PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Colon, Sigmoid”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Basal motility of dilated and non-dilated sigmoid colon and rectum in Chagas' disease.

The basal motility of the sigmoid colon and rectum was evaluated manometrically over 3 consecutive 10-minute periods in 29 control subjects, 14 chagasic patients without megacolon, and 32 chagasic patients with megacolon. The results indicated that the sigmoid colon of both chagasic groups had a lower motility index and lower wave frequency than that of the controls. Reduced wave frequency was observed in the rectum of patients with megacolon, out the rectum of the chagasic patients without megacolon showed manometric characteristics similar to those for the controls. The abnormalities observed were attributed to intramural denervation of the viscera under study. Waves of long duration were observed very frequently in megacolon, and were assumed to be caused by dilatation in itself and not by abnormal contraction of muscle fibers.

Adolescent↗
PubMed1986

Myoelectrical activity and intraluminal flow in human sigmoid colon.

Myoelectric spike bursts were recorded in the sigmoid colon by means of an intraluminal silastic tube equipped with 3 Ag-AgCl ring electrodes fixed 15 cm apart on the tube that was introduced by flexible sigmoidoscopy. In six subjects, the tube was also equipped with three catheters whose tip opened 1 cm aborad from each electrode, for pressure recordings. In six other subjects, the tube was equipped with both electrodes and a catheter opening at the tip of the probe for infusing fluids at a rate of 12 ml/min into the colonic lumen. The fluid was collected with another tube inserted in the rectum and the volume was measured at 1-min intervals. Colonic spiking activity was made of rhythmic stationary bursts (RSB) and of sporadic bursts that were either propagating (SPB) or not propagating (SNPB). All sporadic bursts were associated with intraluminal pressure waves whose amplitude was significantly higher than that associated with rhythmic bursts. In the infusion experiments, the volume of fluid collected did not change significantly whether rhythmic bursts were present or not (3.9 +/- 1.7 ml/min and 3.3 +/- 1.9 ml/min respectively) (mean +/- SD). However, the volume was significantly higher when sporadic nonpropagating bursts were present (9.4 +/- 4.1 ml/min), and even higher when the sporadic bursts were propagating (21.6 +/- 8.8 ml/min). These results indicate that the occurrence of sporadic bursts, particularly when propagating, is associated with intraluminal pressure waves that lead to significant propulsive movements; and rhythmic bursts do not seem to be involved in colonic propulsive activity.

Colon, Sigmoid↗
PubMed1993

Atheroemboli-associated polyps of the sigmoid colon.

Atheroemboli-associated inflammatory type polyps localized to a portion of the sigmoid colon occurred in a 68-year-old diabetic man presenting with a 2-year history of bloody diarrhea and abdominal pain. The patient underwent segmental resection of the sigmoid colon. The specimen contained 15 polyps ranging from 0.3 to 1.9 cm in greatest dimension, localized to an 8-cm length of sigmoid colon. The polyps had an edematous submucosa with a superficially ulcerated mucosa. Microscopically, arterioles within the submucosa of the polyps contained organized atheroemboli. The overlying mucosa was largely replaced by granulation tissue, with foci of coagulation necrosis present in residual mucosa. The remainder of the bowel was unremarkable. The histologic diagnosis of atheroembolization to the gastrointestinal tract is difficult, requiring the inclusion of submucosa with atheroemboli in the biopsy tissue. Ischemic ulcers and erosions as well as inflammatory polyps related to atheroemboli may require deeper biopsy for etiologic diagnosis.

Aged↗
PubMed1988

[Urachal transitional cell carcinoma invading the sigmoid colon].

We report a patient with urachal transitional cell carcinoma invading the sigmoid colon. The diagnostic and therapeutic aspects of this disease are discussed. The literature is also reviewed. This 42-year-old man was admitted with the chief complaint of micturition pain. Operation consisting of total cystourethrectomy, excision of the urachus together with the umbilicus, pelvic lymphadenectomy, ilial conduit plasty, sigmoidectomy, and colorectostomy was performed on June 3, 1986, after the diagnosis of urachal carcinoma invading the sigmoid colon. A tumor the size of a hen's egg was found at the dome of the bladder extending to the sigmoid colon. The urachus 8 cm in length and 2 cm in diameter extended from the site of the tumor to the umbilicus. Histologically the tumor was a transitional cell carcinoma Grade III. The urachus was composed of epithelioid and muscle layers, and its lower end was filled with necrotic inflammatory debris so that the canal was obliterated; tumor cells infiltrated the muscle layer. No metastasis was found in lymphnodes. Combination therapy of 5 fluorouracil, adriamycin and cis-platinum was given after operation. He has returned to work and is doing well without evidence of metastasis or recurrence now at 1 year after the operation.

Adult↗
PubMed2005

Distribution of lymph node metastasis in T1 sigmoid colon carcinoma: should we ligate the inferior mesenteric artery?

OBJECTIVE: In standard oncological sigmoid colectomy, the inferior mesenteric artery is ligated either at its origin or at the level of the left colic artery. However, in patients with early-stage carcinoma, the distribution of metastatic nodes may be limited. The aim of this study was to clarify the prevalence and distribution of lymph node metastasis in T1 sigmoid colon carcinoma and to determine the adequate range of lymph node dissection. MATERIALS AND METHODS: The study included 121 consecutive patients treated for T1 sigmoid colon carcinoma. Clinicopathologic factors associated with nodal metastasis and the distribution of metastatic nodes were analyzed. RESULTS: Of 121 patients, 12 (10%) had nodal involvement. The depth of invasion and the presence of lymphatic and vascular invasion were significantly associated with nodal metastasis. Of these 12 patients, 11 (92%) had lymph node metastasis confined to pericolic nodes. Nodes along the sigmoidal artery were involved in one patient. There was no involved node along the superior rectal artery or at the root of the inferior mesenteric artery. CONCLUSIONS: Lymph node dissection for T1 sigmoid colon carcinoma should be limited to the root of the sigmoidal artery, and the inferior mesenteric artery should be preserved.

Adenocarcinoma↗
PubMed1985

Elastosis in diverticular disease of the sigmoid colon.

Diverticular disease of the sigmoid colon is an increasingly common clinical problem in the ageing population of western industrialised countries but the mechanism by which the disease develops remains unknown. The muscular abnormality is the most striking and consistent feature and this has been studied by light and electron microscopy in 25 surgical specimens of uncomplicated diverticular disease and in 25 controls. This is the first ultrastructural study of human colonic muscle to be published and shows that the muscle cells in diverticular disease are normal; neither hypertrophy nor hyperplasia is present. There is, however, an increase in the elastin content of the taeniae coli by greater than 200% compared with controls: elastin is laid down between the muscle cells and the normal fascicular pattern of the taeniae coli is distorted. There is no alteration in the elastin content of the circular muscle. As elastin is laid down in a contracted form, this elastosis may be responsible for the shortening or 'contracture' of the taeniae which in turn leads to the characteristic concertina-like corrugation of the circular muscle. Such a structural change could explain the altered behaviour of the colon wall in diverticular disease and its failure to change on treatment with bran.

Collagen↗
PubMed2006

Outcome of elective primary surgery for diverticular disease of the sigmoid colon: a risk analysis based on the POSSUM scoring system.

BACKGROUND: The outcome of surgery for diverticular disease of the sigmoid colon remains largely unclear. A comparison of studies is hardly possible because risk factors for diverticular disease severity and patient-related risk factors are lacking. The purpose of this study was to define morbidity and mortality of primary surgery for nonacute complications of diverticular disease of the sigmoid colon and to identify the risk factors that predict a higher morbidity and mortality. METHODS: Patients who underwent elective surgery for complications of diverticular disease of the sigmoid colon (n = 149) were identified in a prospective computerized morbidity and mortality registration. In all patients, the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) was calculated, as were the morbidity and mortality rates. Factors predicting postoperative morbidity and mortality were identified. To audit mortality figures, a POSSUM based scoring system is introduced. RESULTS: The mortality rate was 4.7% and morbidity rate was 53.7%. Significantly higher morbidity rates were correlated with a higher physiological POSSUM score (P = 0.010). Non-survivors were older (P = 0.029) and also had a higher physiological POSSUM score (P < 0.001) and operation severity POSSUM score (P < 0.001). CONCLUSION: The morbidity and mortality rates of surgery for nonacute complications of diverticular disease of the sigmoid colon are considerable. To a large extent, mortality and morbidity are driven by patient- and disease-related factors, as expressed by elevated physiological severity and operative severity scores and failures of peri-operative management in most deceased patients.

Aged↗
PubMed1998

[A case of colo-vesico-vaginal fistula caused by sigmoid colon diverticulitis].

A 74-year-old woman was referred to our hospital with the chief complaints of pneumaturia, fecaluria and discharge of feces and urine from vagina. Fistulography on the vaginal side showed the presence of contrast medium both in the sigmoid colon and bladder. Colonoscopy revealed multiple diverticulosis of the sigmoid colon. Under diagnosis of colo-vesico-vaginal fistula due to sigmoid colon diverticulitis, a one-stage operation removing sigmoid colon, uterus-vaginal wall and urinary bladder wall including the fistula and careful reconstruction was performed. Postoperatively, urinary leakage from vagina in large amounts continued due to the recurrence of vesico-vaginal fistula. An attempt to use human fibrin glue in the recurrent fistula was successful, and the patient was asymptomatic at 21 months of follow-up. Colovesical fistula has been reported in about 10-20% of patients undergoing surgery for complicated diverticulitis, but a combined fistula is a rare condition. Furthermore, we recommend the use of human fibrin glue for a recurrent fistula.

Aged↗
PubMed2000

Volvulus of the transverse and sigmoid colon.

A case of transverse and sigmoid-colon volvulus and a discussion of the probable mechanism of large-bowel volvulus (LBV) in children and its management is presented. A 5-year-old male with cerebral palsy presented with transverse-colon and subsequently sigmoid volvulus. The child underwent resection of the involved segments with primary colocolic and colorectal anastomosis, respectively. The recovery was uneventful. LBV in children is due to congenital anomalous or absent ligamentous fixation of the colon. Constipation is probably the result of the volvulus. Resection of the involved segment and primary anastomosis is the definitive treatment.

Abdominal Pain↗
PubMed2006

Mortality after acute surgery for complications of diverticular disease of the sigmoid colon is almost exclusively due to patient related factors.

OBJECTIVE: Auditing the outcome of surgery for complicated diverticulitis of the sigmoid colon is difficult. A comparison of studies is hardly possible because risk factors both in terms of the severity of diverticulitis and patient-related risk factors are neither well described nor standardized. The purpose of this study was to define morbidity and mortality of primary surgery for acute complications of diverticular disease of the sigmoid colon and to identify the relation between risk factors and morbidity and mortality. METHODS: In a prospective computerized morbidity and mortality registration from 1990 to 2002, 114 patients, who underwent surgery on an acute or urgent base for acute complications of diverticular disease of the sigmoid colon, were identified. In all patients the POSSUM score was calculated. To audit mortality rates a POSSUM based scoring system was introduced. RESULTS: Mortality was 16.7%, and morbidity 71.1%. Higher morbidity rates were significantly related to a higher POSSUM physiological score (P = 0.012) and to older age (P < 0.001). Higher mortality rates also were significantly related to a higher POSSUM physiological score (P < 0.001) and older age (P = 0.003). Patients who died had significantly more sepsis (P < 0.001), multiple organ failure (P = 0.027), cardiac (P < 0.001) and pulmonary (P = 0.013) complications. Gender, operation indication and type of neither surgery nor surgeon had a significant relation with morbidity or mortality. CONCLUSION: Surgery for acute complications of diverticular disease of the sigmoid colon carries a high morbidity rate and a substantial mortality rate. The majority of deceased patients had severe comorbidity. Post-operative mortality and morbidity are to a large extent driven by patient related factors. Elevated physiological severity scores and a lack of peri-operative management failures express this in the majority of deceased patients.

Aged↗
PubMed1979

Acute perforations of the sigmoid colon secondary to diverticulitis.

Diverticulitis is a complex disease and demands careful cooperation between physician and surgeons, because although it is a benign disease, the presence of complications makes it potentially lethal. For successful management, knowledge of the treatment in past decades should be integrated with current surgical technics. A retrospective review of forty-one patients with perforated diverticulitis revealed a significant decrease in morbidity and hospital stay for the group of patients undergoing the Hartmann procedure versus the group undergoing the classic three stage approach. In addition, the Hartmann group required fewer additional surgical procedures for drainage of abscesses. In view of these results as well as those of others, we believe that resection is the primary goal of therapy. The two stage approach therefore offers significant decrease in morbidity with acceptable mortality.

Abscess↗