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At least 1,423 records · Page 79Linked to original sources
PubMed1983

Identification and quantification of lower gastrointestinal flexible endoscopic microflora.

After use in 29 patients undergoing mechanical bowel preparation and cleansing by an acceptable, standardized method, flexible colonoscopes and sigmoidoscopes were cultured for identification and enumeration of bacterial organisms that might be transmitted during subsequent endoscopic procedures. Using a unique, new application, RODAC aerobic and anaerobic cultures of the shaft surface showed no evidence of residual fecal contamination, sparse growth of cutaneous and airborne organisms on some instruments, and no aerobic or anaerobic bacterial growth on others. There were no post-endoscopy infectious complications. Our results would indicate that proper cleaning of the flexible endoscope using an acceptable method does prevent bacterial disease transmission from patient to patient.

Bacteria↗
PubMed1982

Colonoscopy: its role in cancer of the colon and rectum.

In order to determine the feasibility, yield, and impact of routine total colonoscopy on the management of large-bowel cancer, 157 cancer patients underwent 175 colonoscopic procedures; 13.6 per cent of the cancers had been missed on double-contrast barium enema examination. Among 92 patients undergoing perioperative colonoscopy, the lesion was reached in 90 per cent and the cecum in 60 per cent; 7.6 per cent demonstrated synchronous cancers, all curable, and all missed on barium-enema examination. Seventy-eight patients underwent colonoscopy at an average of 3.7 years after treatment of the index cancer; 7.7 per cent demonstrated metachronous cancers, all curable, two-thirds of which were missed on barium-enema examination. Benign polyps were noted in 62 per cent of the patients studied; 77 per cent of those polyps, 1 cm or greater in size, were missed on barium-enema examination. Polyps were found proximal to the cancer in 60 per cent of the patients with polyps. Approximately 85 per cent of those with multiple cancers demonstrated benign polyps. Preoperative total colonoscopy with periodic postoperative colonoscopy at an interval of three to five years are essential in the reliable detection of synchronous cancers and for the detection of metachronous cancers at an earlier, more favorable stage.

Cecal Neoplasms↗
PubMed1979

Sigmoidoscopic examinations with rigid and flexible fiberoptic sigmoidoscopes in the surgeon's office: a comparative prospective study of effectiveness in 1,012 cases.

The results obtained from 1,012 examinations in an on-going, cooperative study indicate that the overall yield provided by use of the flexible fiberoptic sigmoidoscope is 3.2 times greater than that of examinations with the rigid sigmoidoscope. More than twice (2.4 times) the number of polyps and more than three times the number of cancers were detected with the flexible fiberoptic sigmoidoscope. Experienced endoscopists can perform an examination with the flexible fiberoptic sigmoidoscope expeditiously in the office with minimal patient preparation, a high level of patient and physician acceptance, and relative safety when the usual mandatory colonoscopic precautions and guidelines are obeyed. The extraordinary advantages demonstrated by this study warrant wide clinical application of the flexible fiberoptic sigmoidoscope. We strongly recommend provision be made for appropriate training of physicians in the use of the instrument.

Colon, Sigmoid↗
PubMedDate not supplied

Inflammatory fibroid polyp of sigmoid colon.

A case of inflammatory fibroid polyp of the sigmoid colon is presented. This is the eight case of this type of polyp in the colon and, to the best of our knowledge, the first one involving the sigmoid and producing intussusception. Symptomatology of the inflamed fibroid polyp in this part of the gut closely simulates gastrointestinal malignancy. The treatment is surgical excision of the polyp, or colonoscopic resection when it is possible. Intraoperative colonoscopy helps the surgeon to localize the lesion and to role out the existence of other lesions.

Colon, Sigmoid↗
PubMedDate not supplied

Colonoscopy in the differential diagnosis of colonic strictures: report of four cases.

Colonoscopy was performed on ten patients who had colonic strictures demonstrated by barium-enema examination. In all cases the diagnosis of carcinoma had been considered, but it was confirmed by colonoscopic examination, cytology, and biopsies in only two patients. Five patients were shown to have benign inflammatory strictures due to ischemic colitis, ulcerative colitis, Crohn's disease, irradiation colitis, or postoperative strictures. The remaining three patients were shown to have no intrinsic lesion. These eight patients were thereby spared further diagnostic procedures, and even unnecessary laparotomy.

Aged↗
PubMedDate not supplied

Rectal bleeding due to amebic colitis diagnosed by multiple endoscopic biopsies: report of two cases.

Recurrent rectal bleeding over a period of seven and 12 months, respectively, was the main and unusual manifestation of amebic colitis in two patients. The difficulty in establishing the diagnosis led to one patient's receiving potentially dangerous steroid therapy. Only by taking multiple colonoscopic biopsies was the amebic colitis recognized. This and serologic tests, should be routine in all cases of inflammatory bowel disease before initiating therapy.

Adolescent↗
PubMed1991

An appraisal of small and diminutive colonic polyps.

A retrospective review of all colonoscopic polypectomies performed in a busy surgical endoscopy unit over a 6-month period was undertaken. All patients were included who presented with colonic polyps measuring less than 1 cm in diameter for which sufficient specimens were available for histopathologic examination. In all, 262 were polyps removed from 206 patients; of these, 158 (60%) were neoplastic. There was a statistically significant predilection for polyps in the right colon to be neoplastic. Worrisome histologic patterns (severe dysplasia, carcinoma in situ, or invasive carcinoma) were seen in 18 specimens (6.5%). In two patients, polypoid carcinoma could be identified; in one case it involved a lesion measuring 0.2 cm in diameter. Since these lesions exhibit no distinctive gross features, only their endoscopic removal and histologic study can ensure proper diagnosis and treatment.

Adult↗
PubMed1978

Endoscopic studies on the minute structures of colonic mucosa in the follow-up observation of ulcerative colitis.

Thirty cases of ulcerative colitis were examined endoscopically by means of magnifying colonoscope with dye spraying method (the combined method), and their minute mucosal structures were classified into four categories endoscopically, which correlated well with the histological findings. By this procedure, it was easy to detect the subsidence of inflammation of the mucosa in the quiescent phase or to reveal the active inflammatory involvement of the bowel. Moreover, inspecting the minute changes of the colonic mucosa detected by the combined method, remission was more correctly decided and rigid control is contributing to the decrease in the recent rate of recurrence of ulcerative colitis.

Adolescent↗
PubMed1990

Colonoscopy for investigation of unexplained rectal bleeding in a tropical country.

One hundred and forty four patients underwent colonoscopy to detect the cause of rectal bleeding. This was successful in either identifying the lesion or excluding the presume of lesions up to the cecum in 88.8% patients. The source of bleeding was diagnosed in 106 (73.61%) patients. Predominant lesions were nonspecific colitis and ulcers (62.26%), polyps (17.92%), cancer (8.49%), rectal varices (3.77%) and tuberculosis (1.88%). The remainder had other colonic conditions such as radiation colitis, ischemic colitis, vascular malformation, diverticulosis, right sided ulcerative colitis and pseudo-pancreatic cyst communicating with the descending colon. The majority (94.33%) of these lesions involved the left colon. Thus colonoscopic examination was useful in localizing the cause of rectal bleeding and the predominant lesions were differed from those reported in the western hemisphere.

Adult↗
PubMed1998

Ischemic stricture of the small intestine associated with acute pancreatitis.

A 37-yr-old man underwent an open drainage operation for severe acute pancreatitis and received respiratory ventilation support for 4 mo because of respiratory failure based on disseminated intravascular coagulation (DIC) and septic shock. Under intensive care, he sometimes had bloody diarrhea for about 6 wk. Colonoscopic findings suggested that the bleeding had derived from the small intestine. The patient then gradually recovered from acute pancreatitis and was discharged from the hospital. Thereafter, he suffered relapses of ileus and his symptoms progressively worsened. The patient underwent a second operation about 2 yr after the onset of acute pancreatitis. At celiotomy, multiple stenoses of the distal ileum measuring about 60 cm in length were found and the segment was resected. The resected specimen demonstrated six separate circumferential strictures and shallow ulcerations. Histologically, multiple ulcerations were restricted to the mucosa and were accompanied by marked submucosal edema and fibrosis. The mucosa between the ulcers revealed chronic regenerative changes: intimal thickening of small mesenteric arteries causing luminal narrowing and organized thrombosis in small mesenteric veins. Therefore, these were considered to be a series of segmental ischemic lesions. Note that delayed ischemic stricture of the small intestine may occur as a chronic complication of acute pancreatitis.

Acute Disease↗
PubMedDate not supplied

C-reactive protein and monitoring the activity of Crohn's disease.

Biological treatments (anti-tumor necrosis factor-a antibody, mitogen-activated protein kinase inhibitors) and azathioprine given to patients with Crohn's disease (CD) provide the opportunity for mucosal healing. This fact has given rise to the question of whether clinical relief or mucosal healing is the treatment goal in CD. If only clinical relief is sought, current indexes should be reevaluated. In this study, investigators explored the relationship between findings of endoscopic activity, Crohn's Disease Activity Index (CDAI) scores, and C-reactive protein (CRP). This study attempted to clarify the relationship between a high CDAI score (CDAI >150), raised serum CRP, and endoscopic activity in patients with CD. This retrospective study included 115 patients with Crohn's ileocolitis and colitis. CDAI score, CRP level, and mucosal lesions were compared with the chi2 test. The relation between endoscopic activity and raised CRP was significant (P=.001), unlike the association of endoscopic activity with CDAI (P=.287). Mucosal activity was most intense in patients who had both a high CDAI and a raised CRP (84%). No significant difference in endoscopic activity was noted, however, between patients with raised CRP + high CDAI, raised CRP + low CDAI, normal CRP + high CDAI, and normal CRP + low CDAI (P=.113). CRP seemed to be more sensitive than CDAI in the evaluation of patients with CD. The relationship between high CDAI, raised CRP, and the presence of colonoscopic mucosal activity was poor. Therefore, CDAI and CRP are not viewed by the authors as reliable measures of CD activity.

Biomarkers↗
PubMed1989

Mast cells in ulcerative colitis. Quantitative and ultrastructural studies.

The changes in the number and ultrastructure of mast cells were studied in 37 colonoscopical biopsies from patients with ulcerative colitis. Changes in the active stage of the disease and during remission were compared. Cell counts were performed on semithin sections stained with Giemsa after osmium tetroxide fixation. This method overcome the uncertain staining found after formalin fixation. Accumulation of mast cells accompanied by intense degranulation was found to be significant in the active stage of the disease. Two forms of degranulation were observed: discharge of the individual granules and protrusion and detachment of the cytoplasmic processes containing granules. The latter was a sign of rapid degranulation, as described earlier in animal experiments. Mast cells were closely associated with capillary blood vessels, Schwann cells, neural fibres, myofibroblasts and collagenous fibres, and were also present between epithelial cells. It is assumed that close topographic contact may also imply a functional correlation.

Adult↗
PubMed1997

Varioliform mucosal polypoid lesions in intestinal tract in a patient with adult T-cell leukemia.

We describe a case of adult T-cell leukemia (ATL) with intestinal infiltration. In the early clinical stage, the endoscopic findings for the intestine were similar to those of amebic enterocolitis, i.e., varioliform mucosal polypoid lesions, and amebic cyst was detected with stool examination. Although no specific pathological factor could be identified on biopsy, the patient was treated for amebiasis as a diagnostic therapy. The findings of varioliform mucosal polypoid lesions were detected in the duodenum on endoscopic examination, but the lesions eventually disappeared during the treatment for amebiasis. We then suspected lymphoma partially masked by the amebiasis. Immunological staining of a specimen of the colonic mucosa revealed T cell invasion and Southern blotting demonstrated adult T-cell leukemia provirus invasion. Thus, ATL cell infiltration of the intestinal tract was confirmed. It is suggested that systemic disease should also be considered when varioliform mucosal polypoid lesions are found on colonoscopic examination.

Amebiasis↗
PubMedDate not supplied

Pseudocarcinomatous invasion in adenomas of the colon and rectum.

Of 182 polyps retrieved from 100 patients who underwent colonoscopic polypectomies, 160 were adenomas; of these, 16 contained epithelial inclusions within the stalk. The importance of recognizing this lesion lies in the fact that it mimics invasive cancer. From histologic study, criteria are proposed for differentiating the pseudocarcinomatous lesion from invasive cancer. The differentiation from colitis cystica profunda is also discussed.

Adenoma↗
PubMed2003

Acute colonic pseudo-obstruction (Ogilvie's-syndrome) and pneumatosis intestinalis in a kidney recipient patient.

Acute colonic pseudo-obstruction (Ogilvie's syndrome) is a clinical entity characterized by massive nontoxic dilatation of the colon in the absence of mechanical obstruction and is associated with increased morbidity and mortality in the immunosuppressed patient. We present a case of a kidney transplant recipient developing a life-threatening condition with acute colonic pseudo-obstruction associated with radiologic findings of a linear pneumatosis intestinalis (PI). Urgent laparotomy and resection of the dilated cecum, colon ascendens and transversum was performed because of bowel necrosis with multiple serosal defects. Stool cultures and special stains for microorganisms were all negative, and there was no evidence for viral or fungal infection. The patient was discharged 31 days after transplantation with normal renal function. In conclusion, this steroid-induced ileus (pseudo-obstruction) is a potentially malignant early form of colonic dysmotility rarely reported in transplant recipients. Awareness and early recognition of the condition are critical for a successful outcome. Colonoscopic decompression can achieve reversal of colonic dilatation in most cases, but in some patients prophylactic laparotomy is indicated for prevention of the catastrophic consequences of perforation.

Adrenal Cortex Hormones↗
PubMed2000

Active intestinal tuberculosis with esophageal candidiasis due to idiopathic CD4(+) T-lymphocytopenia in an elderly woman.

We describe a case of intestinal tuberculosis and esophageal candidiasis in an 85-year-old Japanese woman with idiopathic CD4+ T-lymphocytopenia (ICL). The patient exhibited clinical symptoms of odynophagia, bloody diarrhea, and high fever. Physical examination on admission showed a poor nutritional status. Endoscopic examination of the upper digestive tract revealed the esophageal mucosa to be covered with yellowish-white plaque-like lesions. Colonoscopic examination revealed multiple annular ulcerations with bleeding. She was diagnosed with intestinal tuberculosis by polymerase chain reaction (PCR) and fecal culture. Her CD4+ T-lymphocyte count was 178/mm3 and no evidence of human immunodeficiency virus (HIV) infection was found. She was successfully treated with fluconazole and antituberculosis drugs. This case emphasizes the importance of opportunistic infections in elderly patients with predisposing conditions such as ICL.

Aged↗
PubMed2001

Multiple colonic ulcers caused by Churg-Strauss syndrome in a 15-year-old girl.

Churg-Strauss syndrome (CSS), or allergic granulomatous angiitis, is an uncommon vasculitic syndrome that is found mainly in middle-aged adults. We describe a 15-year-old girl with CSS, diagnosed by histological findings and characteristic clinical features. The patient experienced two episodes of catastrophic gastrointestinal vasculitis, resulting in resection of 150 cm of small intestine and right hemicolectomy. Colonoscopic examination showed multiple colonic ulcers with active bleeding. The clinical course of the patient was grave and refractory to the therapy of steroid and cytotoxic drugs. In the world literature only two patients with multiple colonic ulcers caused by CSS have been reported, and very rare cases of childhood-onset CSS have been published. We reviewed CSS in children and found that the prognosis was poorer than that in adults.

Adolescent↗