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At least 1,333 records · Page 74Linked to original sources
PubMed2003

Colonic pacing in patients with constipation due to colonic inertia.

BACKGROUND: The colon exhibits electrical activity in the form of pacesetter potentials (PPs) and action potentials (APs); no activity is recorded in total colonic inertia (TCI). Electrical activity mediates colonic motility. We have elsewhere demonstrated that 4 pacemakers initiate colonic electric activity. We investigated the hypothesis that the absence of electric activity in TCI is due to non-functioning pacemakers and that their stimulation produces colonic motility and defecation. MATERIAL/METHODS: 19 patients with TCI were divided into 2 groups: a study group of 11 patients (age 42.6 +/- 6.8 years; 7 women) and a control group of 8 patients (age 41.4 +/- 6.3 years, 5 women). 7 healthy volunteers (age 40.9 +/- 6.1 years, 5 women) were also studied. Pacing electrodes were endoscopically hooked to colonic mucosa: one stimulating and 2 or 3 recording. Stimulating electrodes were applied to the 4 potential pacemaker sites located at the cecal pole, the cecocolonic junction, the mid-transverse colon, and the colosigmoid junction. Electrical activity was recorded before and during electrical stimulation. RESULTS: Colonic pacing of healthy volunteers caused a significant increase in the frequency, amplitude and conduction velocity of basal electric waves. Colonic pacing in the study group produced PPs and APs, which varied between colonic segments. No waves were recorded from the control group in which the pacemakers were not activated. CONCLUSIONS: Colonic pacing produces electrical activity in patients with TCI. This method can be applied for the treatment of constipation in these patients.

Action Potentials↗
PubMed1980

[Colonic complications of pancreatitis. A report on 39 cases (author's transl)].

Colonic complications of pancreatitis are not infrequent occurrences, as illustrated by the fact that the authors have personally treated 39 such cases. Lesions are found in the colon at sites which correspond perfectly to diffusion of pancreatic necrotic lesions along mesenteric pathways as described by Meyers. They occur mainly in the left colic flexure (17 cases) and transverse colon (10 cases) but may affect the ascending (6 cases) and descending (4 cases) colon by diffusion of the pancreatitis into the anterior extrarenal space. These topographical characteristics, associated with the extrinsic and inflammatory nature of the lesions, produce a very specific and typical radiological syndrome which should assist diagnosis.

Adult↗
PubMed2002

Sliding hiatal hernia with intrathoracic stomach and obstructed colon.

A 61-year-old woman was admitted to hospital with features of subacute bowel obstruction. Contrast enema and computed tomography (CT) scanning showed evidence of a diaphragmatic hernia. The patient underwent thoraco-laparotomy which revealed a sliding hiatal hernia with transverse colon in the hernial sac. Repair of the defect and segmental resection of the colon were performed, with good postoperative recovery.

Barium Sulfate↗
PubMed1977

Inhibitory effects of selenium on 1,2-dimethylhydrazine and methylazoxymethanol acetate induction of colon tumors.

Sprague-Dawley rats were injected weekly with either 1,2-dimethylhydrazine (DMH) or methylazoxymethanol acetate (MAM). Addition of 4 ppm selenium (sodium selenite) in the drinking water reduced the number of rats developing DMH-induced colon tumors from 13 to 6 groups of 15 each. The total number of tumors observed in these two groups was 39 in the DMH treated and 11 in the DMH plus selenium. The incidence of MAM-induced tumors was 93% (14/15) with the selenium additive and 100% (14/14) when MAM was administered without the selenium supplement. However, selenium decreased the total number of colon tumors induced by MAM to 42 tumors as compared to a total of 73 tumors in rats receiving only MAM. Both carcinogens induced tumors with a higher frequency in the transverse colon as compared to either the proximal or distal colon. Selenium at this level did not affect the weight gain of the animals.

Adenocarcinoma↗
PubMed1984

Colonic motility in the postoperative period.

The effect of a laparotomy on postoperative motility in the colon has been studied in dogs. Movement has been recorded by an electrical impedance method each day after a standard laparotomy. Mean values of movement in the descending colon were reduced, not abolished, for 3 days after operation (preoperative: 34.0%; day 1: 17.9%; day 2: 22.1%; day 3: 23.9%). In contrast, there was no reduction in motility in the transverse colon but a rise in activity on the first postoperative day (preoperative: 39.1%; day 1: 63.3%). It is concluded that a laparotomy does not abolish colonic movement postoperatively and that there is a reduction which affects the distal colon for 3 days.

Abdomen↗
PubMed1995

Ascending colon response to feeding: evidence for a 5-hydroxytryptamine-3 mechanism.

BACKGROUND: The role of serotonergic type-3 receptors in proximal human colon is unclear. Our aims were to assess the postprandial volume and emptying of the ascending colon and to explore the role of 5-hydroxytryptamine-3 (5HT3) mechanisms. METHODS: In healthy subjects with unprepared colons we evaluated in a randomized trial the effects of the 5HT3 antagonist ondansetron (n = 5) or placebo (n = 5) on ascending colon volume and emptying, using a scintigraphic method. RESULTS: Base-line ascending colon volumes were similar and were unaltered by ondansetron. After a 1000-kcal liquid meal the placebo group showed a variable change in volume (P = NS versus base line) during the first 25 min (median, -4%; range, -13% to 135%). Increases in volume during this period coincided with ileal emptying of chyme. During a second phase (30-105 min) there was a significant decrease of ascending colon volume (P = 0.02) relative to the early postprandial volume, but the volume was not significantly different from base line. This second phase was associated with transfer of chyme towards the transverse colon. In the ondansetron group there was an initial modest increase in volume (median, 5%; range, -15% to 14%; P = NS versus base line), and the second phase of contraction was inhibited. CONCLUSIONS: The ascending colon response to a meal in health is characterized by a variable initial change in volume, accommodating ileal chyme in some individuals, and a more consistent reduction in volume from 30 to 105 min postprandially. The latter response is inhibited by ondansetron, suggesting partial control of postprandial colonic motor function by 5HT3 mechanisms.

Adult↗
PubMed1989

[Colonic occlusion. Apropos of a surgical series of 63 cases].

63 colonic occlusions were operated on from 1975 to 1988. Cancer and stenotic diverticular sigmoiditis were found to be the main causes of colonic obstruction in respectively 36 cases (55%) and 8 cases (13%). Other etiologies were represented by neoplasic gynecologic diseases (9.5%). The rectosigmoid was involved in 50% of the cases (31) while transverse colon and caecum were respectively concerned in 25% and 17%. The 2 main therapeutical procedures used were colic resection (35 cases-55%) with immediate anastomosis in 1 case out of 3 and derivation (26 cases 41%) mostly in the proper from of a colostomy (20 cases). Operation was undertaken during the first 48 hours in 65% of the cases. Death occurred in 8 patients (12.5%). Related to etiology the death rate was 11% in cancers and 25% in stenotic diverticulitis. Where linked to treatment this mortality rate reached 27% in derivations and 3% in colic resections. 38% of non lethal complications were recorded, two-third being due to the bad general conditions of the patients. Several times operations, such as first colostomy or resection without anastomosis, should remain the basic rule one should not depart from without great carefulness. However a new interesting trend toward one time surgery with intraoperative colonic lavage is taking shape.

Adolescent↗
PubMed1995

A case of diclofenac-induced colitis with focal granulomatous change.

We report a case of severe colitis from diclofenac (Voltaren), one of a number of nonsteroidal anti-inflammatory drugs (NSAIDs) that can cause colonic injury. The patient, a 68-yr-old woman, presented with acute onset of bloody diarrhea, having taken diclofenac for more than 2 yr. Colonoscopy revealed deep ulcerations in the transverse colon and erythema and erosions scattered elsewhere. Biopsy findings included crypt distortion, cryptitis, hemorrhage, and some fibrosis. Also, in one biopsy taken from an area of deepest ulceration, a large, non-foreign body-type granuloma was seen, raising the specter of Crohn's colitis. All symptoms subsided within 24 h after discontinuation of the diclofenac, and follow-up colonoscopy 17 days later showed complete endoscopic and histological resolution. Patients and physicians should be aware of the possibility of colitis from NSAIDs. In rare cases, some will show granulomatous change that may be confused with Crohn's disease. Early recognition and discontinuation of NSAIDs is crucial to prevent clinical worsening that could lead to colectomy or even prove fatal.

Aged↗
PubMedDate not supplied

[The age-related and local quantitative macro- and microscopic characteristics of the glands of the large intestine in the human adult].

A macro-microscopic investigation of the intestinal glands was carried out in 97 total preparations of the colon in practically healthy people from 20 to 99 years of age. The glands are distributed all over the colon higher than the rectal-anal line. Their general amount decreases from 50-59 years of age. The density of distribution of the glands in the blind gut, ascending and transverse colons becomes less from 50-59 years of age. The lumen area of the opening of the colonic glands is continuously increasing from 20-29 years up to 90-99 years of age (2.5 times). The distribution density of the intestinal glands becomes somewhat less from the blind gut to the rectum, while the area of the intestinal gland lumen increases in the same direction.

Adult↗
PubMedDate not supplied

A quality assurance monitor on preparation for outpatient lower endoscopic procedures.

A two-phase quality assurance monitor was performed with a pediatric outpatient population to determine how well the current preparation of Fleet Phospho-Soda, Fleet enemas, and diet modification cleaned the colon. We studied 99 patients in Phase 1, implemented changes, and then studied 99 patients in Phase 2. Phase 2 found increasing age to be significantly related to decreasing cleanliness of the transverse colon, ascending colon, and cecum, and increasing weight was found to be significantly related to decreasing cleanliness of the cecum. Phase 2 also found the second enema to be significant for increasing cleanliness of the rectum.

Adolescent↗
PubMed1999

Loss of interstitial cells and a fibromuscular layer on the luminal side of the colonic circular muscle presenting as megacolon in an adult patient.

BACKGROUND: Animal studies have shown that the neuromuscular structures on the luminal side of the colonic circular muscle coordinate circular muscle activity. These structures have been identified by electron microscopy in the normal human colon, but have never been thoroughly studied in patients with acquired intestinal hypoganglionosis. AIMS: To perform histological, immunocytochemical, and electron microscopic examinations of the colon of a patient with acquired intestinal hypoganglionosis presenting as megacolon. PATIENT: A 32 year old man with a one year history of constipation and abdominal distention, a massively dilated ascending and transverse colon, and a normal calibre rectum and descending and sigmoid colon. He had a high titre of circulating serum anti-neuronal nuclear antibodies. METHODS: Histology, immunocytochemistry (for neurofilaments, neurone specific enolase, synaptophysin, glial fibrillar acidic protein, S100 protein, and smooth muscle alpha-actin), and electron microscopic examinations on the resected colon. RESULTS: The number of ganglion cells and nerve trunks was decreased throughout the colon. Disruption of the neural network and a loss of interstitial cells of Cajal were observed on the luminal side of the circular muscle; in their place, the non-dilated colon contained a hypertrophic fibromuscular layer. CONCLUSIONS: Striking architectural alterations occurred at the site regarded as the source of the coordination of colonic circular muscle activity in an adult patient with acquired intestinal hypoganglionosis presenting as megacolon.

Adult↗
PubMedDate not supplied

[Multiorgan resection in T4 colonic adenocarcinoma. Report of a case].

BACKGROUND: Colorectal cancer is the second among gastrointestinal malignancies in Mexico Locally advanced disease or metastatic lesions are frequently found. To resect or not such a tumor is a difficult decision. OBJECTIVE: To report a case of colon cancer with multivisceral invasion resected and to review the published information. CLINICAL MATERIAL: A 43 year-old Mexican male with rectal bleeding and weight loss with a tumor located in transverse colon with direct invasion to stomach. CT scan demonstrated invasion to spleen and pancreas. En-bloc radical-extended right colectomy, total gastrectomy, distal pancreatectomy, splenectomy and left adrenalectomy was performed. Adjuvant chemotherapy was used. At 12-month follow-up he is asymptomatic, without neoplasic activity and with good quality of life. CONCLUSION: An aggressive multiorganic resection in T4 colorectal tumors is justified in selected cases. The high morbidity and mortality of these procedures must be evaluated individually, and if permissive must be performed.

Adenocarcinoma↗
PubMed1984

[Changes in electromyogram of the colon related to ingestion of undigestible particles in dogs].

The relationship between undigestible particle intake and myoelectric activity of the colon was examined in three dogs fed with a low-fiber diet alone or with polyethylene particles containing 10 p. 100 and 45 p. 100 of dry matter. When compared to controls colonic electromyograms of dogs fed on polyethylene revealed a 40 p. 100 reduction in long spike bursts (LSBs). The sequences of LSBs propagated over long distances, or MSBs (migrating spike bursts) were unchanged and only the myoelectric activity corresponding to LSBs propagated for very short distances was abolished by polyethylene diets. Concurrently, the percentage of water excreted in the feces was increased. Undigestible and inert particles were thus able to modify the colonic motor profile and to increase the fecal excretion of water. Such effects were similar to those observed with dietary fibers. It is suggested that dietary fiber effects on fecal excretion and colonic motility are partially induced by their mechanical action on the intestinal wall. In addition, the absence of LSBs propagated in both directions and for short distances on the canine proximal and transverse colons seems to be a limiting factor in the movements of water absorption.

Animals↗
PubMed1997

[A case of advanced colon cancer with marked response to combination chemotherapy with 5-FU, low dose CDDP, and leucovorin].

We encountered an elderly patient with advanced colon cancer who responded marked by to combination chemotherapy with 5-fluorouracil (5-FU), low-dose cisplatin (CDDP), and leucovorin (LV). The 86-year-old man was admitted for advanced transverse colon cancer with liver and lung metastasis. Combination chemotherapy with 5-FU, low dose CDDP, and LV was given for a total of 12 weeks. After this chemotherapeutic regimen, diagnostic CT scan revealed the metastatic lesions had disappeared, and a pathological analysis of primary tumor confirmed that the patient had achieved a complete remission (CR). During chemotherapy, there was no severe side effect, apart from mild nausea (WHO: Grade 1). The patient is presently enjoying a good general condition and has been rehabilitated for discharge.

Adenocarcinoma↗
PubMed1998

[Dieulafoy colonic ulcer. A rare cause of lower gastrointestinal hemorrhage].

Dieulafoy's disease is an unusual cause of gastrointestinal hemorrhage, reported to account for less than 2% of acute gastrointestinal bleeding episodes. Bleeding occurs from a defect in an unusually large submucosal artery, through a minute mucosal erosion. Endoscopic diagnosis is sometimes difficult, but primary endoscopic therapy may be successful and should be attempted. In most cases the lesion is found in the proximal stomach. Sixteen cases of Dieulafoy's lesion located in the colon have been reported in the literature but only nine have been confirmed by histology. We present the case of a 63 year-old male with Dieulafoy's lesion of the transverse colon which was diagnosed by endoscopy and confirmed by histology.

Arteries↗
PubMed2002

[Granulocytic sarcoma of the colon in chronic myelomonocytic leukemia].

A 59-year-old man with a six-month history of chronic myelomonocytic leukemia (CMML) was admitted to the Kitasato University Hospital because of melena in September 2000. Colonofiberscopy and barium enema demonstrated an ulcerated tumorous lesion in the transverse colon. The histopathologic findings of the ulcer bed revealed diffuse infiltration of granulocytes at each stage of differentiation. The diagnosis of granulocytic sarcoma (GS) was made. Surgical resection was not indicated, because thrombocytopenia was hardly improved enough to allow surgery despite repetitive transfusion of platelet concentrates. CMML developed to refractory anemia with excess of blast in transformation in February 2001. Two courses of low dose cytarabine plus aclarubicin were ineffective on the GS in spite of a decrease in the peripheral blood blasts. Progression to acute myeloid leukemia eventually broke out, in July 2001. The patient died of leukemia complicated with pneumonia and intestinal obstruction. At present, nine cases of GS in the colon have been reported. However, these cases did not include CMML. This is the first report describing GS in the colon associated with CMML.

Colonic Neoplasms↗
PubMed2003

Adenocarcinoma arising in a tubular duplication of the jejunum.

To our knowledge, only five cases of malignant changes in small-bowel duplication have been reported previously in the English-language literature, and these were found only in ileal duplications. We describe a unique case of adenocarcinoma arising in a tubular duplication of the jejunum; this is the oldest patients in whom malignant tumor of alimentary tract duplication has been reported. A 73-year-old man was admitted to our hospital because of lower abdominal pain. Computed tomography (CT) and ultrasonography showed two abdominal masses; one, about 5 cm in size, was observed in the upper abdomen, the superior mesenteric artery (SMA) and the other, which was a well-demarcated heterogeneous mass, was revealed in the lower abdomen. Laparotomy revealed the mass in the upper abdomen involved the SMA and transverse colon, while the mass in the lower abdomen was of white globular form, ping-pong ball size, in the jejunal serosa approximately 40 cm on the anal side from Treiz's ligament. Transverse colostomy and a partial jejunectomy were performed, and the tumor was resected. Histologically, the diagnosis was adenocarcinoma arising in a tubular duplication of the jejunum. The patient died of necrosis and perforation of the intestine due to obstruction of the SMA 7 months after the surgery. Autopsy revealed that the upper abdominal mass consisted of metastatic foci associated with the lymph node of the SMA.

Adenocarcinoma↗