Mouth-to-cecum transit time in patients affected by chronic constipation: effect of glucomannan.

Mouth-to-cecum transit time was studied in 13 patients affected by chronic idiopathic constipation and 18 control subjects matched with the constipation group for age, sex, and dietary habits. In a preliminary investigation, all patients showed a prolonged whole gut (oroanal) transit time as measured with radiopaque markers. Mouth-to-cecum transit time was studied through the serial determination of breath H2 after administration of 12 g lactulose diluted in 120 ml water. Breath H2 was measured with a gas analyzer and was determined in parts per million (ppm). Breath H2 after lactulose was also determined in the group with constipation after a 10-day diet that included either glucomannan (1 g tid orally) or placebo administered in a double-blind manner. The results show a statistically significant increase in mouth-to-cecum transit time in the group with constipation, compared with controls, and a return to within the normal range after the 10-day treatment with glucomannan. With placebo, no difference in transit time was noted. We therefore suggest that chronic idiopathic constipation is a disease that involves the whole gut.

Breath Tests↗

Effects of xylazine and/or butorphanol or neostigmine on myoelectric activity of the cecum and right ventral colon in female ponies.

Effects of xylazine HCl (0.5 mg/kg of body weight, IV) and/or butorphanol tartrate (0.04 mg/kg, IV) or neostigmine methylsulfate (0.022 mg/kg, IV) on myoelectric activity of the cecum and right ventral colon were studied in 4 conscious female ponies. Eight bipolar Ag/AgCl electrodes were sequentially placed on the seromuscular layer of the cecum (6 electrodes) and right ventral colon (2 electrodes). Recordings began 30 minutes before and continued for 90 minutes after drug administration. Each drug or drug combination was studied on 2 occasions in each pony. Two major patterns of coordinated spike bursts were identified. A series of coordinated spike bursts began at the cecal base and was conducted to the cecal apex (pattern I). A series of coordinated spike bursts began at the cecal apex, traversed the cecum, cecocolic orifice, and right ventral colon and was termed a progressive pattern (pattern II). Xylazine administration caused a significant decrease in patterns I and II for 20 minutes (P less than 0.05). Butorphanol tartrate administration caused a significant decrease in the progressive pattern for 10 minutes (P less than 0.05) without affecting the orally directed pattern. Administration of the combination of xylazine/butorphanol significantly decreased the frequency of pattern I for 40 minutes (P less than 0.05) and pattern II for 30 minutes (P less than 0.05). Neostigmine administration caused a significant increase in the frequency of pattern II for 30 minutes (P less than 0.05) without affecting pattern I (P greater than 0.05). Changes in conduction velocity of pattern I or II or the duration of spiking activity were not significantly different because of any treatment.

Animals↗

Normal motility of the cecum and right ventral colon in ponies.

To study the normal motility of the cecum and right ventral colon (RVC) in 3 mature Shetland ponies, a 6-part, indwelling, intraluminal catheter system was used to measure intraluminal pressure changes. Three catheters were placed in the cecum at 10, 25, and 40 cm from the cecocolic orifice, and 3 catheters were placed in the RVC at 10, 20, and 30 cm from the cecocolic orifice. Recordings were made during the interdigestive period beginning 2 weeks after surgical operation was done. Frequent, low-amplitude peaks (0.35 +/- 0.13 coordinated peaks/min) were seen involving the cecal body and caudal cecal base, which represented a haustra-to-haustra mixing pattern. Coordinated pressure peaks originated in the cecal body and progressed to the cranial cecal base (0.07 +/- 0.01/min) or originated in the cranial cecal base and progressed to the cecal body (0.07 +/- 0.04/min). Associated with a loud rush of ingesta heard on transabdominal auscultation and progression of liquid ingesta confirmed with barium contrast radiography, there was a series of coordinated, progressive pressure peaks which originated in the cecal body, sequentially involved the cecal base, traversed the cecocolic orifice, and extended into the RVC (0.36 +/- 0.05/min). It seemed that a pacemaker region existed in the cecal body and initiated the important aborally propagated progressive pattern responsible for the transit of ingesta from the cecum to the RVC. A separate mechanism for the transit of gas was not identified. In the RVC, infrequent, nondirectional, low-amplitude segmental pressure peaks (0.12 +/- 0.06/min), and aborally progressive coordinated pressure peaks originating at the beginning of the RVC (0.09 +/- 0.02/min), occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Experimental dilatation of the cecum and colon in rats. II. Reversion after induction by the continuous administration of lactose].

Fifty female Wistar weanling rats were fed a laboratory diet containing lactose (25 g/100 g of the final mixture) during 28 days. Following this period the lactose was substituted isocalorically by saccharose (25 g/100 g of the final mixture) and the diet given to the animals for 21 days. Thirty control rats of the same sex and weight received a laboratory diet containing saccharose (25 g/100 g of diet) during 49 days. The animals were weighed weekly. Subgroups of experimental and control rats were sacrificed at days 28, 30, 32, 35, 42 and 49. Rats given a diet containing lactose showed restriction of body weight gain. Upon rehabilitation the body weight of these animals increased rapidly. The external volume of the cecum and colon showed a significant increase during the 28-day period. After nutritional rehabilitation this change reduced gradually, beginning in the first week. Although the weight of the cecum reduced gradually during the rehabilitation period, the values were slightly augmented at day 49 as compared to controls. In conclusion, in the conditions of the present study, the consequences on the cecum and colon of adding lactose to the diet of rats are not persistent.

Animals↗

Myoelectric activity of the ileum, cecum, and right ventral colon, and cecal emptying of radiolabeled markers in clinically normal ponies.

OBJECTIVES: To determine normal cecal emptying curves for liquid- and solid-phase radiolabeled markers and to further define myoelectric patterns of the ileum, cecum, and colon in healthy ponies. ANIMALS: 6 adult ponies. PROCEDURE: A cecal cannula and 12 bipolar Ag-AgCl recording electrodes were sutured to the ileum, cecum, and right ventral colon of the ponies. Radioisotopes, indium 111-labeled diethyltriaminepentaacetic acid (111In-DTPA) and technetium 99m (99mTc)-labeled sulfur colloid bound to egg albumen, were introduced through the cannula directly into the cecal body. Movement of these markers from the cecum was monitored by a gamma camera, and power exponential clearance curves were generated. Myoelectric data were collected before and after i.v. administration of isotonic saline (0.9% NaCl) solution, and were analyzed for spike burst (SB) rate, relative activity index, and mean burst duration. Myoelectric complexes were identified from observation of chart recordings or compressed, digitized data. RESULTS: Clearance curves were generated for liquid (111In-DTPA)- and solid (99mTc)-phase markers. Marker types were not different with respect to lag phase, but liquid markers emptied at a slightly faster rate than did solids. Baseline values were calculated after saline solution administration for each of the myoelectric variables investigated. A relation between ileal, cecal, and colonic myoelectric activity was identified. Activity consistent with the previously described colonic migrating myoelectric complex in the pelvic flexure was identified in the right ventral colon. CONCLUSIONS AND CLINICAL RELEVANCE: Baseline data on normal cecal emptying was obtained; this technique could be used to evaluate the effect of postulated motility-modifying treatments used in equine practice.

Animals↗

Effect of alpha 2-adrenergic, cholinergic, and nonsteroidal anti-inflammatory drugs on myoelectric activity of ileum, cecum, and right ventral colon and on cecal emptying of radiolabeled markers in clinically normal ponies.

OBJECTIVE: To determine effect of xylazine hydrochloride (XYL), yohimbine hydrochloride (YOH), bethanechol chloride (BET), neostigmine methyl sulfate (NEO), or flunixin meglumine (FLU) on ileocecocolic myoelectric activity and passage of radiolabeled markers from the cecum. ANIMALS: 6 healthy adult ponies. PROCEDURE: A cecal cannula was surgically implanted, and 12 were sutured to the ileum, cecum, and right ventral colon. After a 12-hour nonfeeding period, 370 MBq of technetium 99m-labeled sulfur colloid in egg albumen and 37 MBq of indium 111-labeled diethyltriaminepentaacetic acid in 60 ml of water were injected into the cecal apex. All drugs were administered i.v. as a bolus, with the exception of NEO, which was given SC: XYL, 0.5 mg/kg of body weight; YOH, 0.075 mg/kg; BET, 0.025 mg/kg; NEO, 0.025 mg/kg; FLU, 1.1 mg/kg; and saline solution (SAL), 10 ml. Drugs were administered in a randomized complete block design, each treatment was administered twice to each pony, and dual-phase scintigraphic images were obtained. The time to 50% emptying (t50) and the slope of the emptying curve (beta) were derived from the calculated power exponential equation. RESULTS: The t50 after BET (184.8 +/- 16.5 minutes) and NEO (124.7 +/- 16.5 minutes) administration were significantly shorter than values after saline (230.2 +/- 17.1 minutes) administration. The t50 after XYL administration (250.5 +/- 18.6 minutes) was longer, and that after YOH administration (190.1 +/- 16.2 minutes) was shorter, than the t50 after saline administration, but neither difference was significant. The t50 and beta after FLU administration differed from those after saline administration. Myoelectric data appeared to be well correlated with drug-induced alterations in isotope clearance. CONCLUSIONS AND CLINICAL RELEVANCE: Cholinergic agonists, BET and NEO, have significant effects on the myoelectric activity of ileum, cecum, and right ventral colon, with the net effect of hastening cecal emptying.

Adrenergic alpha-2 Receptor Agonists↗

Ultrasonography of the cecum.

Ultrasound can define masses in the cecum and the cecal bed. In the patient with a prior resection of adenocarcinoma of the cecum, the sonogram fulfills a primary role in the detection of large and ill-defined recurrences not amenable to detection by barium enema because of a right colectomy. Discrete lesions within the cecum whether secondary to inflammatory or neoplastic processes could not be differentiated.

Adenocarcinoma↗

A mixed mesodermal tumor of the cecum: report of a case.

We herein report the case of a 69-year old woman presenting with an abdominal mass, who was found to have a mixed mesodermal tumor (MMT) of the cecum. Imaging studies and endoscopic investigations were consistent with the diagnosis of a nonepithelial malignant tumor of the cecum. On laparotomy, a knuckle-sized firm mass involving the cecum was noticed. As a result, a right hemicolectomy was performed. Pathological examinations, including immunohistochemical staining, resulted in the diagnosis of mesodermal mixed tumor, homologous type. The patient was advised to undergo postoperative chemotherapy but she did not comply. She has been followed up as an outpatient and is still alive 1.5 years after the operation.

Aged↗

Psoas abscess and cellulitis of the right gluteal region resulting from carcinoma of the cecum.

Although retroperitoneal or psoas abscess is an unusual clinical problem, the insidious and occult characteristics of this abscess sometimes cause diagnostic delays, resulting in considerably high morbidity and mortality. In particular, psoas abscess caused by perforated colon carcinoma is uncommon. We report a case of psoas abscess caused by a carcinoma of the cecum. A 72-year-old Japanese woman was admitted to our hospital, with pain in the right groin and buttock. The pain had appeared 6 months before admission, and the symptoms had then been relieved by oral antibiotics. On March 25, 1999, inflammatory signs in the right buttock indicated localized cellulitis, and incision and drainage was performed at a local hospital. The patient was referred to our hospital on the same day. On admission to our hospital, computed tomography (CT) scan revealed a thick right-sided colonic wall and enlargement of the right ileopsoas muscle. Barium enema and colonofiberscopy revealed an ulcerated tumor occupying the entire circumference of the cecum. A retroperitoneal abscess and fistula had been formed by the retroperitoneal perforation of cecum carcinoma: surgical resection was performed after remission of the local inflammatory signs. Operative findings indicated that the cancerous lesion and its surrounding tissues were firmly attached to the right iliopsoas and major psoas muscle, and en-bloc resection, including adjacent muscular tissue, was performed. The fact that carcinoma of the colon could be a cause of psoas abscess and cellulitis in the gluteal region should be considered when an unexplained psoas abscess is diagnosed.

Adenocarcinoma↗

Epidermoid cyst of the cecum.

An epidermoid cyst of the cecum is reported in an 8-year-old girl who presented with vague abdominal pain. Abdominal ultrasound scan showed a mass that was cystic in nature. During operation, a subserosal cystic mass was found in the wall of the cecum and confirmed to be an epidermoid cyst histopathologically. This is the first case of epidermoid cyst of the cecum in children reported in the literature.

Cecal Diseases↗

Acute diverticulitis of the cecum and ascending colon: the value of thin-section helical CT findings in excluding colonic carcinoma.

OBJECTIVE: The purpose of this study was to assess the value of characteristic thin-section helical CT findings of acute diverticulitis involving the cecum and ascending colon in excluding colonic carcinoma. MATERIALS AND METHODS: Thin-section helical CT scans (5-mm collimation) of 19 consecutive patients with proven diverticulitis and 21 consecutive patients with surgically proven carcinoma involving the cecum and ascending colon were reviewed retrospectively. Two radiologists independently analyzed these parameters: degree of pericolic infiltration, mesenteric fluid, vascular engorgement, arrowhead-shaped wall thickening, air-filled diverticula, inflamed diverticula, and preserved enhancement pattern of involved colonic wall. Inter-observer agreement was assessed with a kappa statistical analysis, and the features that most distinguished diverticulitis from colonic carcinoma were selected with a stepwise logistic-regression analysis. RESULTS: The two CT findings of right-sided colonic diverticulitis that most distinguished it from colonic carcinoma were inflamed diverticula and the preservation of an enhancement pattern of the involved colonic wall. Excellent interobserver agreement (kappa > 0.60) was obtained for both findings. Inflamed diverticula (kappa = 0.80) had a mean sensitivity, specificity, and accuracy for diverticulitis of 86.8%, 92.9%, and 90.0%, respectively, in differentiating right-sided colonic diverticulitis from colonic carcinoma. Preserved wall enhancement pattern (kappa = 0.70) had a mean sensitivity, specificity, and accuracy of 89.5%, 95.3%, and 92.5%, respectively. CONCLUSION: On thin-section helical CT, an inflamed diverticula and a preserved enhancement pattern of the thickened colonic wall were the two most statistically significant CT findings of acute diverticulitis involving the cecum and ascending colon that distinguished diverticulitis from colonic carcinoma.

Acute Disease↗

Giant submucosal lipoma of the cecum: report of a case and review of literature.

Lipoma of the colon is a relatively rare benign tumor. A case with intermittent subacute colon obstruction due to a giant lipoma of the cecum is reported. A 51-year-old woman presented with intermittent, abdominal crampy pain in the right upper and lower quadrants, accompanied by alternative episodes of diarrhea and constipation. She had had similar symptoms over the last three months. A double-contrast barium enema showed a large (approx. 7 cm in diameter) polypoid mass occluding the lumen of the cecum and the ascending colon. Colonoscopy revealed a submucosal mass suspected of benign tumor but too large for endoscopic resection. Surgery revealed a hard elongated mass in the right colon, which telescoped into the transverse colon and caused colo-colonic intussusception. Right hemicolectomy was performed and pathology documented a mature, submucosal lipoma of the cecum. Six years after the surgery, the patient has not showed any of the previous symptoms. Along with a review of the literature, the incidence, diagnosis complications and treatment of colonic lipomas are discussed.

Barium Sulfate↗