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PubMed1988

Quantitative measurement of feline colonic transit.

Colonic transit scintigraphy, a method for quantitatively evaluating the movement of the fecal stream in vivo, was employed to evaluate colonic transit in the cat. Scintigraphy was performed in duplicate in five cats and repeated four times in one cat. After instillation of an 111In marker into the cecum through a surgically implanted silicone cecostomy tube, colonic movement of the instillate was quantitated for 24 h using gamma scintigraphy. Antegrade and retrograde motion of radionuclide was observed. The cecum and ascending colon emptied rapidly, with a half-emptying time of 1.68 +/- 0.56 h (mean +/- SE). After 24 h, 25.1 +/- 5.2% of the activity remained in the transverse colon. The progression of the geometric center was initially rapid, followed later by a delayed phase. Geometric center reproducibility was found to be high when analyzed using simple linear regression (slope = 0.92; r = 0.73; P less than 0.01). Atropine (0.1 mg/kg im) was found to delay cecum and ascending colon emptying and delay progression of the geometric center. These results demonstrate both 1) the ability of colonic transit scintigraphy to detect changes in transit induced by pharmacological manipulation and 2) the fact that muscarinic blockade inhibits antegrade transit of the fecal stream. We conclude that feline colonic transit may be studied in a quantitative and reproducible manner with colonic transit scintigraphy.

Animals↗
PubMed2005

[A case of colon obstruction developed during the recovery period of acute pancreatitis].

Complications of acute pancreatitis usually occur in pancreas and its contiguous organs. The prevalence of colonic invasion is rare, however, the consequence is fatal, with mortality above 50%. The initial symptoms and onset times are variable and major affected sites are transverse colon and splenic flexure. The spread of inflammatory exudates into the colon is the main mechanism of colonic invasion. If the colonic stenosis develops, it is necessary to manage it surgically. We report a case who arrived at the hospital with watery diarrhea and abdominal distension in the recovery period of acute alcoholic pancreatitis and was diagnosed as a colonic obstruction in the splenic flexure. The patient underwent loop ileostomy instead of the resection of the lesion because of severe adhesion around the splenic flexure. The patient died due to sepsis 5 days after the operation.

Acute Disease↗
PubMedDate not supplied

[The Hartmann type of operation].

In spite of the contemporary progresses in the field of surgical therapies, of the use of antibiotics, and of resuscitation techniques, resection of the colon with closure of the distal end and terminal colostomy, as suggested by Hartmann at the start of the century, has still some indications. Moreover, beside the original indications, this type of intervention can also be aplied in the case of some other benign lesions, and extension of the colon resection may involve other areas beside the recto-sigmoid zone. The specific indications of the intervention are the severe, very extensive and usually complicated lesions of the colon, frequently associated with a general biologic deterioration, conditions that make highly improbably the success of other surgical procedures. In a group of 28 patients (4,6 percent of the total number of cases in which interventions on the colon have been performed), of which 15 neoplasies and 13 benign lesions, the following resections have been carried out: 19 sigmoid resections, one resection of the transverse colon, 3 rectosigmoid resections, one left hemi-colectomy, 2 sub-total colectomies, 2 interventions for dehiscence of anastomoses. Considering the critical condition of the patients the high post-operative mortality appears to be easy to explain, as well as the non-lethal septic post-operative complications. In 7 patients (25 percent of the survivors) secondary restoration of the transit was carried out (4 benign lesions, and 3 cases of neoplasy). Reconversion raises some tactical and technical problems concerning the time of the intervention, the route, the attitude in front of colostomy, the mobilization of the segments and the type of anastomoses.

Adult↗
PubMed1983

Neutropenic colitis and aplastic anemia: a new association.

Colitis is a life-threatening complication of aplastic anemia which occurs during periods of profound neutropenia. Four cases of this previously unreported association are described here. A syndrome of fever, watery diarrhea, and generalized abdominal pain and tenderness occurred in close temporal relationship to development of severe neutropenia (less than 50 neutrophils per cu mm). None of the patients had received antibiotics, nor had a history of previous episodes of colitis. Three had cultures positive for colonic organisms during the episodes. In only one instance was the correct diagnosis made without operation. Gross evidence of disease was found in the cecum, the transverse colon, and rectosigmoid in three patients, but the true extent of disease was underestimated. Microscopic examination of the two resected specimens showed extensive mucosal and variable submucosal necrosis with invasion of the colonic wall by bacteria. Acute inflammatory changes were absent. With profound neutropenia, the colon wall lacks resistance to invasion by the resident microflora. The condition is probably best treated without operation. If first recognized at laparotomy, resection should be avoided.

Adolescent↗
PubMed2000

Invasive colon cancer derived from a small superficial depressed cancer: report of a case.

A 64-year-old male in May 1997 was diagnosed by colonoscopy and a barium enema examination as having an invasive cancer in the transverse colon. Pathologic study of the resected surgical specimen revealed a well-differentiated adenocarcinoma invading the muscularis propria. He had a colonoscopic examination in 1991 and was diagnosed as having multiple adenomas, which were endoscopically removed. After that he had annual colonoscopy or barium enema examination follow-ups. At endoscopy in February 1994, a superficial depressed cancer 6 mm in diameter had been detected. However, the cancer was not seen again in several endoscopic examinations until one in 1997. Because the location of the lesion detected in 1994 and that of the invasive carcinoma detected in 1997 were identical, it was considered that the superficial depressed cancer developed, 40 months later, to an advanced cancer. Doubling time was calculated as 8.4 months.

Adenocarcinoma↗
PubMed1997

Mucosal changes in interposed colon segment as gastric substitute following gastrectomy in rats.

BACKGROUND: An interposed colon segment has been clinically reconstructed as a gastric substitute. The purpose of this study is to establish a rat model of colonic interposition and to investigate serial mucosal changes and adaptation of interposed colon mucosa under prolonged exposure to bile and pancreatic juice reflux. METHODS: About 80% of the glandular stomach was resected, and a 3-cm segment of the transverse colon interposed isoperistaltically between the remnant stomach and duodenum. Epithelial proliferation, aberrant crypt foci (ACF), and tumors in the interposed colon segment were investigated after 4 months of administration of N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) to rats (ENNG-treated rats). RESULTS: In the interposed colon, crypt lengths increased significantly, and the number of goblet cells per crypt per 1 mm decreased significantly compared to those in the remnant colon, whether ENNG was administered or not. Both crypt lengths and the number of goblet cells in the interposed colon of controls and ENNG-treated rats showed no significant difference. A proliferating cell nuclear antigen (PCNA) labeling index (LI) of the remnant colon was almost 30% in both controls and ENNG-treated rats. In controls, the PCNA LI in the interposed colon at 4, 8, and 12 months after surgery was 30.8, 31.8, and 47.8%. In ENNG-treated rats, the PCNA LI in the nontumorous mucosa of the interposed colon was 44.9, 55.4, and 61.5% at the above postsurgical intervals. ACF and carcinoma were observed only in the interposed colon of ENNG-treated rats. ACF was observed as early as 4 months after surgery, and its incidence increased serially. Both the incidence of carcinogenesis and the number of tumors had increased 8 months after surgery. CONCLUSIONS: We established a rat model of colonic interposition following gastrectomy. The adaptation of interposed colon mucosa was well conducted. A malignant condition, however, was induced in the interposed colon segment serving as a gastric substitute because of both carcinogen predisposition and prolonged exposure to bile and pancreatic juice reflux.

Adaptation, Physiological↗
PubMed2003

Pseudo-colonic carcinoma caused by abdominal actinomycosis: report of two cases.

BACKGROUND: Abdominal actinomycosis is an infrequent chronic, suppurative infection caused by the aerobic gram-positive bands Actinomyces israelii. PATIENT PRESENTATION: We report two cases of abdominal actinomycosis, simulating colon cancer. Before operation, both patients presented with abdominal pain and a palpable mass. Abdominal computed tomography (CT) revealed an infiltrating irregular mass in the cecum and transverse colon, respectively. Surgical intervention was then performed under the impression of colonic malignancy. CONCLUSION: Postoperatively, pathologic examination confirmed the diagnosis of abdominal actinomycosis in which the characteristic finding of sulfur granules in the resected specimen was demonstrated. After surgery, the patients continued antibiotic treatment with ampicillin for 2 months at our OPD and had no signs of recurrence 1 year after surgery.

Abdominal Pain↗
PubMed1997

New model of colon interposition following distal gastrectomy in rats.

An interposed colon segment has been clinically used as a gastric substitute following an esophagogastric resection for benign or malignant esophageal and gastric cardia disease. The purpose of this study is to establish a rat model of colonic interposition following distal gastrectomy and to investigate its serial mucosal changes. About 80% of the glandular stomach was resected, and a 3-cm segment of the transverse colon interposed isoperistaltically between the remnant stomach and duodenum. Epithelial proliferation and aberrant crypt foci in the interposed colon segment were investigated serially. Crypt lengths in the interposed colon increased significantly (P < 0.05) compared to the remnant colon. The number of goblet cells per crypt per 1 mm in the interposed colon also decreased significantly (P < 0.05) compared to the remnant colon. A PCNA labeling index (LI) of the remnant colon was almost 30%. A PCNA LI in the interposed colon at 4, 8, and 12 months after surgery was 30.8%, 31.8%, and 47.8%, respectively. The PCNA LI in the interposed colon increased significantly (P < 0.05) 12 months after surgery compared to the remnant colon at 4, 8, and 12 months after surgery. Aberrant crypt foci were not detected in the interposed colon segment. In conclusion, we established a rat model of colonic interposition following distal gastrectomy. The interposed colon mucosa adapted well. Long-term mucosal changes of the interposed colon segment should now be studied.

Anastomosis, Surgical↗
PubMed1993

Electrogenic colonic ion transport in Hirschsprung's disease: reduced secretion to the neural secretagogues acetylcholine and iloprost.

The effects of the abnormal innervation in Hirschsprung's disease on colonic ion transport were examined in vitro using Ussing chambers. The response of the mucosal/submucosal preparations to different secretagogues were investigated in aganglionic and ganglionic rectosigmoid and transverse colon from children with Hirschsprung's disease and compared with normally innervated colon from children with anorectal anomalies. Basal values were similar in aganglionic and ganglionic rectosigmoid colon. Neurally mediated secretion with iloprost (10(-6) M) and acetylcholine (900 and 9 microM) was considerably reduced in aganglionic colon compared with normally innervated ganglionic colon. The ganglionic colon proximal to the aganglionic colon also had a reduced response to acetylcholine despite a normal acetylcholinesterase staining pattern. The responses to Escherichia coli STa enterotoxin (50 MU/ml) and isobutylmethylxanthine (10(-3) M) were similar in ganglionic and aganglionic colon. The response to STa enterotoxin was not changed by the nerve blocking agent tetrodotoxin (10(-6) M). The data show that colonocytes from aganglionic colon are capable of a normal secretory response if stimulated directly by cAMP or cGMP acting secretagogues but secretion in response to neurally mediated secretagogues is impaired. The hypertrophied acetylcholinesterase positive nerve fibres that infiltrate the aganglionic colon are likely to contribute to the reduced secretion to acetylcholine.

1-Methyl-3-isobutylxanthine↗
PubMed1999

Acute colorectal obstruction: treatment with self-expandable metallic stents before scheduled surgery--results of a multicenter study.

PURPOSE: To evaluate the efficacy of treatment with self-expandable metallic stents for acute colonic obstruction before elective surgical resection. MATERIALS AND METHODS: In 71 patients with malignant obstruction seen from October 1993 through December 1996, lesions were located in the transverse colon in one patient, in the descending colon in 22 patients, and in the rectosigmoid region in 48. A total of 72 self-expandable metallic stents were implanted within 24 hours of diagnosis. RESULTS: Technical success was obtained in 64 patients (90%). In two cases (3%), it was not possible to advance across the obstructing mass. In five cases (7%), the prostheses were poorly positioned at the site of obstruction, requiring placement of a new stent in three cases. Clinical improvement and resolution of the obstruction were confirmed in 66 patients (93%) within 96 hours. Minor complications developed in nine cases (13%). One patient (1%) underwent surgery to resolve a colonic perforation caused by wires at the ends of the stent. The mean time between stent placement and surgery was 8.6 days (range, 6-16 days). CONCLUSION: Implantation of colorectal stents is a safe treatment of acute malignant colonic obstruction before resection.

Acute Disease↗
PubMed2001

Ambulatory 24-h colonic manometry in healthy humans.

Our aim was to investigate motor activity of the healthy, relatively unprepared colon in the ambulatory state. Twenty-five age- and gender-matched adults had a six-sensor solid-state probe inserted into the proximal transverse colon without sedation. Subjects ambulated freely and ate standard meals. In 528 h of recording, we found a lower (P < 0.05) area under the curve during the night. Waking induced a threefold increase in motility, whereas meals induced a twofold increase. Women showed less activity (P < 0.05) in the transverse/descending colon than men. The transverse/descending colon showed more (P < 0.05) activity than the rectosigmoid colon. Seven patterns were recognized; predominantly, they were simultaneous, propagated, or periodic bursts of 3-cycles/min (cpm) waves. A specialized propagating pressure wave with a high amplitude (>105 mmHg) and a prolonged duration (>14 s) occurred in all subjects (mean 10/day), mostly after waking, after meals, or with defecation. A 3-cpm motor activity was seen in the rectosigmoid region predominantly at night. The colon exhibits a wide spectrum of pressure activity around the clock, with gender and regional differences and circadian rhythm. This comprehensive study provides qualitative and quantitative normative data for colonic manometry.

Aged↗
PubMed1990

Herpes simplex virus type 1 colitis: an unusual cause of diarrhea.

Herpetic infections of the gastrointestinal tract are a well-recognized entity. Involvement of the colon seems to be very rare. A 78-yr-old woman developed bloody diarrhea and abdominal discomfort 2 months after surgical treatment for adenocarcinoma of the transverse colon. Colonoscopy revealed diffuse hemorrhagic, erosive, aphtoid, and ulcerative lesions. Histology showed nonspecific inflammatory changes. Herpes simplex virus type 1 (HSV-1) was isolated from endoscopic biopsy and stool specimens. The patient responded rapidly to symptomatic treatment with loperamide. This case demonstrates the potential for HSV-1 to induce infectious colitis; failure to obtain microbiologic evaluations and the rapid response to empiric, symptomatic treatment may be responsible for the rarity of diagnosis of this infection. The implications of this diagnosis are probably more relevant in immunosuppressed individuals, and may be important in the elderly population.

Aged↗
PubMed1979

Restoration of gastrointestinal continuity (Pauchet's operation).

Restoration of continuity of the gastrointestinal tract following resection has always presented a challenge to the general abdominal surgeon. Restoration of the left colon has been especially dangerous. In the early days the mortality approached 90% due mainly to breakdown of the anastomosis. Recently, with a better understanding of the blood supply to the colon and more careful preparation of the colon, the mortality and morbidity have been reduced. In a small group of cases, in which previous surgery has interfered with the blood supply to the colon or a secondary pathologic condition exists, continuity cannot be restored by end-to-end anastomosis. In this group the interposition of the ileum between the transverse colon proximally and the rectum distally has resulted in functional continuity of the colon with no adverse metabolic effects.

Aged↗
PubMed1994

[Establishment and characterization of a new cell line (KT-COLO-8) derived from a colonic mucinous adenocarcinoma].

We have established a human colonic carcinoma cell line, designated KT-COLO-8, derived from cancerous ascites of a 64-year-old male patient who had mucinous adenocarcinoma of the transverse colon. The cells have been cultured with RPMI-1640 medium supplemented with 10% fetal bovine serum. They grew in vitro free-floating and formed sheet-like clusters as large as 2-3 mm in diameter. Population doubling time for the cells was 48 hours. The chromosome number ranged from 48 to 50. The Q-band analysis revealed abnormal karyotype with three marker chromosomes including 1p-, 4q- and 5q-. The cells produced and released high level of carcinoembryonic antigen (CEA) in the conditioned medium. Percentage of CEA positive cells was 98%. An aggregation assay revealed that 80% of the cells dissociated into single cells aggregated within 30 min. The self aggregation of the cells was completely inhibited only by anti-CEA monoclonal antibody, suggesting that the cluster formation of KT-COLO-8 cells was dependent on CEA molecules.

Adenocarcinoma, Mucinous↗
PubMed1993

[A case of advance colon cancer responding to sequential methotrexate and 5-fluorouracil therapy].

A 60-year-old female was diagnosed by X-ray examination and endoscopy as ascending colon cancer. Ultrasonography and computed tomography revealed two metastatic tumors in the liver. Abdominal surgery revealed peritoneal disseminations, massive lymph node metastasis and direct invasion of the transverse colon and ileum. From pathological examination the diagnosis was moderately differentiated adenocarcinoma. After right hemi-colectomy, sequential methotrexate and 5-fluorouracil therapy as well as oral administration of UFT, liver metastasis disappeared and no sign of ascites was found in this case. Complete response time was over 8 months. There have been no severe complications.

Adenocarcinoma↗
PubMed1977

[Angiographic research on the blood supply of the colon with a view to oesophagoplasty (author's transl)].

The author presents an angiographic study of 34 cadavers concerning the colonic vessels, and draws up an original classification of colonic vessels which arise from the inferior mesenteric artery. He found 16 variants of the left colonic artery which he groups into 5 main types, the classical type being only encountered in 22.6 p. cent of cases. In 32 p. cent, the ascending and descending branches of the left colonic artery had a separate origin from the inferior mesenteric artery. The variants of the sigmoid arteries and of the left colonic veins were also identified. In one case, the inferior mesenteric vein was absent, being supplanted by the marginal vein. As for colo-oesophagoplasty, the isoperistaltic transverse colon was found to be better than the ileo-colon in 64 p. cent of cases and equivalent in 20 p. cent. In 16 p. cent the ileo-colon was preferable. The site of the arterial sections in colo-oesophagoplasty according to the colonic vascular type is discussed.

Adolescent↗
PubMedDate not supplied

Recto-colic reflex: role in the defecation mechanism.

As urge is felt and defecation starts, it is postulated that the colon continuously feeds the rectum with stools until the colon is empty. The relationship of rectal distension at defecation to colonic activity is not yet fully explored. The current communication studies this relationship in 11 patients (mean age 48.4+/-18.8 years, 6 men and 5 women) with transverse colostomy performed after transverse colectomy for cancer of the transverse colon. The rectum was distended by a condom-ended catheter in increments of 10 ml of H20, and the pressures in the right and left colon were measured by balloon catheters introduced through the colostomy. The test was repeated after anesthetizing the rectum or colon, respectively. Upon rectal distension up to sensation of urge, there was no colonic pressure response. At urge (mean distension volume of 160+/-36.7 ml), the left colonic pressure showed a significant rise (p<0.001), while the right colon revealed no response (p>0.05). Rectal distension during rectal or colonic anesthetization effected no colonic pressure response (p>0.05). The left colonic contraction upon rectal distension, being reproducible and absent with the anesthetized rectum or colon, postulates a reflex relationship which we call "recto-colic reflex". This reflex acts at defecation to feed the rectum successively with fecal material until the colon is emptied. Reflex derangement may play a role in defecation disorders.

Adult↗
PubMed1987

Carcinoma of the colon presenting with dyspepsia.

Three patients with upper abdominal symptoms responding to anti-ulcer medication are reported who had negative upper gastrointestinal endoscopies. Subsequent barium enemas showed that each of the patients had either a carcinoma of the transverse colon or caecum. Investigation of the colon should be considered in all such cases.

Adult↗