SEARCH · PubMed Health

Results for “Colon, Transverse”

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 1,009 records · Page 56Linked to original sources

PubMed1975

Colonic urinary diversion: 10 years of experience.

Experience with 46 colon urinary conduits is summarized. The transverse colon was used in 39 patients and the sigmoid in 7. Initially, we considered widened uretercolic anastomosis with free reflux desirable but later, upon realizing the dangers of reflux, antireflux procedures were incorporated into the operation. Among the advantages of the colon conduit are minimal stomal stenosis, little residuum, less electrolyte disturbance and availability for high and low diversions.

Adolescent↗

PubMed1991

Metabolic changes in patients undergoing right colon continent urinary pouch diversion.

The concept of continent urinary diversion is undergoing re-evaluation now that a stable continent valve can be produced with certainty. The right colon pouch consists of the distal 6 inches of the terminal ileum, the cecum, ascending colon, and proximal third of the transverse colon, and has a volume of up to 1,200 mL. The present study investigates the electrolyte changes that occur when urine is held in the pouch for increasing lengths of time. No significant changes in serum electrolytes occurred with catheterization intervals up to six hours in a group of patients that were studied for an excess of six months.

Colon↗

PubMed1999

Regional differences in quinine absorption from the undisturbed human colon assessed using a timed release delivery system.

PURPOSE: To investigate the regional absorption characteristics of the distal gut using two markers of permeability, quinine (a transcellular probe) and 51CrEDTA (a paracellular probe). METHODS: The permeability markers were delivered to the undisturbed gastrointestinal tract in 39 healthy volunteers using an oral timed-release delivery vehicle which allowed pulsed release within a particular site of the gut. Site of release was identified using gamma scintigraphy. Absorption of quinine and 51CrEDTA was assessed by measuring the percent excretion in the urine using HPLC and gamma counting respectively. Serial plasma samples allowed time-concentration curves for quinine to be plotted. RESULTS: There was a significant trend for diminished absorption with more distal delivery of the transcellular probe, quinine, which was: 6.26 +/- 0.87% (small intestine, n = 10); 4.65 +/- 0.93% (ascending colon, n = 16); and 2.59 +/- 0.52% (transverse colon, n = 10) of the ingested dose excreted respectively (p < 0.001). No such gradient was seen with the paracellular marker, 51CrEDTA. CONCLUSIONS: These results suggest that delayed release formulations should aim for release in the distal small bowel and proximal colon if absorption is to be maximised. Absorption by the transcellular route diminishes in the more distal colon, a fact which has implications for delayed or sustained release formulations.

Adult↗

PubMed1998

Hyperbaric oxygen therapy in a case of post-total body irradiation colitis.

We report a 21-year-old man who experienced symptoms of colitis following autologous TBI-conditioned PBSC transplantation, which persisted despite conventional treatment. Abdominal echography showed a thickened, stratified wall of the cecum, of the right colon and of part of the transverse colon. Hyperbaric oxygen therapy (20 sessions of 100% oxygen inhalation at 2.5 bar for 120 min in a hyperbaric chamber) achieved a prompt clinical recovery as well as complete disappearance of the ultrasound abnormalities.

Abdomen↗

PubMed2001

The serous-lined tunnel principle for urinary reconstruction: a more rational method.

OBJECTIVE: To examine the feasibility of using the serous-lined-tunnel principle for orthotopic neobladder, continent cutaneous diversion and ureteric replacement by an intestinal segment. Patients and methods We created: (i) an orthotopic ileal neobladder using the serous-lined technique for antirefluxing ureteric implantation in 16 patients; (ii) a continent ileal pouch, adopting the principle for continent-valve construction and for ureteric implantation, in 10 patients (another patient with a failed continent valve underwent revision using an adaptation of this principle; and (iii) by applying the same principle an ileal ureter with a proximal antirefluxing mechanism was constructed in two patients (with lower ureteric cancer), and total replacement of the ureter by a tubular segment of the colon in association with a continent transverse colon pouch in one irradiated patient. RESULTS: In all, 52 ureters implanted into ileal neobladders or continent pouches functioned well, with neither obstruction nor reflux; 11 continent valves functioned well with no incontinence. Two patients with ileal ureters showed no ileo-ureteric reflux and had less hydronephrosis than before surgery. The tubularized ureter provided a unidirectional flow into the pouch. Conclusion Ureteric reimplantation and continent valve formation achieved by adopting the serous-lined tunnel principle provided satisfactory results. The versatility of the principle is apparent in the present experience and the creative application of the serous-lined tunnel principle should be possible in urinary reconstruction.

Adolescent↗

PubMed1984

[Colorectal angiodysplasias (vascular ectasias). Endoscopic morphology, localization and incidence].

In a prospective study, angiodysplasias were looked for in 824 patients during total coloscopy. Such angiodysplasias were discovered in 30 patients (3.6%). The endoscopic morphology varied, most of the angiodysplasias being smaller than 5 mm (23 patients), with a homogeneous structure in 19, spider-like extensions in only 11 patients. In 13 patients there were multiple angiodysplasias. Two or more segments of the colon were affected in 7 patients. Site of lesions was as follows: in 19 patients in the caecum and/or ascending colon; descending colon, sigmoid and/or rectum in 16; transverse colon in 3 patients. Histological confirmation was obtained in 9 of 20 patients who had a biopsy. Right-sided colectomy for bleeding angiodysplasias (resulting in anaemia) is indicated only if endoscopic coagulation has failed and other colorectal sources of bleeding (neoplasm, diverticulum or polyp) and especially angiodysplasias in the left colon or rectum have been excluded by endoscopy or angiography.

Adolescent↗

PubMed2001

Usefulness of Dennis Colorectal Tube in endoscopic decompression of acute, malignant colonic obstruction.

BACKGROUND: Colonoscopic decompression has been attempted in patients with acute colonic obstruction caused by colon cancer to avoid emergency surgery and multiple subsequent operations but has usually been unsuccessful. This is an evaluation of the usefulness of a new device for endoscopic decompression in these patients. METHODS: Nine consecutive patients (6 men, 3 women; 65 to 89 years of age) with acute colonic obstruction resulting from colon cancer underwent endoscopic decompression with a Dennis Colorectal Tube. RESULTS: In all 9 patients (1 with carcinoma of the sigmoid colon, 3 with carcinoma of descending colon, 2 with carcinoma of the transverse colon, 2 with carcinoma of the ascending colon, and 1 with carcinoma of the cecum), endoscopic decompression was successful. After decompressing and cleansing the colon for several days, a one-stage operation was possible in all patients. CONCLUSION: Dennis Colorectal Tube is an excellent device for endoscopic decompression of acute, malignant colonic obstruction.

Acute Disease↗

PubMed1991

Obstructing carcinomas of the colon and rectum: clinicopathologic analysis of 40 cases.

A review of 40 cases of obstructing colorectal carcinoma selected from 1,786 cases of surgically resected colorectal carcinomas was undertaken. The average age of the patients was 63 years, and there were 22 women and 18 men. Twenty-three lesions (58%) arose in the sigmoid colon and nine (23%) in the transverse colon, and obstructing rectal carcinomas were significantly rare. All of the obstructing tumors displayed a circumferential growth, 32 being examples of the annular constricting type. Obstructive colitis was caused by a combined lesion in only three cases. Microscopic characteristics of the obstructing carcinomas were as follows: 1) invasion of the whole thickness of the colorectal wall by the malignant tissue, 2) complete discontinuance of the muscularis propria in the affected area, 3) striking fibrous stromal reaction in the tumor, 4) upward rising, not descending, of both stumps of the discontinuous muscularis propria, 5) infiltrative growth of the tumor into the subserosa with scar-like fibrosis. It is indicated from the present study that obstructing carcinomas have features promising construction of the bowel lumen, but patients with such a tumor are not appreciably different in prognostic, histologic nor immunohistochemical aspects from those with a non-obstructing carcinoma.

Adenocarcinoma↗

PubMed1985

Experience with 1000 colonoscopic polypectomies.

Experience with 1000 consecutive polypectomies in 591 patients, from December 1975 to October 1982, is reviewed. There were 633 adenomas, 292 hyperplastic, and 75 miscellaneous polyps. While eight minor bleeding episodes (0.8%) occurred, there were no major complications (perforations or bleeding requiring transfusion). The polyp retrieval rate was 97.9%. Of the 633 adenomas, seven (1.1%) had in situ carcinoma and ten (1.6%) invasive. Eight of the invasive group underwent colon resection with no positive nodes present. Anatomic location demonstrated a shift to the right side of the colon. Three hundred thirty-six (53.1%) were in the rectosigmoid; 134 (21.3%) were in the left colon; 79 (12.3%) were in the transverse colon; and 84 (13.3%) were in the right colon and cecum. Patients who have undergone benign polypectomy are colonoscoped again in 1 year, and, if negative, every 3 years thereafter. Postpolypectomy patients with malignant adenomas require closer observation. Endoscopic polypectomy, with its lower morbidity and mortality, has revolutionized the treatment of the colon polyp. It is also more cost-effective, with outpatient polypectomy being 29 times less expensive and inpatient polypectomy four times less expensive than transabdominal polypectomy.

Adenoma↗

PubMed2000

Collating collagenous colitis cases.

Between 1980 and 1993, collagenous colitis was diagnosed in 56 patients at UCLA. These authors evaluated the histology of almost 300 biopsies from these patients to further clarify the relationship between diagnostic histology and site of biopsy. As expected, their patients were predominately women (71%), with a mean age at diagnosis of 59 yr. Chronicity of diarrheal symptoms ranged from 3 months to 15 yr. Diagnostic subepithelial collagen thickness was variable throughout the colon. The highest yield was in transverse colon (83%), right colon (70%), and lowest in rectosigmoid (66%). Diagnostic collagen thickness was >15 microm in most biopsies, but was detected most readily when >30 microm--a threshold the authors suggest increases the diagnostic com-fort level. They recommend flexible sigmoidoscopy as adequate for diagnosis of most patients with collagenous colitis, noting colonoscopy is often used to clarify diagnosis, i.e., when only mild or focal colitis is seen distally.

Colitis↗

PubMed1988

Abdominal and pelvic CT: use of oral metoclopramide to enhance bowel opacification.

The value of orally administered metoclopramide hydrochloride to enhance bowel opacification during abdominal and pelvic computed tomography (CT) was analyzed prospectively in 202 patients in a control group and 334 patients in an experimental group who received 10 mg of metoclopramide with the first dose of oral contrast material. Five hundred milliliters of 2% sodium diatrizoate was given orally 45-60 minutes and 30 minutes before the study, and 250 mL was given 5-10 minutes before the study. Opacification of stomach, duodenum, and small and large bowels was graded from 0 to 3+, and the presence of pseudotumors or side effects from metoclopramide were noted. No significant difference was found in the opacification of stomach, duodenum, and jejunum between control and experimental studies. Opacification was significantly better in metoclopramide studies than control studies in the proximal ileum (P less than .05), distal ileum (P less than .05), right colon (P less than .05), and transverse colon (P less than .05). Pseudotumors were seen in 7% of control and 3% of experimental subjects. No side effects were encountered. Routine oral administration of metoclopramide before abdominal and pelvic CT examinations is recommended for rapid opacification of the ileum and proximal colon for all outpatients and for inpatients who must undergo CT on an emergency basis.

Administration, Oral↗

PubMed2000

Malignant colonic obstruction due to extrinsic tumor: palliative treatment with a self-expanding nitinol stent.

OBJECTIVE: The purpose of this study was to evaluate the usefulness of self-expanding nitinol stents for palliative treatment of malignant colorectal obstruction caused by unresectable extrinsic tumor, colorectal metastasis, or peritoneal seeding. SUBJECTS AND METHODS: One covered stent and 10 uncovered stents were deployed in eight patients with colorectal obstruction due to extrinsic tumor under fluoroscopic guidance. The sites of obstruction were located in the rectum (n = 5), in the rectosigmoid colon (n = 2), and from the transverse colon to the descending colon (n = 1). Clinical usefulness and complications were analyzed. RESULTS: Stents were placed successfully in all patients. Minor modifications of the delivery system were required in the tortuous rectosigmoid and lower rectum strictures. Symptoms of obstruction were initially resolved in all but one patient. In that patient, the presence of other points of obstruction was suspected. Bowel obstruction recurred in two patients: one obstruction was due to migration of a covered stent 4 days after the procedure, and the other obstruction was due to peritoneal seeding 33 days after the procedure. Both required colostomy or ileostomy. All patients died 12-111 days after stent placement (mean, 56 days). In five patients (63%), colonic obstruction was palliated by placing a stent until the patients' death between 39 and 111 days after stent placement (mean, 62 days). Six complications occurred in four patients and included stent migration (n = 1), anal bleeding (n = 2), anal pain that required analgesia (n = 1), and fever (n = 2). CONCLUSION; This self-expandable nitinol stent adequately palliated 63% of patients with colonic obstruction due to extrinsic tumor in this small series. Patient selection is very important to the success of this treatment.

Alloys↗

PubMed1990

[Detubularized right-hemicolonic continent urinary reservoir with plicated terminal ileum].

A continent urinary reservoir which consists of 1) detubularized caecum, ascending colon and the right half of transverse colon. 2) anastomosis of ureter and ascending colon with antireflex technique, and 3) plicated terminal ileal segment for continence and catheter insertion was created in 12 patients after radical cystectomy for urothelioma. Our method to create a continent urinary reservoir is simple and technically easy. It can, therefore, provide patients' satisfaction with low incidence of complication. However, such continent urinary reservoir diversion should be performed only for carefully selected patients, taking into consideration the physical status and the character and social status of the patient. This is because some patients who have had such surgery may change their mind to keep a balloon catheter to avoid the intermittent self-catheterization every 3 to 4 hours after surgery.

Aged↗

PubMed2006

A study of colorectal polyps.

OBJECTIVE: To determine various features of colorectal polyps and to evaluate the safety of colonoscopic polypectomy. DESIGN: Case series. PLACE AND DURATION OF STUDY: The Department of Gastroenterology and Hepatology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital, Lahore, from January 1987 to January 2004. PATIENTS AND METHODS: This study was based on data analysis of 393 patients who underwent colonoscopic polypectomy at our institution during 17 years from January 1987 to January 2004. Presenting complaints of patients were noted. Polyps were evaluated in terms of size, site, number and histopathology. RESULTS: Among 393 patients, 268 were male and 125 female. Presenting complaints were bleeding per rectum in 339 patients, diarrhea with blood in 34 and without blood in 6 patients, and lower abdominal pain in 12 patients. Two patients were being investigated for iron deficiency anemia. Two hundred and sixty-four patients had juvenile polyps, 39 had adenomatous polyps, 39 hyperplastic polyps, 39 inflammatory polyps, 3 malignant polyps and 2 patients had familial polyposis. Histopathological reports were not available in 7 patients. Size of the polyps ranged from 0.3 cm to 3.0 cm. Left colon was involved in 353 patients, transverse colon in 15, right colon in 8 patients and diffuse involvement of colon found in 17 patients. Bleeding following polypectomy occurred in 2% of the patients. No other procedure related complication occurred. CONCLUSION: Juvenile polyps were the commonest variety of polyps in our study. Colonoscopic polypectomy has very low complication rate.

Colonic Polyps↗

PubMed1989

The role of the pelvic nerves in the realization of the reservoir function of the colon.

In situ experiments were made on a group of dogs and in vivo experiments on another group of dogs with implanted electrodes for recording the electrical activity of the colonic muscle wall. A bipolar platinum electrode implanted in the pelvic nerve entering into the distal area of descending colon was used for electrical stimulation of the nerve (1 ms impulse duration, frequency of 2, 8, 10 and 15 Hz and amplitude of 10, 15 or 20 V). Electrical stimulation of the pelvic nerve with a frequency of 2 Hz resulted in inhibition of the spike activity. However, groups of spike potential burst in the distal part of the descending colon in response to electrical stimulation with frequencies of 8, 10 or 15 Hz. Repeated stimulation caused spreading of the spike activity of the descending colon in oral direction until the transverse colon. These antiperistaltic waves probably prevented the propulsion of the content of the descending colon. Thus, in addition to the inhibitory effect exercised by the sympathetic and noncholinergic nonadrenergic inhibitory part of the intrinsic nervous system, the reservoir function of the colon is influenced by these orally spreading waves of spike activity (antiperistaltic waves), which are caused by impulses along the pelvic nerves.

Animals↗

PubMed1989

Colonic motor response to eating: a manometric investigation in proximal and distal portions of the viscus in man.

The motor response of the human colon to a meal is still poorly characterized. Such data as are available were obtained chiefly for the distal colonic portions with myoelectrical techniques. For these reasons, we investigated proximal and distal colonic motor responses to food ingestion in a rather large group of healthy subjects. Twenty-nine healthy volunteers were studied with a colonoscopically positioned multilumen manometric probe and low-compliance infusion system. Recordings were obtained for 2 h during fasting and for 3 h after the subjects had eaten a 1000-kcal standard mixed meal. During fasting, motility was quite low, and no significant differences between proximal and distal portions were seen. After eating, each portion significantly increased its motor activity throughout the subsequent recording period, but there were differences in the time course in the response to eating for different colonic segments. Proximal portions (especially the transverse colon) had first a sudden maximal increase and then a decrease, whereas the distal ones had a slower and more sustained increase in activity. These findings are of interest, especially for comparison with those of patients with suspected motor dysfunction of the large bowel.

Adult↗

PubMed1987

Hernia through the foramen of Winslow: a complication of cholecystectomy. A case report.

In 151 years since first described, there have been 112 reported cases of hernia through the foramen of Winslow (HFW). All thus far have described HFW as a primary entity. The case reported appears to be unique with HFW as a surgical complication. HFW is the least common of internal hernias. The primary symptom is pain referred from the herniated organ and the hepatoduodenal ligament. An interesting sign is that the patient is found curled up or stooped over for pain relief. Anatomic factors implicated in HFW are an enlarged epiploic foramen, a floppy cecum and ascending colon, or abnormal length of small bowel mesentery. Tension on these structures causes pain with the torso extended. Distention of bowel in the lesser sac mimics gastric obstruction. Organs herniated are: small bowel (63%); cecum, ascending colon, and terminal ileum (30%); and transverse colon (7%). Of 25 cases reported since 1966, cecal herniation comprised two-thirds. The diagnosis may be made radiologically and the treatment is surgical. The case and a review of the literature are presented with attention to the anatomy. Also provided are the signs and symptoms of this interesting and perplexing diagnosis.

Aged↗

PubMed1984

A case of colon cancer metastasizing to the spleen.

A case of colon cancer metastasizing to the spleen is reported. The patient was a 43-year-old man who was laparotomized under the diagnosis of colon cancer. The tumor of the transverse colon showed a small ulcer and polypoid projections. Poorly differentiated adenocarcinoma was noted in the mucosa. Marked tumor metastasis was found in the parenchyma of the spleen and the peripancreatic, portohepatic, mesenteric and periaortic lymph nodes. The literature on the incidence and mechanism of metastasis to the spleen was reviewed, and metastasis to the spleen was found to be not infrequent at a late or advanced stage of cancer.

Adult↗