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At least 1,441 records · Page 80Linked to original sources
PubMed2006

[Rare case of duplex colon invagination].

Authors recite the records of a patient (26) with a 3-year history of dubious abdominal complaints and subileus resulting in numerous examinations and surgical observations, with the diagnosis of lower abdominal pain of unknown origin. He was acutely admitted to the department of surgery because of haemorrhage ex ano and convulsive left abdominal pain. Image creative examinations revealed ileus of a probable invagination origin. Partial resection of the transverse colon with "end to end" anastomosis was performed. Histology verified Peutz-Jeghers syndrome. The authors draw attention to the fact that although invaginations are rare above 18 years, when verified preoperatively, elective procedures can be carried out with lower risk to the patient.

Adult↗
PubMedDate not supplied

[Critical areas and suture incompetence in interintestinal anastomoses].

Clinical observations confirming the presence of critical zones in blood supply of the intestine are presented. It was shown that exclusion of the vessels of the right half of the colon is responsible for the disturbance of blood supply in the terminal part of the small intestine. Suture bands should be displaced to the level at which the intramural pressure ensures the viability of the intestine in the anastomosis zone. This should be taken into account in resections of the transverse colon, left-side hemicolectomy, abdominal resection and frontal resection of the rectum.

Anastomosis, Surgical↗
PubMed2000

Site-dependent production of transforming growth factor beta1 in colonic mucosa: its possible role in tumorigenesis of the colon.

Transforming growth factor (TGF) beta1 has an antitumorigenic role in the gastrointestinal tract and may be associated with the development of colon neoplasia. In the present study we investigated whether TGF-beta1 production in mucosa is lower in the distal colon, which is where clinical evidence shows that the incidence of colon neoplasia is higher, and whether TGF-beta1 levels were lower in the mucosa of patients with colon adenoma. Production of colon mucosa TGF-beta1 was investigated by means of a 24-hour organ culture with biopsy specimens taken from different segments of the colon of 58 normal subjects by using an enzyme immunoassay. TGF-beta1 production in colon mucosa from locations near the site of sporadic adenoma was also investigated in 46 patients. TGF-beta1 production gradually increased from the rectum to the ascending colon in a statistically significant manner in both normal (r = 0.77, P < .0001) and adenoma-bearing (r = 0.8, P < .0001) mucosa. When TGF-beta1 production was compared between normal and adenoma-bearing mucosa, levels were lower in the latter, although statistically significant results were seen only in the transverse colon (P < .05). TGF-beta1 production has clear site dependency, being lowest in the rectum and highest in the ascending colon. Furthermore, low levels of TGF-beta1 are associated with the development of adenoma. Our results suggest the possibility that this site dependency is associated with the higher epidemiologic incidence of colon neoplasia in the distal colon.

Actins↗
PubMedDate not supplied

[Primary intestinal tuberculosis].

Tuberculosis, with its pulmonary and extrapulmonary localizations, is rapidly increasing in Italy. The authors describe a case of a primary colonic tuberculosis in a 52-year-old Caucasian man. At admission the patient reported a 6-month history of constipation, weight loss and abdominal pain. He had rectal bleeding in the last two weeks. Haematological tests and chest X-ray were negative. Colonoscopy showed a stricture in the proximal transverse colon and multiple ulcers in the ileocecal tract. Multiple biopsies and culture demonstrated tuberculosis. The patient underwent a right hemicolectomy after an episode of acute intestinal hemorrhage and received pharmacological treatment for nine months. After four years he is still free of disease.

Antitubercular Agents↗
PubMed2001

Schwannomas in the colon and rectum: a clinicopathologic and immunohistochemical study of 20 cases.

Schwannomas of the colon and rectum are uncommon and incompletely characterized tumors, and only a small number of cases have been reported. This study was undertaken to determine the clinicopathologic profile of such tumors. A total of 20 colorectal schwannomas were identified and analyzed in a review of 600 mesenchymal tumors of the colon and rectum from the files of the Armed Forces Institute of Pathology. The schwannomas occurred equally in men (n = 9) and women (n = 11) in a wide age range (18-87 years; median age 65 years). The most common location was cecum (n = 7), followed by sigmoid and rectosigmoid (n = 6), transverse colon (n = 3), descending colon (n = 2), and rectum (n = 1); the location of one tumor had not been specified. The tumors commonly presented as polypoid intraluminal lesions, often with mucosal ulceration. Rectal bleeding, colonic obstruction, and abdominal pain were the most common presenting symptoms. The most common histologic variant (n = 15) was a spindle cell schwannoma with a trabecular pattern and vague or no Verocay bodies. These tumors ranged from 0.5 to 5.5 cm in diameter. A lymphoid cuff with germinal centers typically surrounded these tumors and focal nuclear atypia was often present, but mitotic activity never exceeded 5 per 50 HPF. All four epithelioid schwannomas occurred in the descending colon or sigmoid, three of them as small submucosal tumors. There was one plexiform schwannoma in the sigmoid composed of multiple nodules of prominently palisading schwann cells similar to those seen in conventional soft tissue schwannomas. All tumors studied were strongly positive for S-100 protein and also for low affinity nerve growth factor receptor (p75), collagen IV, and GFAP. Three tumors had CD34-positive cells, but all were negative for CD117 (KIT), neurofilament proteins, smooth muscle actin, and desmin. The percentage of MIB-1-positive cells was usually less than 1% and never higher than 3%. Colorectal schwannomas behaved in a benign fashion with no evidence of aggressive behavior or connection with neurofibromatosis 1 or 2, based on follow-up information on 18 patients.

Adolescent↗
PubMed1998

Nonsteroidal-induced benign strictures of the colon: a case report and review of the literature.

Colonic strictures are a rare complication reported to result from chronic use of sustained release formulations of indomethacin and diclofenac. Such strictures often present with associated mucosal ulceration and are thought to result from nonsteroidal antiinflammatory drug-induced alterations in enterocyte homeostasis. Strictures generally occur in the cecum, ascending, and proximal transverse colon with symptoms of occult blood loss, obstruction, changes in bowel habits, and rarely, perforation. The first reported case of a 69-year-old woman who developed recurrent colonic strictures with inflammatory changes and mucosal ulceration while taking Lodine (etodolac) is presented. A brief review of the relevant literature and suggested preventative therapies are discussed.

Aged↗
PubMed2005

Difficulties in assessing cytomegalovirus-associated gastric perforation in an HIV-infected patient.

BACKGROUND: Active Cytomegalovirus (CMV) infection is a common complication in advanced symptomatic Human Immunodeficiency Virus (HIV) infection. CMV-induced intestinal perforations are hard to diagnose and may be observed throughout the gastrointestinal tract. Isolated stomach perforation is exceptional. CASE PRESENTATION: A 47-year-old man was admitted to our intensive care unit with multiorgan failure. Gastrointestinal endoscopic examination showed erythematous gastritis but normal duodenum and colon. CMV blood culture was positive. Histologic examination of a gastric biopsy showed inflammatory infiltrate and immunostaining typical intranuclear CMV inclusion bodies. Concomitant abdominal CT scan disclosed large peripancreatic hypodensities without pneumoperitoneum. The patient died despite supportive therapies and ganciclovir infusion. Postmortem examination showed a 4-cm gastric perforation adhering to the transverse colon and liver, with a thick necrotic inflammatory coating around the pancreas. The whole GI tract, except the stomach, was normal. As other causes, especially Helicobacter pylori infection could be ruled out, a causal relationship between CMV and gastric disease was assumed. CONCLUSION: CMV may be responsible for gastric perforations, with difficulties in assessing the diagnosis. Early diagnosis based on cautious endoscopy and histopathologic examination is needed to make a favorable outcome possible.

Antiviral Agents↗
PubMed1987

Chronic nonspecific inflammatory bowel disease of the cecum and proximal colon in children with grossly normal-appearing colonic mucosa: diagnosis by colonoscopic biopsies.

The diagnosis of inflammatory bowel disease rests on radiologic, endoscopic, and histologic criteria. Five patients, 2 to 17 years of age, sought medical attention because of chronic abdominal pain, diarrhea, and heme-positive stools. Rectal biopsies, visual inspection of colonic mucosa through the colonoscope, and contrast radiographs of the large and small intestine yielded nonspecific results. Serial endoscopic biopsies demonstrated a gradient of inflammatory changes diminishing in severity distally from the ileocecal valve and cecum. The disease process was most evident in specimens from the cecum, whereas biopsies distal to the transverse colon had a normal histologic appearance in all five patients. Biopsies from the proximal colon may provide evidence of inflammatory bowel disease not detectable using standard techniques. The combination of chronic abdominal pain, diarrhea, and heme-positive stools associated with inflammatory changes in biopsy specimens obtained from the proximal colon, but normal findings on radiologic, colonoscopic, and rectal biopsy examinations, may represent an early stage in the evolution of chronic nonspecific inflammatory bowel disease, including ulcerative colitis or regional enteritis (Crohn disease).

Adolescent↗
PubMed2004

Sudden death of a patient with primary hypereosinophilia, colon tumours, and pulmonary emboli.

A 33 year old man was admitted to hospital six days after the onset of abdominal pain. There was hypereosinophilia, but the cause could not be identified (primary hypereosinophilia). The hypereosinophilia, high C reactive protein concentration, and gastrointestinal symptoms were alleviated by corticosteroid treatment. Unexpectedly, after this apparent recovery, he was found dead on the 27th day after admission. Necropsy disclosed two solid tumours primarily composed of eosinophils in the ascending and transverse colon. The cause of the sudden death was pulmonary artery emboli, derived from a thrombus in the left iliac vein.

Adult↗
PubMed1979

Colonic obstructions due to enteroliths in four horses.

Four cases of enterolith obstruction in horses aged from six to 14 years are reported. All four cases had symptoms of persistent low grade abdominal pain and anorexia with an absence of defaecation. Examination revealed reduced gut motility and accumulation of gas, but heart and respiratory rates, rectal temperatures and complete blood counts were all within normal limits. Enteroliths of varying sizes were removed from the region of the transverse colon in all four horses.

Animals↗
PubMed2006

Ethanol injection for ablation of an intractable digestive tract fistula: report of a case.

We successfully occluded an intractable digestive tract fistula by injecting it with absolute ethanol after all other treatments failed. A 48-year-old man suffered from a complex and relapsing digestive tract fistula after curative surgery for advanced colon cancer invading the pancreas and duodenum. After conservative management by fasting, drainage, and irrigation failed, fibrin glue infusion achieved only transient occlusion. We performed surgical repair and he was discharged from hospital, at which time fistulography showed no fistula. However, 1 month later fistulography showed that the fistula had recurred and involved the transverse colon, stomach, and intrahepatic bile duct via the jejunum. Finally, we gave five injections of absolute ethanol into the fistula, which resulted in complete occlusion within 6 months. Considering its clinical efficacy, safety, and cost efficiency, we think that ethanol sclerotherapy is a feasible treatment for intractable digestive tract fistula when conservative therapy fails.

Ethanol↗
PubMedDate not supplied

Retroarterial colon with right-sided obstructive gangrenous colitis.

Retroarterial colon is a rare entity in which the colon is located behind the superior mesenteric vessels. Transmesenteric internal hernias result in portions of the bowel protruding through a defect in the mesentery and are often acquired but may be congenital. We report a 10-year-old female with trisomy 13 who lacked retroperitoneal fixation of the intestines and had a retroarterial transverse colon possibly resulting from a congenital transmesenteric internal hernia, that eventually lead to obstructive gangrenous colitis.

Abnormalities, Multiple↗
PubMed1976

[Colon occlusion due to safety belt (authors transl)].

The author describes a delayed occlusion of the colon, consecutive to an ischemic constriction, occurring after a car accident in a patient wearing his safety belt. The patient, 49 years old, had undergone urgent laparotomy just after the accident: intraabdominal hemorrhage from hepatic and mesocolic lacerations were discovered and treated. Six weeks after that operation the patient developed an occlusion of the transverse colon necessitating segmental resection and end-to-end anastomosis. Pathology disclosed typical signs of ischemia with constriction. This was considered due to the horizontal part of the safety belt. This should be placed low and tight enough so that the pelvis, rather than the abdominal viscera, receives the shock. After accidents with safety belts the possibility of such complications should be present at mind.

Abdominal Injuries↗
PubMedDate not supplied

Hiatal herniation of the colon in an infant.

Colonic herniation through the esophageal hiatus is an unusual condition. This paper deals with such a case involving a seven month-old girl. She had had no previous symptoms, but had bloody feces after a diagnosis of sliding hiatal herniation of the stomach had been made. Barium enema revealed hiatal herniation of the transverse colon accompanying gastric herniation. At operation hiatal hernia was corrected and Nissen's fundoplication was added. Her postoperative course was uneventful. To our knowledge this is the first description of hiatal herniation of the colon in infancy and childhood.

Barium Sulfate↗
PubMedDate not supplied

[Angiographic study of the colonic vessels with a view to esophagoplasty].

Variants of the colic vessels were studied angiographically in 34 cadavers, drawing up an original classification of the colic arteries arising from the lower mesenteric artery. Sixteen variants of the left colic artery were found, which were grouped into five main types, the classical type being encountered in only 22.6% of the cases. In one case the lower mesenteric artery was absent. In coloesophagoplasty better results were obtained with the isoperistaltic transverse colon than with the upper ileocolon in 64% of the cases and similar results in 20%; in 16% of the cases the latter operation was preferable.

Angiography↗
PubMed1999

Colonoscopy aided by magnetic 3D imaging: is the technique sufficiently sensitive to detect differences between men and women?

Colonoscopy tends to be more difficult to perform in women. Women also experience more pain during flexible sigmoidoscopy, and the mean insertion distance of the instrument is less than in men. The 'Bladen system', first described in 1993, is a non-radiological method of continuously visualising the path of the endoscope using magnetic drive coils under the patient and a chain of sensors up the biopsy channel of the instrument. In 1998, results were published that used a novel computer graphics system (the 'RMR system'), in which a much more realistic endoscope could be produced using the stored positional data from the Bladen system. The RMR computer graphics system has been further refined to enable measurement of the anatomical lengths of different parts of the large intestine to an accuracy of greater than 5 mm. The system is used to analyse the results obtained in 232 patients undergoing a total colonoscopy. In women, the colonoscope tends to form loops in the sigmoid colon more readily than in men (p < 0.05). When the first 50 cm of the endoscope are inserted for the first time, the tip passes either up to or beyond the splenic flexure in 40/116, or 34.5%, of males, compared with 24/117, or 20.5%, of females (p = 0.0137). It is demonstrated that women have longer transverse colons than men, and the differences are especially apparent when a stiffening tube is used to splint the left side of the colon (p < 0.0001). The possible relevance of these observations to biomedical engineers and those manufacturing and assessing prototype endoscopes is discussed.

Adult↗
PubMed2003

[Comparative evaluation of surgical interventions in patients with colonic tuberculosis].

Forty-two patients aged 20-60 years with colonic tuberculosis underwent surgical intervention. At the same time, the following types of surgical intervention were used: exploratory laparatomy in 15 patients, colectomy, ileostomy in 8, right-sided hemicolectomy with ileotransverse anastomosis in 7, right-sided hemicolectomy with abdominoanal resection of the rectum in 3, left-sided hemicolectomy by bringing down a transverse colonic segment into the anal canal with ileotransverse anastomosis in 2, ileotranverse anastomosis in 3, initial colonic resection in 2, and colonic resection with ileosigmoidal anastomosis in 2 patients. The purpose of the study was to elaborate the optimum type of an operation depending on the site of a process. It has been ascertained that it is advisable to perform one-stage surgical interventions. At the same time it is necessary to accomplish a through comprehensive preparation for surgery and to take into account contraindications, such as severe heart and respiratory failures, and ileus.

Adult↗
PubMedDate not supplied

Localized AL amyloidosis of the colon and clinical features of intestinal obstruction. A case report.

The term amyloidosis refers to a group of disorders characterized by the extracellular accumulation of insoluble, fibrillar proteins (i.e. amyloid) in various organs and apparatuses. Local deposition of amyloid without systemic involvement is a rather uncommon form that gives rise to an amyloid pseudo-tumor or "amyloidoma". This paper describes the clinical features of an intestinal subocclusion observed in an elderly patient with localized primary amyloidosis of the transverse colon. The endoscopic picture indicated a stenosing neoplasm. Segmentary colectomy, however, followed by histological examination (characteristic green color in polarized light after staining with Congo red) and immunohistochemical analysis of the resected tissue, revealed massive deposits of amyloid composed of lambda light chains in the interstitial connective, and perivascular tissue and muscular tunic, and resulted in a diagnosis of AL amyloidosis. This was successfully treated with a combination of melphalan and prednisone.

Aged↗