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A clinical evaluation of lymphangioma of the large intestine: a case presentation of lymphangioma of the descending colon and a review of 279 Japanese cases.

With the development and widespread use of colonoscopy, lymphangioma of the large intestine has recently been reported frequently. This paper presents some findings from a review of 279 cases of this disease in Japan, including a typical case that we encountered. A 69-year-old female was diagnosed as having lymphangioma of the descending colon based on the findings of a barium enema and a colonoscopy, and the lesion was successfully removed by an endoscopic resection. In the published reports, the etiology of this disease is not clear yet but the age at onset range shows a tendency toward a higher incidence in comparatively older patients and the male-to-female ratio indicates a higher incidence in males. If there is no complication, endoscopic treatment seems to be the preferable procedure for this disease.

Aged↗

[Non-Hodgkin's lymphoma of the descending colon in a 6-year-old girl].

The most common site of non-Hodgkin lymphoma of the intestinal tract in children is the terminal ileum and the ileocecal region; boys are 5- to 10 times more frequently affected than girls, peak incidence is between 5 and 8 years of age. We present a 6-year-old girl with non-Hodgkin lymphoma of the descending colon.

Burkitt Lymphoma↗

[A descending colon tumour prolapsing from anus: case report].

Most colonic polyps are asymptomatic and the incidence rises during sixth and seventh decades. Symptoms and signs may vary with histological types and location. Clinical features include fresh rectal bleeding, mucoid diarrhea and prolapsus of stalked rectal polyps located near distal segment. Here we discuss a case with a rare clinical presentation, who had sessile malign villous adenoma located in the descending colon, which caused colocolic intussusception and prolapsed through the anus.

Adenoma, Villous↗

The antisecretory effects of somatostatin and analogues in rat descending colon mucosa.

Somatostatin-14 (SS-14) and somatostatin-28 (SS-28) produce concentration dependent reductions in short-circuit current in rat colonic mucosa. EC50 values of 15.0 and 13.3 nM were obtained for SS-14 and SS-28 respectively while the N-terminal fragments of SS-28, namely somatostatin-(1-12) (SS1-12) and somatostatin-(1-14) (SS1-14) were inactive. Cyclo(Pro-Phe-D-Trp-Lys-Thr-Phe) and cyclo(Pro-Tyr-D-Trp-Lys-Thr-Phe) were potent antisecretory peptides, like SS-14 and SS-28; while the putative somatostatin antagonist, cyclo(7-aminoheptanoyl-Phe-D-Trp-Lys-Thr[Bzl]) exhibited neither agonist nor antagonist effects. Responses to SS-14 could be regulated by agents which affected the secretory state of the epithelium. Antisecretory effects of SS-14 were markedly attenuated by piroxicam and were restored following piroxicam plus either forskolin or vasoactive intestinal polypeptide (VIP). SS-14 also attenuated secretory responses produced by carbachol, substance P (SP), VIP and alpha- and beta-calcitonin gene related peptide (alpha-, beta-CGRP). Therefore, SS-14 exhibits broad spectrum antisecretory effects in rat descending colon mucosa.

Amino Acid Sequence↗

Torsion and volvulus of the transverse and descending colon in a German shepherd dog.

A German shepherd dog was presented two months after surgery for correction of acute gastric dilatation volvulus. The dog had been diagnosed with exocrine pancreatic insufficiency. Radiographs revealed marked gaseous distension of one loop of intestine with a generalised increase in intestinal gas content. A 360 degrees anticlockwise rotation of the descending and transverse colon, around the longitudinal axis of the mesocolon, was diagnosed at exploratory coeliotomy. The transverse and descending colon appeared uniformly necrotic and an end-to-end colo-colic resection and anastomosis was performed. The dog initially made satisfactory postoperative progress but was euthanased on the third postoperative day after it developed an intestinal intussusception.

Anastomosis, Surgical↗

Concentration polarization of fluorescent dyes in rat descending colonic crypts: evidence of crypt fluid absorption.

1. Using confocal microscopy, the rate of fluid absorption into isolated perifused descending rat colonic crypt lumens is estimated from the concentration polarization and distribution of fluorescein sulphonate (FS) and fluorescein isothiocyanate-dextran (FITC-dextran; molecular weight, 10,000) within the crypt lumens and pericryptal fluid. 2. The probe dyes enter the crypt via the luminal opening, are concentrated in the lumen, then escape into the pericryptal space via the paracellular spaces spanning the crypt wall. 3. FITC-dextran is maximally accumulated at a luminal depth of 60 microns to 5 times the concentration at the crypt opening (p < 0.001) and penetrates 150-200 microns along the lumen. FS is maximally accumulated within crypt lumen close to the opening. At crypt luminal depths 10-60 microns from the opening FS is accumulated by a factor of 1.5-2.0 above that found in HgCl2-treated tissue (p < 0.001). 4. Dye enters the crypt lumen slowly from the basal side, but from this side does not accumulate above the bathing solution concentration. 5. HgCl2 (20 microM) or theophylline (10 mM) completely inhibit concentrative accumulation of FITC-dextran and FS within the crypts and pericryptal space (p < 0.001). 6. Computer simulation of the dye uptake indicates that the rate of water flow into the crypt luminal opening is 1 x 10(-3) cm s-1 which is equivalent to 15 microliters (cm mucosa)-2 h-1. Approximately 75% of the fluid entering the crypt is abosrbed across the proximal 50 microns of crypt wall as a consequence of the large osmotic pressure gradient between the pericryptal and crypt luminal solutions. A pericryptal diffusion barrier with lower permeability than that across the crypt wall is required to simulate dye accumulation in the pericryptal space. Differences between FITC-dextran and FS accumulation are explained by the lower diffusion coefficient within the crypt lumen, and lower crypt wall permeability of FITC-dextran.

Absorption↗

Transverse to descending colon volvulus and megacolon with mesenterium commune: report of a case.

We report a case of volvulus of the transverse-descending (T-D) colon and megacolon associated with mesenterium commune. A 70-year-old man was referred to our hospital for investigation of severe constipation and abdominal fullness. On physical examination, his abdomen was remarkably distended with generalized tenderness, and weak bowel sounds. Abdominal X-ray showed megacolon at the splenic flexure and a contrast medium enema study showed tapering of the upper rectum. Accordingly, under a diagnosis of T-D colon volvulus, we performed an emergency operation to release the colon volvulus. The intraoperative findings showed a volvulus of the T-D colon with mesenterium commune. The patient recovered uneventfully and his symptoms resolved; however, a postoperative barium enema showed residual megacolon at the splenic flexure.

Aged↗

Primary resection and anastomosis in obstructed descending colon due to cancer.

Intraoperative colonic irrigation followed by one-stage resection is gaining popularity as the optimal surgical treatment for left-sided colonic obstruction. However, its efficacy and potential hazards have not been adequately tested in obstruction due to colonic cancer. We analyzed the early results of 23 consecutive patients with obstructive left-sided colonic carcinoma treated by primary resection and anastomosis following intraoperative antegrade colonic lavage. Two patients (8.6%) died, one from complication of anastomotic leakage. The significant postoperative complications were chest infection in three (13%) and wound infection in seven (30.4%). The average hospital stay was 16.5 days. The results of this study suggest that intraoperative bowel irrigation permits one-stage resection and anastomosis to be conducted with reasonable safety provided care is taken in operative techniques.

Adenocarcinoma↗

[Effect of local moderate hyperthermia in combination with chemotherapy by N-nitroso-1,3-bis-(2-chloroethyl)urea (BCNU) on the descending colon of the rat with transplanted Yoshida sarcoma. 2. Monochemotherapy in combination with subsequent hyperthermia at various time intervals].

There are numerous reports on in vitro and in vivo investigations of hyperthermia for cytostasis of malignant tumors. Combination of chemotherapy and hyperthermia is to potentiate the therapeutic effect. The time interval between the two types of therapy was the main subject of the present investigation. Local hyperthermia (43 degrees C, 60 min) following BCNU chemotherapy at intervals of 0, 3, 6, 9, 12, and 24 h, respectively, was studied in a colonic Yoshida sarcoma model in Sprague-Dawley rats. No significant increase in the curing rate resulted from hyperthermic treatment. The results suggest that the highly anticipated hyperthermic peritoneal lavages should be investigated in controlled animal experiments prior to clinical use.

Animals↗