Images in clinical medicine. Laterally spreading colon cancer.
Explore the source record for details and available documents.
Aged↗
SEARCH · Search PubMed
Results for “Colon, Transverse”
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Arterial fibrodysplasia: rapid progression complicated by rupture of a visceral aneurysm into the gastrointestinal tract.
We report the case of a 44-year-old woman who had extensive stenosis and dilatation of the aortoiliac arteries and an aneurysm of the superior mesenteric artery as a result of fibrodysplasia. Both the aortoiliac and the superior mesenteric arteries were treated by resection and reconstruction. Within one year after this operation, fibrodysplastic aneurysms developed in previously angiographically normal visceral arteries. The patient came to us with massive lower gastrointestinal bleeding caused by rupture of a visceral fibrodysplastic aneurysm of the middle colic artery into the transverse colon. The classification, the origin, the localization, and the natural history of fibrodysplasia are discussed.
Adult↗
Ligand binding and structural analysis of a human putative cellular retinol-binding protein.
Three cellular retinol-binding protein (CRBP) types (CRBP I, II, and III) with distinct tissue distributions and retinoid binding properties have been structurally characterized thus far. A human binding protein, whose mRNA is expressed primarily in kidney, heart, and transverse colon, is shown here to be a CRBP family member (human CRBP IV), according to amino acid sequence, phylogenetic analysis, gene structure organization, and x-ray structural analysis. Retinol binding to CRBP IV leads to an absorption spectrum distinct from a typical holo-CRBP spectrum and is characterized by an affinity (K(d) = approximately 200 nm) lower than those for CRBP I, II, and III, as established in direct and competitive binding assays. As revealed by mutagenic analysis, the presence in CRBP IV of His(108) in place of Gln(108) is not responsible for the unusual holo-CRBP IV spectrum. The 2-A resolution crystal structure of human apo-CRBP IV is very similar to those of other structurally characterized CRBPs. The side chain of Tyr(60) is present within the binding cavity of the apoprotein and might affect the interaction with the retinol molecule. These results indicate that human CRBP IV belongs to a clearly distinct CRBP subfamily and suggest a relatively different mode of retinol binding for this binding protein.
Amino Acid Sequence↗
Internal herniation with fatal outcome: herniation through an unusual apertura between epiploic appendices and greater omentum.
Internal hernia is an unusal cause of intestinal obstruction. Herniation related to epiploic appendix is a very rare entity. We herein report a case of internal herniation due to an adhesion between epiploic appendixes and the greater omentum. A 71-year-old woman complaining of abdominal pain and intermittent nausea was operated on with the pre-operative diagnosis of intestinal obstruction. Three epiploic appendixes of the left side of the transverse colon and the corresponding part of the greater omentum had created a tunnel and a loop of small bowel 25 cm in length was strangulated. No resection was required after releiving the strangulation. However, the patient died due to massive myocardial infarction in the postoperative period. Internal herniation must be included in the differential diagnosis of patients with acute abdomen or intestinal obstruction. A high index of suspicion with prompt surgical intervention may be the key to the reduction of morbidity and mortality.
Aged↗
Comparison of the characteristics of submucosal injection solutions used in endoscopic mucosal resection.
OBJECTIVE: Submucosal injection is used to prevent complications, such as perforation, during endoscopic mucosal resection (EMR). Since injection of normal saline produces mucosal elevation of short duration, repeated injection is needed for extensive resection. To overcome this limitation, various submucosal injection solutions have been developed but there are few data comparing their efficacy. This study was therefore conducted to compare the physical and chemical properties and the duration of mucosal elevation of various submucosal injection solutions. MATERIAL AND METHODS: A fresh transverse colon specimen acquired from a mongrel was used. Experiments were repeated four times. To compare the efficacy of mucosal elevation, 1 ml of each solution was injected into the submucosa: 0.9% NaCl, 20% mannitol, 0.1% sodium hyaluronate, 0.3% hydroxypropyl methylcellulose (HPMC), and 2% fibrinogen. Physical and chemical properties such as viscosity and osmolarity were compared. RESULTS: The heights of initial mucosal elevations were 6.52+/-0.26 mm, 6.87+/-0.05 mm, 6.92+/-0.09 mm, 6.90+/-0.08 mm, and 6.90+/-0.08 mm for normal saline, mannitol, sodium hyaluronate, HPMC, and fibrinogen, respectively. Whereas injection of normal saline took about 20 min and mannitol about 30 min for the initial elevation to be reduced to more than half the initial height, it took more than 60 min for all the other agents. A correlation was found between the duration of mucosal elevation and viscosity but not with osmolarity. CONCLUSIONS: The mucosal elevation lasted longer with sodium hyaluronate, HPMC, and fibrinogen than with mannitol or normal saline, and this seems to be due to the viscosity rather than the osmolarity of each solution.
Animals↗
Pneumatic reduction of intussusception in children.
The use of an air enema in the diagnosis and reduction of intussusception, using a simple home-made device, was prospectively studied in 36 children with the tentative diagnosis of intussusception. Plain abdominal films were inconclusive in 19 patients (53%). Using an air enema, the diagnosis of intussusception was easily reached or excluded in all suspected cases. Twenty-nine patients had intussusception. Their ages ranged from 3 to 20 months (mean: 7 months), and all had ileo-colic involvement. Pneumatic reduction was successful in 23 cases (79%), and reduction was completed within 2-3 minutes in all successfully reduced cases. At operation, three children had a tear of the sero-muscular layer of the transverse colon, but there were no perforations or recurrences of the intussusception in the immediate post-reduction or follow-up period (1-25 months). An air enema is a safe, cheap, clean and reliable procedure for the diagnosis and reduction of intussusception, and can now be considered as the treatment of choice in uncomplicated intussusception.
Child, Preschool↗
Acute gastric volvulus: an unusual cause of gastric outlet obstruction.
Gastric outlet obstruction initiated by acute gastric volvulus is rare but potentially fatal. An unusual case of intrathoracic acute gastric volvulus complicated by distal stomach and transverse colon herniation into retrocardial space is reported. Prompt clinical diagnosis was followed by emergency laparoscopic de-rotation and gastropexy.
Journal Article↗
RESISTANCE OF THE MOUSE'S INTESTINAL TRACT TO EXPERIMENTAL SALMONELLA INFECTION. I. FACTORS WHICH INTERFERE WITH THE INITIATION OF INFECTION BY ORAL INOCULATION.
Multiplication of Salmonella enteritidis was inhibited in vitro by buffered suspensions of fecal material freshly removed from the large intestine of normal mice. Most effective was material obtained from cecum and transverse colon. Inhibitory activity was not impaired by sterilization by heat or filtration. From such materials were isolated acetic and butyric acids in concentrations which inhibited Salmonella in vitro. The degree of inhibitory activity of suspensions of colon content and of mixtures of the two fatty acids was conditioned by pH and favored by anaerobiosis. Effective inhibition occurred at or slightly below the pH of colon content of most normal mice as determined in situ by direct measurement. Acetic and butyric acids were isolated from anaerobic cultures of several strains of Bacteroides previously demonstrated to be one of the most numerous inhabitants of the large intestine of the normal mouse.
Acetates↗
RESISTANCE OF THE MOUSE'S INTESTINAL TRACT TO EXPERIMENTAL SALMONELLA INFECTION. II. FACTORS RESPONSIBLE FOR ITS LOSS FOLLOWING STREPTOMYCIN TREATMENT.
Determinations of pH, Eh, and concentrations of acetic, butyric and lactic acids were made on the content of cecum and transverse colon of groups of mice killed 1, 3, and 5 days after oral administration of 50 mg streptomycin. Control observations on untreated mice are reported in the preceding communication. Heat-killed supenatants of suspensions of bowel content were tested in vitro for their ability to inhibit multiplication of our standard streptomycin-resistant strain of Salmonella enteritidis during aerobic and anaerobic incubation. Also tested in like fashion were series of cultures in broth buffered at various pH levels and containing acetic, butyric, and lactic acids in varying concentrations. In colon content of mice on the 1st day after streptomycin treatment, the pH had risen and the concentrations of the fatty acids fallen, a combination of effects which adequately accounts for its inability to inhibit multiplication of Salmonella in vitro and in vivo. By the 3rd day after streptomycin treatment, pH and fatty acid concentrations had returned to normal levels. The susceptibility of mice to oral challenge on the 3rd day was explained by the finding that lactic acid had accumulated in colon content to levels which, in broth, effectively counteracted the activity of inhibitory concentrations of the fatty acids. Other cocarboxylic acids also antagonized the inhibitory activity of the fatty acids; glucose did not.
Acetates↗
Laparoscopic repair of a Morgagni hernia presenting with syncope in an 85-year-old woman: case report and update of the literature.
An 85-year-old woman was transferred from her local hospital for cardiac evaluation after presenting with repeated episodes of syncope during bowel movements. A thorough evaluation revealed no cardiac abnormalities but did reveal a Morgagni hernia with transverse colon in the mediastinum. She underwent laparoscopic reduction of the colon and repair of the hernia with mesh and had a rapid and uneventful recovery.
Aged↗
Morgagni's hernia resolved by laparoscopic surgery.
Morgagni's hernias represent between 2 and 4% of the whole of nontraumatic diaphragmatic hernias in the adult, and the treatment (even with minimal symptoms) is always with surgery. We present the case of a 50-year-old woman with an oppressive, postprandial discomfort in the right side of her thorax and with increased pain when supine. The x-ray examination indicated a large portion of transverse colon inside the thoracic cavity. Once the diagnosis of Morgagni's hernia had been obtained, she was scheduled for laparoscopic surgery to reduce the hernia and to reconstruct the defect of the diaphragm using a polypropylene mesh.
Female↗
Laparoscopic repair of a Morgagni-Larrey hernia.
The authors report a case of a large Morgagni hernia treated by laparoscopy. The patient complained of dyspnea, cough, and a sensation of tightness in the chest 1 month prior to admission. Preoperative diagnosis was made by chest x-ray, CT scan, and MRI, which showed a large right paracardiac mass consisting of an omentum and transverse colon. By reducing the hernial content, a 6 x 10-cm defect was revealed; the repair was performed with a Marlex mesh sutured by a hernia stapler. Postoperative recovery was uneventful, and 3 months after surgery the patient is well. Laparoscopic treatment of a Morgagni hernia provides an excellent view of the surgical field and ease of execution, joined with a minimal surgical trauma with rapid recovery for the patient.
Diaphragm↗
Laparoscopic resection of gastric diverticulum.
Gastric diverticulum is a rare disorder. The laparoscopic approach may be ideal for the resection of gastric diverticulum in some cases. The authors believe this to be the first reported case of gastric diverticulum resected laparoscopically. A 59-year-old woman was admitted with indigestion and epigastric pain. Upper gastrointestinal series showed a single diverticulum (3 x 2 cm) on the posterior wall of the upper part of the stomach. The neck of the diverticulum was relatively narrow. Gastroduodenoscopy revealed that food residues were impacted within the diverticular pouch. Other areas of the stomach and the duodenum were normal. Abdominal ultrasonography showed no other pathologic conditions in the upper part of abdomen. On operation, the lesser sac was entered by division of the greater omentum along the avascular plane of the transverse colonic attachment. The location of the diverticulum was confirmed by intraoperative gastroscopy. Using a 5-cannula techniques, the diverticulum was resected with an endoscopic linear stapler device. Pathologic examination of the resected specimen demonstrated chronic superficial gastritis. Flatus was passed out on the first postoperative day, diet was started from the second day, and the patient was discharged on the fifth day without problems.
Diverticulum, Stomach↗
Laparoscopic repair of a Morgagni hernia: report of a case and review of the literature.
A case is reported of an 85-year-old woman with subacute intestinal obstruction due to a large Morgagni hernia containing the transverse colon. The repair was carried out laparoscopically without a mesh. The procedure lasted 45 min, and the patient was discharged after 4 days. According to the literature, mini-invasive repair of a Morgagni hernia can be performed easily and without complications. In only few cases was a mesh necessary. The Morgagni hernia must be considered a clear indication for laparoscopic surgery, which should be offered as the first approach to this disease.
Aged↗
Applicability of laparoscopic surgery for colorectal disease.
BACKGROUND: The advantages of laparoscopic colorectal surgery for selected patients have been well established. However, the applicability of laparoscopic surgery in the whole population of patients with colorectal disease is not well known. METHODS: A single-institution medical records review of 269 patients subjected to colorectal surgery was made. Of these, 206 open colorectal procedures were performed, and data were reviewed retrospectively. In addition, 63 patients were subjected to laparoscopy, and their data were recorded prospectively. An analysis of the existence of factors that contraindicate laparoscopic colorectal surgery was done. These factors were of two types: absolute (urgent intervention, severe cardiopulmonary disease, advanced liver cirrhosis, tumor invasion into adjacent organs, simultaneous major surgery) and relative (midrectal tumors, tumors in the transverse colon, bulky tumors, more than two previous infraumbilical operations, previous intestinal surgery, and previous peritonitis). RESULTS: Factors that could contraindicate the laparoscopic approach were found in 118 patients (44%). The most common were urgent intervention (40%), midrectal tumors (19%), locally advanced cancer (13%), previous intestinal surgery (13%), and tumors >10 cm (6%). We considered 25% of the contraindications to be absolute and 19% relative. Taking these exclusion criteria into consideration when selecting patients for laparoscopic surgery, the conversion rate in our initial laparoscopic series (63 cases) was 13%. CONCLUSION: The indication for laparoscopic surgery for patients with colorectal disease is superior to 60% (absolute 56%, relative 81%). When using appropriate selection criteria, the conversion rate may be maintained below 10%. Preoperative selection of patients with colorectal disease allows optimal use of the advantages of laparoscopic surgery.
Adult↗
Laparoscopic removal of a swallowed sewing needle that migrated into the greater omentum without clinical evidence.
We report a case of a sewing needle, presumably originating from the transverse colon or the ligament of Treitz, that migrated to the greater omentum. A 24-year-old woman was referred to our clinic with a complaint of abdominal pain which was exacerbated by breathing or any physical activity. Abdominal plain x-ray showed a needle in the left upper abdominal area. Abdominal computed tomography (CT) and contrast enhanced x-ray studies was unable to reveal whether the needle was in the colonic lumen. Virtual colonoscopy examination demonstrated that the foreign body was not in the lumen. The foreign body was removed from the patient's greater omentum in a fluoroscopy- guided laparoscopic surgery. An accurate and rapid diagnosis of a perforation in the gastrointestinal tract as the result of an ingested foreign body is difficult in the absence of peritonitis or abscess formation. In such cases, the virtual colonoscopy is useful if there is uncertainty whether the foreign body is in the lumen. Perioperative fluoroscopy can be useful to overcome the lack of tactile discrimination in laparoscopy, in patients who have been scheduled for surgery who have no signs of the localization of the foreign body (such as abscess or solid organ migration).
Adult↗
Emergency laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma.
BACKGROUND: We report our preliminary experience in urgent laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma. MATERIALS AND METHODS: From January to April 2005, seven consecutive patients with obstructing right-sided colon carcinoma underwent emergency laparoscopically assisted right or extended right hemicolectomy. Patient demographic data, operative details, and short-term clinical outcomes were prospectively collected and analyzed. RESULTS: The median duration of obstructing symptoms prior to admission was 3 days (range, 1-6 days). Two patients underwent palliative resection and five patients underwent curative resection. The median operative time was 180 minutes (range, 125-350 minutes). There were no conversions to the open procedure. Median blood loss was 30 mL (range, negligible-300 mL). The median times to resuming diet, first bowel motion, and full ambulation were 4 days (range, 3-10 days), 5 days (range, 3-7 days), and 4 days (range, 4-5 days), respectively. The median duration of hospital stay was 7 days (range, 6-19 days). One patient with ischemic heart disease developed acute coronary syndrome postoperatively and died on postoperative day 19. The remaining patients had no complications. The median tumor length was 3.5 cm (range, 2-5 cm) and the median number of lymph nodes removed was 17 (range, 16-36). CONCLUSION: Emergency laparoscopically assisted right hemicolectomy for obstructing right-sided colon carcinoma is feasible and safe, with favorable short-term clinical outcomes and an acceptable number of lymph nodes removed.
Adenocarcinoma↗
Primary yolk sac tumors of the mesentery. A report of two cases.
Two yolk sac tumors that arose in the mesentery of the jejunum and the mesentery of the transverse colon of two male patients, aged 2 and 17 years, are reported. Both patients had abdominal masses. The tumors measured 9 and 11 cm in maximum dimension. One of them grew into the bowel lumen. Microscopically, both neoplasms exhibited several of the typical patterns of yolk sac tumor and stained immunohistochemically for alpha-fetoprotein. Both patients received chemotherapy postoperatively and are alive, but follow-up is short. The subject of extragonadal yolk sac tumors is reviewed, and histogenetic implications of their occasional origin in the mesentery is discussed.
Adolescent↗