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At least 307 records · Page 17Linked to original sources
PubMed1987

The bowler hat: a valid sign of colonic polyps?

This report briefly describes several cases of diverticula simulating colonic mucosal lesions. We have found that the bowler hat configuration, in particular, frequently occurs in the presence of diverticular disease. In our series, no polyp was found to exhibit the bowler hat sign, while 12 cases of diverticular disease displayed 1 or more "bowler hats." Differentiation between polyps and diverticula displaying the bowler hat sign may be possible, but we conclude that the bowler hat sign per se is a nonspecific finding and that additional views may be necessary to confirm the presence of polyps.

Barium Sulfate↗
PubMed1990

Colocolic intussusception in a three-year-old child caused by a colonic polyp.

Colocolic intussusception is an uncommon cause of pediatric intestinal obstruction in North America; 95% of cases are ileocolic in location, with an equal percentage in which no pathologic lead point is evident on barium enema or laparotomy. In the last 20 years less than 3% of approximately 32,500 reported cases of intussusception originated in the colon. In a significant number of these cases juvenile polyps were identified as leading points. The majority of juvenile polyps occur in the rectosigmoid colon within the reach of a standard pediatric sigmoidoscope. These tumors most often cause painless hematochezia. Occasionally, juvenile polyps may grow large and serve as lead points for colocolic intussusception when located in the proximal colon. Pediatric patients presenting with documented colocolic intussusception should suggest the possibility of a colonic polyp or other mass lesion. Careful physical examination and barium studies should provide important diagnostic clues. Treatment is aimed at removing the lead point in patients presenting with intestinal obstruction. Colonoscopic polypectomy performed by an experienced endoscopist may serve as an alternative to surgical removal of the polyp. We report a case in a three-old-child of colocolic intussusception caused by a colonic polyp, and review some of the salient features of this clinical entity.

Child, Preschool↗
PubMed1987

Early invasive cancer in adenomatous colonic polyps ("malignant polyps"). Evaluation of the therapeutic options by decision analysis.

The management alternatives of segmental colonic resection versus follow-up alone for colonic adenomas containing early invasive carcinoma (i.e., polypectomy resection margin free of tumor) were evaluated by decision tree analysis. Using data from the literature, the major variables influencing the decision were as follows: probability of residual disease after polypectomy, operative efficacy (defined as the chance of curing a tumor that would otherwise recur without surgery), and operative mortality. For a hypothetical patient with low operative risk (operative mortality of 0.2%), resection would yield the best outcome in terms of life expectancy as long as the probability of residual disease was greater than 0.5%. Extensive analysis of the impact of changes in assumptions about the parameters characterizing the problem showed this conclusion to be unchanging over wide ranges of operative efficacy and probability of residual disease. However, the decision to do a secondary resection in this situation was still close because surgery was only marginally justifiable on economic grounds. Observation would be preferred in patients with higher operative risk (operative mortality greater than 2%).

Adenocarcinoma↗
PubMed1998

Colonic polyp differentiation using time-resolved autofluorescence spectroscopy.

BACKGROUND: Steady-state autofluorescence spectroscopy has been examined previously as a technique for distinguishing polyp types during colonoscopy. Although time-resolved methods have shown promise for tissue diagnosis in vitro, they have never been applied endoscopically. The aim of this study was to examine the feasibility of performing time-resolved autofluorescence spectroscopy in vivo and to determine the diagnostic accuracy of the technique as applied to colonic dysplasia. METHODS: A time-resolved spectrometer was used to measure the spectrally resolved transient decay of laser-induced autofluorescence emission from colonic tissue in vivo. RESULTS: Seventeen patients with 24 polyps (13 adenomatous, 11 non-adenomatous) were studied. The autofluorescence decay from adenomas was faster than that from non-adenomas. The measured decay time provided a means of distinguishing adenomas from non-adenomas with a sensitivity of 85%, a specificity of 91%, a positive predictive value of 92%, and a negative predictive value of 83%. CONCLUSIONS: Time-resolved autofluorescence spectroscopy is a promising optical diagnostic technique for determining polyp types in vivo.

Adenomatous Polyps↗
PubMed1978

Familial myopathy. Exacerbation by hypokalemia associated with colonic polyp.

A patient with Charcot-Marie-Tooth disease developed profuse mucinous diarrhea and severe potassium depletion. After two weeks, her muscle weakness grew worse, rhabdomyolysis occurred, and kaliopenic nephropathy was suspected. The patient's diarrhea ended abruptly after a single tubular adenomatous polyp was removed from her colon. Her metabolic status became normal and remained normal six weeks after transcolonic polypectomy.

Charcot-Marie-Tooth Disease↗