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PubMed2004

Testicular metastasis of primary cecal carcinoid tumor.

Testicular carcinoids are rare and the majority are of primary testicular origin. Testicular carcinoids can also be secondary from extra-testicular primary tumors, but the incidence is even less common. The case described here is a patient who initially had an infiltrating cecal carcinoid with hepatic metastasis. Following surgery, he was managed with octreotide and had close monitoring of the levels of serum serotonin and its urinary metabolite. He experienced a fairly indolent clinical course and 5 years after excision of the primary cecal carcinoid, his hepatic lesion has virtually been unchanged. However, he developed a secondary testicular metastasis. He has otherwise remained well, without evidence of metastases elsewhere on imaging studies.

Adult↗
PubMed1975

[False positive tumour diagnosis in the caecum(author's transl)].

Radiographic appearances simulating tumours were found in 25 patients; the causes of the mistaken diagnosis are critically analysed. The commonest mistake was caused by inflammatory process (eight patients), caecal contents (seven patients) and an enlarged ileo-caecal valve (five patients). Ways of avoiding such misinterpretation are described.author

Adult↗
PubMed2001

Ciliated epithelium in a midgut enteric duplication: a case report.

We report the case of a 7-year-old male child with a cystic tumour attached to the caecum close to the ileocaecal valve. The histological examination showed that the cyst had a ciliated epithelial lining, containing serous and mucous glands, with surrounding smooth muscle, inner circular and outer longitudinal layers. The cyst was interpreted as an intestinal duplication lined with respiratory epithelium. This structure and its location, originating from the midgut, is not in accordance with the typical conception of the embryogenesis. The clinical picture and treatment are described and compared to other findings in the literature.

Cecal Neoplasms↗
PubMed2003

[Laparoscopic-assisted colonoscopic polypectomy--indications and results].

OBJECTIVE: Endoscopic treatment of large, sessile or awkward localized polyps, especially in the colon sigmoideum or the coecum holds the risk of colonic perforation. For these cases the combined colonoscopic-laparoscopic approach is described in this publication as an alternative procedure. PATIENTS AND METHODS: Since 1995 23 patients (male 11, female 12, age 70.7 +/- 12.0 years) were treated by laparoscopic-assisted colonoscopic polypectomy. Thirteen polyps were localized in the colon descendens or sigmoideum, seven in the cecum and one in the right respectively the left colonic flecture. Under general anesthesia and modified lithotomy position laparoscopy with occlusion of the colon or terminal ileum was followed by colonoscopy. After endoscopic localization the polyp was removed under laparoscopic visualization. During this procedure the colonic wall was stabilized, interfering adhesions were cut and coagulation- induced lesions of the wall were laparoscopically sutured if needed. RESULTS: In 17 patients the endoscopic polypectomy could be performed laparoscopically-assisted. In two patients the polypectomy was done by colotomy and in two others by segmental colonic resection due to the volume of the polyp. In two patients with histologically verified carcinoma laparoscopic-assisted left hemicolectomy was performed secondarily. Intra- or perioperative complications did not occur. CONCLUSION: Laparoscopic-assisted colonoscopic polypectomy is a new minimal-invasive therapeutical approach in selected cases with large, sessile or arkward localized polyps. The endoscopic procedure is possible also in polyps which should be treated by colotomy or segmental resection in the past. The additional discomfort for the patients due to laparoscopy is minimal.

Adult↗
PubMed2003

[Differential diagnosis of morbus Crohn disease: intussusception of the colon].

We report on a 35-year old women with severe abdominal pain, cramps, diarrhea with blood and a palpable paraumbilical resistance. The symptoms appeared a few days before admission and were recurrent within the last two years. The abdominal ultrasound showed a target sign with a thickened wall from the right to the left colon flexure with inhomogeneous reflexes. The CT-scan and barium enema showed an intussusception of the colon. After hemicolectomy of the right colon a 6 x 4 x 4 cm exophytic tumor near the ileocoecal valve was detected. Histologically the tumor was diagnosed as adenocarcinoma of the coecum (pT2pNOpMX G2).

Adenocarcinoma↗
PubMed2004

Ileocolic anastomotic ulcer after surgery in adulthood: case report and review of the literature.

Anastomotic ulcer is a rare complication after ileocolic resection, especially in adults without evidence of inflammatory bowel disease or tumor recurrence. We report the case of a 63-year-old male patient who presented 6 years after ileocolic resection, and also review the data of six similar cases described in the literature. The markedly reduced bile acid absorption found in our case raises the possibility of an etiological role of bile acids in the development of ileocolic anastomotic ulcers.

Anastomosis, Surgical↗
PubMed2006

Colonic explosion during endoscopic polypectomy: avoidable complication or bad luck?

We were confronted recently by an intraluminal colonic explosion during a colonic polypectomy procedure using snare loop electrocautery, probably caused by the presence of hydrogen and/or methane in combustible concentrations. Our patient needed immediate surgery, when several lacerations were found in the colon: a right hemicolectomy and a partial sigmoid resection with primary anastomoses were performed. Colonic bacteria, rests of fecal fluids, certain cleansing solutions, and oxygen insufflation are the main factors involved in cases of colonic explosion. We describe this dramatic event in our patient and discuss whether this complication might be avoidable in the future.

Adenoma↗
PubMed1990

[Diagnosis of tumors of the large intestine by colonic ultrasound].

Retrograde instillation of liquid into the colon allows a specific, percutaneous sonographic examination of the colon to be performed. As part of a prospective study of the diagnosis of colonic tumors in 260 patients, this form of colon sonography was examined together with colonoscopy. Sonographically, colonic polyps and carcinomas of the colon manifested as echogenic, parietal masses. Using colonic sonography, it was possible to identify 96% of the carcinomas that had been diagnosed colonoscopically. The sonographic diagnosis of polyps was insufficient if they were smaller than 6 mm: if they were larger than 7 mm, however, diagnostic sensitivity was 91%. The results of this study show that colon sonography is a new, sensitive method in the diagnosis of colonic tumors.

Cecal Neoplasms↗
PubMed1982

Colonoscopic appearance of the remnant of the appendix after total inversion.

In a series of 395 total colonoscopies, an oblong smooth tumor was seen in the cecum of six patients corresponding to the remnant of the totally inverted appendix. All the patients had undergone a laparotomy during which the appendix was inverted. The histological examination demonstrated a uniform finding without any signs of polyp or malignancy. Our findings stress that the appendix fails to undergo necrosis after total inversion in some cases, in which the changes in the cecum can be readily identified by total colonoscopy.

Adult↗