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PubMed1987

Transverse and sigmoid colon motility in healthy humans: effects of eating and of cimetropium bromide.

There have been few studies of the motility of the colon proximal to the rectosigmoid area. For this purpose we evaluated (1) fasting and postprandial transverse and sigmoid colon motor activity and (2) the effects of a new nonselective anticholinergic drug, cimetropium bromide, on transverse and sigmoid motor responses to eating. Two paired studies were carried out in 11 healthy volunteers by means of a colonscopically positioned manometric probe. After placebo, eating significantly increased transverse and sigmoid motility indices throughout the recording period. Cimetropium significantly reduced the motor responses to eating in both the transverse and the sigmoid colon.

Adult↗
PubMed1998

Gastric duplication-colonic fistula with colonic ulceration and bleeding.

An 11-month-old girl had massive rectal bleeding. A midabdominal mass was palpated. Ultrasound scan showed a large cystic mass with diffusely echogenic contents; Tc-99M radionuclide scan confirmed a duplication. Exploratory surgery and pathology examination showed a gastric duplication with formation of a fistula into the transverse colon with a colonic ulcer and hemorrhage. This combination of findings is presented as a rare cause of lower gastrointestinal hemorrhage in infancy.

Colonic Diseases↗
PubMed2006

Primary signet-ring cell carcinoma of the colon at early stage: a case report and a review of the literature.

A 67-year-old man, who had undergone surgery to resect multiple gastric cancers 4 years ago, visited our hospital for surveillance colonoscopy. Colonoscopy revealed a discolored, 7-mm in diameter, flat-elevated lesion with central depression in the transverse colon near the splenic flexure. Although the findings of endoscopy and barium enema were suggestive of submucosal invasion, the patient chose to undergo endoscopic mucosal resection. Pathological examination of the resected specimen revealed signet-ring cell carcinoma and a positive surgical margin. A second operation was performed, and no residual tumor or metastasis to lymph nodes was found in the resected specimens. Primary colorectal cancers composed of signet-ring cell carcinoma detected and treated at an early stage are extremely rare. We present a case and review the literature.

Aged↗
PubMed1997

Analysis of vascular anatomy and lymph node metastases warrants radical segmental bowel resection for colon cancer.

To determine the indications for limited colon cancer surgery in each location, we reviewed the arterial branching patterns and lymph node metastases along the course of specific vascular trunks in 344 colon cancer patients who had undergone preoperative angiography and colectomy with lymph node dissection. Our conclusions are follows: Because the ileocecal artery always arises from the superior mesenteric artery and lymph node metastases of cecum cancer were limited to nodes along the ileocolic artery, cecum cancer can be cured by ileocecal resection. The right colic artery has various origins, and ascending colon cancer shows various patterns of lymph node metastases. Therefore a right hemicolectomy should be performed for ascending colon cancer. The middle colic artery forks into right and left branches, and each branch has different branching variations. If the right colic and middle colic arteries have a common trunk, a right hemicolectomy should be performed for transverse colon cancer on the right side. If the left branch of the middle colic artery has an independent replaced origin, lymph node dissection should be modified according to the variant origin. If the left colic artery and the first sigmoidal artery have a common trunk, the lymph nodes along the common trunk should be removed for sigmoid colon cancer and for descending colon cancer. Of the patients with sigmoid colon cancer, 6.3% also had lymph node metastases along the superior rectal artery. Given that the lymph nodes along the superior rectal artery are skeletonized, sigmoid colon cancer can be also cured by partial sigmoidectomy.

Arteries↗
PubMed2005

Bochdalek's hernia in an adult with colon necrosis.

The improper fusion of the posterolateral foramina of the diaphragm was first described by Bochdalek in 1848. The true incidence of this congenital anomaly ranges from 1/7,000 to 6%. Although it is a well-known neonatal disease, it can also be diagnosed incidentally in adult patients. Until now, a total of around 100 cases of occult asymptomatic Bochdalek's hernia have been reported. The symptomatic cases are encountered more rarely. Colon necrosis among the symptomatic cases was reported in some cases. We herein report a case of a 21-year-old man with a left-sided Bochdalek's hernia which led to total necrosis of the transverse colon. Following resection and colocolonic anastomosis, the defect on the diaphragm was repaired. After an uneventful recovery period, he was discharged from the hospital on the 10th postoperative day. Being aware of this rarely encountered disease and of the factors for early diagnosis is of utmost importance to decrease mortality and morbidity.

Adult↗
PubMed1984

Mineralocorticoid receptors in the epithelial cells of human colon and ileum.

Specific binding of [3H]aldosterone to the cytosolic fraction of epithelial cells was studied in the human colon and terminal ileum. Analysis of [3H]aldosterone binding to the epithelial cells of ascending colon, caecum and ileum as a function of [3H]aldosterone concentration revealed only one class of specific receptors with an affinity constant of about 2 nmol/l. [3H]aldosterone binding was approximately the same in the sigmoid, descending and transverse colon and in the caecum, but slightly lower in the ascending colon and ileum. The specificity of the [3H]aldosterone binding was the same along the colon. The relative order of potency in inhibiting [3H]aldosterone binding was: aldosterone = SC 26304 = dexamethasone much greater than dihydrotestosterone greater than estradiol = RU 26988.

Aldosterone↗
PubMed2004

Intestinal pseudotumorous gouty nodulosis: a colonic tophus without manifestation of gouty arthritis.

A 37-year-old black woman with nephritis secondary to systemic lupus erythematosus, steroid-induced diabetes mellitus, and hypertension presented with fever, nausea, vomiting, and right upper quadrant abdominal pain with distension. Abdominal computed tomography (CT) scan revealed a colonic mass, and CT- guided fine-needle aspiration demonstrated birefringent crystalline material. After several weeks of antibiotic therapy, the patient underwent laparoscopic examination followed by extended right hemicolectomy for a large mass in the subserosa of the transverse colon. Pathological examination of this mass revealed it to be a gouty tophus. To our knowledge, no case of tophaceous gout presenting as an intestinal mass has previously been reported.

Adult↗
PubMed1990

Colonic atresia: current results of treatment.

Eleven cases of colonic atresia presenting in a 13-year period are described. The incidence of this condition is estimated at 1 per 66,000 live births in the north-west of England. A higher incidence of involvement of the transverse colon has been noted in comparison with previously reported cases. Survival was unaffected by the type of surgical procedure, with both primary anastomosis after resection or staged reconstruction after initial colostomy giving excellent results. No deaths occurred in the ten patients subjected to surgical treatment.

Anastomosis, Surgical↗
PubMed1982

Comparison of benzo(a)pyrene metabolism in bronchus, esophagus, colon, and duodenum from the same individual.

The metabolism of benzo(a)pyrene has been investigated in cultured normal human bronchus, colon, duodenum, and esophagus obtained from the same patient. The highest total metabolism was found in bronchus and duodenum, while the highest mean binding level was observed in the bronchus followed, in order, by the esophagus, duodenum, and transverse colon. A 30-fold interindividual variation in the binding level was found in each of the four organs studied, and a positive correlation between the binding levels in bronchus, colon, and duodenum was found. In human bronchus, a positive correlation was found between level of binding of benzo(a)pyrene to DNA and the amount of both benzo(a)pyrene 7,8-diol and the combined group of 3-hydroxybenzo(a)pyrene, benzo(a)pyrene 9,10-diol, and water-soluble metabolites. A significantly higher relative amount of benzo(a)pyrene tetrols and benzo(a)pyrene 9,10-diol was formed by human bronchus compared to the gastrointestinal tissues, while a higher level of benzo(a)pyrene phenols was formed by the latter. The relative distribution of benzo(a)pyrene-DNA adducts was similar in all four organs, the major DNA adduct being formed by trans-addition of anti-7,8-dihydroxy-9,10-epoxide-7,8,9,10-tetrahydrobenzo(a)pyrene to the 2-amino group at guanine. These results indicate that the metabolism of benzo(a)pyrene by at least four different organs is qualitatively similar but that quantitative differences exist.

Adolescent↗
PubMed1984

Hindgut duplication. Report of a patient with long-term follow-up.

A girl with a rare congenital malformation consisting of duplication of the urinary and genital tracts as well as of the entire colon, terminating in double rectogenital fistulas, is presented. Because of a small-capacity urinary bladder on one side and an atonic neurogenic bladder on the other side, urinary diversion was necessary. A preliminary diverting colostomy of the duplicated transverse colon was followed by anoplasty of one anus. Later on, the duplicated proximal colostomy was anastomosed to the one distal colon leading to the rectum with anoplasty. The treatment of this complex anomaly is described.

Abnormalities, Multiple↗
PubMed2006

A case of nonrotation of the midgut with a middle mesenteric artery.

In 2002, we came across a very rare case of nonrotation of the midgut with a middle mesenteric artery (MM) (tentative name). It was found in a 73-year-old Japanese female cadaver donated for student dissection at Kumamoto University. In this case, the small intestine occupied the right half of the abdominal cavity and the large intestine occupied the left half. The caecum was situated on the anterior inferior part of the abdominal cavity near the midline. The duodenum (Du) was fused to the posterior abdominal wall. The small intestine except the Du and the ascending colon were suspended from the posterior abdominal wall by the mesentery, but the remainder of the colon was fused to the left posterior abdominal wall. In addition, an anomalous branch arose from the abdominal aorta between the superior and inferior mesenteric arteries (SM and IM) in this case. It chiefly supplied the ascending and the transverse colons and anastomosed with the SM and IM, respectively, through the marginal arteries. It is very rare that these anomalies appear simultaneously in one body. In this case, it is difficult to declare that the existence of the MM directly caused the nonrotation of the midgut, but it is reasonable to suppose some kind of relation between them.

Aged↗
PubMed2004

An appendix carcinoid tumor in a patient with hereditary nonpolyposis colorectal cancer.

Gastrointestinal carcinoid tumors are often associated with other tumors, particularly colon adenocarcinomas; but the association between carcinoid tumors and hereditary nonpolyposis colorectal cancer (HNPCC) syndrome has not yet been explored. We report an unusual case of a 28-year-old woman with HNPCC who underwent surgery for a transverse colon adenocarcinoma in whom an appendix carcinoid tumor was incidentally found. To assess whether the carcinoid tumor displayed the characteristic molecular features of HNPCC tumors, we investigated the expression of mismatch-repair (MMR) proteins and microsatellite instability (MSI) status in both tumors. Both tumors demonstrated normal expression of the MMR proteins hMLH1, hMSH2, hMSH6, and hPMS2. Interestingly, the adenocarcinoma exhibited an MSI phenotype but the carcinoid tumor did not, indicating that these 2 tumors arose through different molecular pathways.

Adult↗
PubMed2004

Malignant duodenocolic fistula. Various therapeutic surgical modalities.

Malignant duodenocolic fistulas are the most rare and evolutive complication of colonic cancer due to their rapid nutritional disturbances and difficult surgical management. This case report details a 23-year-old female who presented with diarrhea, anorexia, weight loss, anemia and abdominal pain. A series of examinations showed a transverse colon carcinoma with a malignant duodenocolic fistula and direct infiltration of the right lobe of the liver. The patient underwent extended right hemicolectomy with wide local excision of the duodenum and segmental hepatic resection. Postoperative recovery was uneventful. The analysis of other similar cases from the literature treated with this procedure or less frequently, with right hemicolectomy and pancreaticoduodenectomy, allows us to discuss the indications and results of radical surgery. Whenever feasible, resection offers the best treatment as lesser techniques such as bypass and exclusion result only in minimal palliation. The benefit of exploration should almost always be offered, even in such secondary fistulas, as a better quality of life and long term survival are realistic goals and prognostically justifiable.

Adult↗
PubMed1992

[Perioperative morbidity and mortality of colon resection in colonic carcinoma].

An analysis of the local and systemic perioperative complications is conducted to explore the risk of resection of colon cancer. In a retrospective study we analyzed 231 consecutive patients operated on between 1984 and 1988. The mean age was 70 (37-91) years. The operations consisted in 3 ileocecal resections, 144 right hemicolectomies, 10 resections of the transverse colon, 22 left hemicolectomies, 77 resections of the sigmoid colon and 5 subtotal colonic resections. 2 patients (0.9%) had a clinical leakage of the anastomosis. 3 patients were reoperated: one because of anastomotic leakage and two because of ileus due to small bowel adhesions. 2 patients with uncomplicated local healing died within 30 days after the operation from systemic complications (mortality 0.9%). It is concluded that with standardized preoperative bowel preparation, prophylactic perioperative antibiotics and modern anesthesia, the resection of colon cancer is today possible with minimal perioperative risk.

Adult↗
PubMed1994

Feasibility of transcolonic and transgastric abdominal vascular ultrasound.

Abdominal vascular ultrasound is hampered by tissue attenuation. To improve imaging, the feasibility of real-time color Doppler transcolonic and transgastric abdominal vascular ultrasound was evaluated. A monoplane 5 MHz transesophageal probe was inserted via a proctoscope in five patients with normal colons. At 25 cm (end of proctoscope), the aortic bifurcation and iliac arteries were dynamically imaged with high resolution. In three patients undergoing abdominal surgery, the surgeon grasped the probe and advanced it further through the descending to the transverse colon to examine further vascular structures. High resolution two-dimensional imaging and color Doppler flow were obtained from the abdominal aorta, the origins and proximal portions of the superior mesenteric artery, and the renal and the inferior mesenteric arteries. Additionally, the inferior vena cava, left renal vein, and portal system were imaged. All vascular structures imaged were within 3 cm of the probe. In two additional patients undergoing abdominal surgery and transesophageal echocardiography, the surgeon grasped the probe in the stomach and placed it on various vascular structures. The results were similar and the celiac trunk was also imaged. This technique, when integrated with fiberoptics for guidance, could provide a method for abdominal vascular ultrasound with less tissue-imposed attenuation, providing high resolution imaging and allowing additional structure recognition. This has potential applications for studying patients with disease of the abdominal aorta or its branches.

Abdomen↗
PubMed1993

[The continent urinary reservoir].

Continent urinary reservoirs (CUR) have replaced ileum and colonic conducts as the best method for urinary diversion. The author present their experience with two patients in whom they fashioned a CUR in the Dr. Arnulfo Arias M. Metropolitan Complex using the ileocecal segment and part of the transverse colon (The Miami or Florida porch technique). They describe the clinical histories, surgical technique and the results obtained. They feel that the CUR has a large capacity, works at low pressure and is technically accessible. They consider it a good choice when urinary diversion is needed.

Adult↗
PubMed2006

Colonic necrosis because of strangulated recurrent Morgagni's hernia in a child with Down's syndrome.

Postoperative bowel obstruction complicating a recurrent Morgagni's hernia (MH) is an uncommon condition and hence the presentation. Nonspecific symptoms and misleading radiologic image may result in misdiagnosis and severe complications. We report the case of a child with a transverse colon necrosis because of strangulation in a misdiagnosed recurrent MH. The child presented with bowel obstruction and repeated chest infections. Colonic necrosis could be avoided by timely diagnosis and repair of MH. This severe and rare occurrence complicating a recurrent MH should be kept in mind in children with respiratory tract infections and vomiting.

Anastomosis, Surgical↗
PubMed1992

Ileocolonic transit does not change after right hemicolectomy.

The role of the human ileocolonic junction in the transit of solid contents through the entire gut was evaluated. Eight patients, well compensated after right hemicolectomy for localized colon cancer, and eight age-matched healthy controls were enrolled. Scintigraphic transit was quantified after subjects ingested a mixed meal containing 111In-labeled Amberlite beads (average diameter, 1 mm; Sigma Chemical Co., St. Louis, MO). Gastric emptying was initially faster in the postoperative group, but overall emptying was not different from controls; small bowel transit also did not differ between the groups. In patients in whom the distal ileum, ileocolonic sphincter, and proximal colon were absent, isotopes moved from small to large bowel in a manner that was qualitatively and quantitatively no different from that of controls. Major episodes of coloileal reflux could not be identified in either group. After hemicolectomy, the residual transverse colon, and to a lesser degree the descending colon, were able to store solid residue, although in lesser amounts than the unoperated large bowel. The ileocolonic sphincter in humans appears to play only a minor role, at most, in ileocolonic transit, and the colon remaining after right hemicolectomy stores residue so that bowel habits are not greatly disturbed.

Aged↗