[Total rectocolectomy for rectocolitis with inflammatory polyposis].

A 49-year-old woman, who had undergone hysterectomy for low-grade endometrial stromal sarcoma (ESS) 3 years ago, presented with a 2-wk history of lower abdominal pain. Barium enema and sigmoidoscopy disclosed a polypoid submucosal tumor. Histopathologic features of biopsy specimens from the lesion were similar to those of the resected uterine ESS. Under the diagnosis of metastatic ESS of the sigmoid colon, sigmoidectomy was performed. Microscopic examination demonstrated dense proliferation of spindle cells with little nuclear atypia, which were sometimes arranged in whorled pattern around abundant arterioles. Mitotic count is below 1 in 10 high-power fields. Immunohistochemically, the neoplastic cells were strongly positive for vimentin, estrogen receptor and progesterone receptor but negative for alpha-smooth muscle actin, S-100 protein and CD34. Thus, a final diagnosis of low-grade ESS metastasis to the sigmoid colon was made. Her postoperative course was uneventful and hormonal therapy with progestational agents is entertained.

Colon, Sigmoid↗

PubMed2005

A case of perforation and fistula formation resulting from metallic stent for sigmoid colon stricture in Crohn's disease.

A 52-year-old male was diagnosed with Crohn's disease at the age of 25 years. Thereafter, he underwent three operations for intestinal strictures or fistula. A self-expanding metallic stent was inserted into the sigmoid colon stricture endoscopically in November 1999. Thirty two months later, he presented left lower abdominal pain. Endoscopic and radiographic examinations demonstrated perforation of the stent and ileosigmoid fistula. Laparotomy revealed an inflammatory mass around the sigmoid colon, and the wire frame of the metallic stent had penetrated the colonic wall and had fistulized to the ileum. The affected sigmoid colon was resected and low anterior resection and ileostomy were performed. Metallic stent for intestinal stricture of Crohn's disease with active ulceration may postpone surgery temporarily but can be a potentially dangerous procedure.

Colon, Sigmoid↗

PubMed2005

Right colon, sigmoid colon, and transverse colon diverticulitis in the same patient: report of a case.

Although sigmoid colon diverticulitis is frequently seen, right colon and transverse colon diverticulitis remain rare forms of the disease. This case report examined the disease course of a 46-year-old female who first presented to our institution in 1990 with perforated right-sided diverticulitis. During the next 11 years, she developed sigmoid colon diverticulitis and then transverse colon diverticulitis. The right and sigmoid colon diverticulitis were treated with surgery and the transverse colon diverticulitis was managed conservatively. This is the first reported case of a single patient who had separate episodes of diverticulitis in the right, transverse, and sigmoid colon. The evaluation and management of this patient has mirrored a trend in the literature and clinical practice.

Colon, Sigmoid↗