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At least 181 records · Page 10Linked to original sources
PubMed2006

[Ultrasonographic assessment of sigmoid colon in patients with irritable bowel syndrome].

UNLABELLED: Although the pathophysiological factors may play a role in the pathogenesis of irritable bowel syndrome (IBS), the function of sigmoid colon has been reported as a major pathogenesis of IBS. Our objective was to evaluate motility patterns of sigmoid colon by using ultrasonography(US) in patients with IBS compared to healthy volunteers (HV). SUBIECTS AND METHODS: US examination of sigmoid colon was performed in 69 patients with IBS and 69 HV with 3.75 MHz curved array scanner and 7.5 MHz linear array scanner. The US probe was positioned longitudinally to permit simultaneous visualization of sigmoid colon crossing over the iliopsoas. We classified 3 types of fasting sigmoid colon, spastic type, empty type, and normal type, according to the US findings. Four IBS patients with diarrhea, 4 with constipation and 4 HV were given the liquid test meal (200ml, 400kcal). The frequency of segmental contractions (contractions without propagation) and propulsion were evaluated by US in the same fashion for 30 minutes before and for 60 minutes after investigation. RESULTS: Sixty-two percent of IBS showed spastic type and 65% of HV showed normal type. IBS patients accounted for 80 % of spastic type (IBS vs spastic type of US findings: Sensitivity 62%, Specificity 91%). The changes of frequency of segmental contractions were smaller in IBS patients with constipation. The changes of frequency of propulsion were larger in IBS patients with diarrhea. CONCLUSION: Ultrasonographic assessment of sigmoid colon may provide a better understanding of the pathogenesis of IBS.

Colon, Sigmoid↗
PubMed1996

Effect of inferior mesenteric artery ligation on blood flow in the marginal artery-dependent sigmoid colon.

BACKGROUND: Anastomotic leakage after restorative rectal excision may develop from ischemia associated with inadequate blood flow in the marginal artery-dependent colon. STUDY DESIGN: We have used laser Doppler flowmetry to measure blood flow change during mobilization of the sigmoid colon before excision of the sigmoid colon or rectum in 26 patients and proximal to the colorectal anastomosis during the first five postoperative days in five patients. RESULTS: There was a significant (p < 0.005) fall (median, 50 percent interquartile range, 41 to 86 percent) in sigmoid colon serosal flow after ligation of the inferior mesenteric artery (IMA) and distal marginal artery (DMA) that was not influenced by the order of vessel ligation. No increase in perianastomotic colonic perfusion was detected during the first five postoperative days. CONCLUSIONS: The significant blood flow reduction after ligation of the IMA and DMA supports the hypothesis that anastomotic leakage after restorative rectal excision may result from ischemia associated with inadequate blood flow in the marginal artery-dependent sigmoid colon. Improvement in inadequate intraoperative colonic perfusion from increased collateral circulation is unlikely to develop in the marginal artery-dependent colon during the first five postoperative days.

Aged↗
PubMed2004

Our sigmoid colon volvulus experience and benefits of colonoscope in detortion process.

BACKGROUND/AIMS: The sigmoid colon is the most frequent site for a volvulus. In this report, we review our experience with sigmoid colon volvulus. METHODOLOGY: We present our experience of 81 cases of sigmoid volvulus admitted to our department. RESULTS: Preoperative endoscopic volvulus detortion was attempted in all patients, and in 39 of them the procedure was successful. The success rate of endoscopic detortion for sigmoid colon volvulus with a flexible colonoscope (60%) was higher than with a rigid rectosigmoidoscope (42%). In 19 of these 39 non-operatively devolvulated patients, sigmoid resection with primary anastomosis was performed within 7-10 days after reduction, but 20 patients did not accept the elective operation after a non-operative treatment. Among the 61 patients undergoing urgent or elective operation for sigmoid volvulus, there were 17 laparotomies with only detortion, 19 resections with elective anastomosis, 6 resections with primary anastomosis, and 19 resections with a Hartmann's pouch. There were 9 deaths (21%) among 42 patients who underwent an emergency operation, and one (5.2%) among the 19 patients who had elective surgery died because of a cerebral embolus. CONCLUSIONS: Initial therapy with endoscopy affords decompression and an adequate preparation of patients for surgical resection, and a flexible colonoscope has notable advantages over rigid instruments for the detortion process.

Adult↗
PubMed1993

Endotoxaemia, the generation of the cytokines and their relationship to intramucosal acidosis of the sigmoid colon in elective abdominal aortic aneurysm repair.

Ischaemia of the large bowel occasionally occurs following abdominal aortic aneurysm repair and may lead to multiple system organ failure (MSOF). Intramucosal acidosis of the sigmoid colon is a good indicator of sigmoid colonic ischaemia. Intramucosal pH of the sigmoid colon was measured using the silicone tonometer in 21 patients undergoing abdominal aortic aneurysmectomy. Samples were taken for plasma endotoxin, tumour necrosis factor (TNF) and interleukin-6 (IL-6) measurements preoperatively, half-hourly during the operation, 2-hourly for the next 12 h, 4-hourly for a further 48 h and 8-hourly thereafter until the fifth day. The intramucosal pH of the sigmoid colon fell to less than 7.00 peri-operatively in 10 patients, four of whom developed diarrhoea; in comparison, this did not occur in any of the 11 whose pH remained greater than 7.00 (p = 0.036). Higher peak concentrations of endotoxin, TNF and IL-6 were found in those patients whose intramucosal pH fell to less than 7.00 compared to those whose pH remained greater than 7.00 (mean +/- S.E.M. pg/ml, endotoxin = 112 +/- 24 vs. 58 +/- 6, p < 0.05; TNF = 26 +/- 8 vs. 7 +/- 2, p < 0.05; IL-6 = 213 +/- 59 vs. 87 +/- 12, p = 0.09). In the two patients who died, both from the group with pH level less than 7.00, concentrations of IL-6 were considerably higher than that in most of the other patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1998

Electrosigmoidogram in the various pathologic conditions of the sigmoid colon.

The current study investigates the electrosigmoidographic (ESG) patterns in 50 patients with sigmoid colon pathologies and 10 healthy controls. Three electrodes were applied to the skin of the lower abdomen and the reference electrode was placed on the lower limb. Ulcerative colitis patients showed a "tachyarrhythmic" ESG; the PPs had a higher frequency with a lower amplitude and velocity than the normal controls. The sigmoid diverticulitis exhibited a "bradyarrhythmic" pattern; the PP variables were lower than normal. The PPs in sigmoid polyposis were "scarce" and were recorded only occasionally. In sigmoid colon cancer, the electric waves were normal proximal to the tumor and absent opposite and distal to it; a "silent" ESG was recorded in sigmoidectomy patients. Various ESG patterns were recordable in the different pathologic conditions of the sigmoid colon. It is thus suggested that percutaneous ESG can be included as an investigative tool in the diagnosis of sigmoid colon pathologies. The method is simple, easy, non-invasive and non-radiologic.

Adenomatous Polyposis Coli↗
PubMed1984

Self-inflicted sigmoid colon perforation. Report of a case.

A rare, if not unique, case of sigmoid colon perforation by a balloon, self-inserted transanally, is described. Mechanical properties of the sigmoid colon make it prone to rupture by pneumatic distention. Management depends on amount of peritoneal contamination, timing, and associated injury. With prompt surgery, isolated traumatic sigmoid colon perforations have a good prognosis.

Adult↗
PubMed1997

Laparoscopic colpopoiesis using sigmoid colon.

A new technique for colpopoiesis using sigmoid colon autograft by a laparoscopic surgery is introduced for the first time. This technique requires advanced skills perform and may be the choice in respect to naturalness and permanency of the neovagina with minimum invasion.

Adult↗
PubMed2001

Sensory and biomechanical responses to distension of the normal human rectum and sigmoid colon.

BACKGROUND: Visceral pain is a major clinical problem. The aim of the present study was to compare the pain and biomechanical responses to standardized distension of the human colon. METHODS: The relation between pain intensity and pressure, cross-sectional area (CSA) and tension-strain relations of the rectum and sigmoid colon were studied in 11 normal subjects following standardized distension using impedance planimetry. The bag was inflated stepwise with pressures up to 6 kPa. The subjects, who were blinded for the distension procedure, rated their pain intensity using an aggregate visual analogue score (VAS) combining the intensity of the feeling of air, urge to defecate and pain. RESULTS: The distensions produced an initial rapid increase in CSA followed by a phase of slow increase until a steady state CSA was reached after 0.5-1 min. Several phasic contractions (observed as short-term decreases in the CSA) were recorded in the rectum from the end of the rapid phase to the end of distension at pressures from 1 to 5 kPa. The CSA in the rectum and sigmoid colon was 3,706 +/- 426 mm(2) and 2,305 +/- 426 mm(2) at the maximum bag pressure of 6 kPa (F = 52.4, p < 0.001). The tension-strain relation did not differ between the normal rectum and sigmoid colon. The VAS score for every modality (air, defecation and pain) revealed an increase in intensity as a function of pressure. The VAS score in the rectum and the sigmoid colon as a function of tension and strain did not show any differences. CONCLUSIONS: The biomechanical properties in the sigmoid colon and rectum were alike. For a given wall tension and circumferential strain the sensibility seems equal in the rectum and the sigmoid colon. The observed difference in perception between the two segments was related to the greater CSA in the rectum.

Abdominal Pain↗
PubMed1999

Focus of signet ring cell carcinoma in an adenoma of the sigmoid colon.

A case of a pedunculated adenomatous polyp of the sigmoid colon was found to have a primary focus of signet ring cell carcinoma. Histologic examination of the medium-sized polyp was consistent with an adenoma to carcinoma sequence for signet ring cell carcinoma of the colon, similar to that for the common adenocarcinomas.

Adenoma↗
PubMed1993

Clinical significance of diminutive polyps of the rectum and sigmoid colon.

A retrospective review of 637 consecutive colonoscopies with polypectomy in 526 patients was performed to determine the association of small polyps of the rectum and sigmoid colon with more proximal colonic neoplasms. All colonic polyps were proximal to the sigmoid colon in 117 procedures. Proximal neoplasms were found in 32 percent of patients with a single polyp in the rectum or sigmoid colon. The incidence increased to 83 percent for those with three or more polyps. The occurrence of proximal colonic neoplasms was not affected by the size or histologic type of the rectosigmoid polyps. These findings would suggest that total colonic evaluation be considered in all patients with a polyp in the rectum or sigmoid colon regardless of the size or histologic type of the polyp.

Adenoma↗
PubMed1976

Double tracking in the sigmoid colon.

Double tracking of barium in the sigmoid colon has been associated with granulomatous colitis by some; others consider it a sign of peridiverticulitis. Patients who showed no evidence of inflammatory disease elsewhere in the large intestine were analysed. The pathological diagnosis was diverticulitis in 29 of 35 cases, and granulomatous diverticulitis in only 1. In 5 the underlying process was perforated carcinoma of the sigmoid colon. In those with paracolonic sinus tracts due to peridiverticulitis, pathological study demonstrated tracts extrinsic to the muscularis and usually traceable to a perforated diverticulum. Long-term follow-up disclosed no evidence of subsequent inflammatory bowel disease.

Colonic Neoplasms↗
PubMed1999

[Computed tomography study of the sigmoid colon: discriminating diagnostic criteria and interobserver correlations].

PURPOSE: To assess the value of pericolonic findings at CT in the evaluation of the sigmoid colon. MATERIALS AND METHODS: A total of 210 CT examinations were retrospectively reviewed by 3 blinded radiologists. Data was analyzed to determine the interobserver correlation and the value of pericolonic and colonic wall findings in diagnosis of sigmoid colon pathology. RESULTS: The interobserver correlation for pericolonic findings was equal to or superior to that for colonic wall findings. The presence of abnormal pericolonic fat was the most sensitive (88%) and specific (93%) sign to differentiate a diseased sigmoid colon from a normal one or from sigmoid diverticulosis. Wall-thickening was less sensitive (82%) and specific (76%). Findings suggesting malignancy over diverticulitis included acute zone of transition, focal fatty infiltration, and lymph nodes. Symmetrical and circumferential wall thickening, target-like enhancement, and local fatty proliferation were findings suggesting colitis over diverticulitis. Wall thickening more than 15 mm, involvement of 15 cm or less, asymmetrical involvement, acute zone of transition, and homogeneous or heterogeneous enhancement were findings suggesting malignancy over colitis. CONCLUSION: To render a diagnosis, the evaluation of the fat infiltration must prevail on the parietal thickening appreciation.

Adipose Tissue↗