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Results for “Colon, Transverse”

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PubMed1989

Colonoscopy in Jamaica--a 12-year experience.

Four hundred and nine colonoscopic examinations were performed in 335 patients over a 12-year period in Jamaica. The main indications were suspected polyps (34%) rectal bleeding (22%) and suspected carcinoma (11%). Total colonoscopy was performed in 33% of cases. The ascending colon and hepatic flexure were examined in a further 25%, and the transverse colon in another 21%. Endoscopic examination of the suspected abnormal area was possible in all cases. In 142 examinations, no abnormality was detected, reflecting a false positive Barium enema in some. Polyps were found in 135 examinations, diverticula in 69 and carcinoma in 13. There were no complications. Colonoscopy was more sensitive and specific than Barium enema. The Barium enema findings were incorrect in 91 of 224 examinations (41%). Colonoscopy is a safe and accurate procedure which enables improved patient management.

Adolescent↗

PubMed1979

Diagnosis and control of diverticular bleeding by arteriography and vasopressin infusion. A report of 2 cases.

Large-bowel bleeding usually arises from either angiodysplasia or colonic diverticula. Diverticular bleeding is more common in the right or the transverse colon, even though diverticula are more common on the left. Arteriography in these patients may identify the bleeding site, and in some cases vasopressin infusion controls the bleeding. Embolization of the large bowel is not recommended because of the danger of necrosis.

Aged↗

PubMed1979

Effect of lactulose, neomycin and antacid on colonic pH recorded continuously with an implanted electrode.

Colonic pH was continuously monitored by a pH electrode implanted in the transverse colon of rats over a 24-hour period. Lactulose significantly reduced the colonic pH to 5.37 +/- .39 from a fasting value of 6.77 +/- .75. Pretreatment with neomycin or concomitant use of a nonabsorbable antacid prevented lactulose-induced reduction in the colonic pH. The clinical implication of the study is that combined use of lactulose with neomycin or high doses of non-absorbable antacids in the treatment of chronic portasystemic encephalopathy may be undesirable.

Animals↗

PubMed2004

[A case of advanced colon cancer responding completely to systemic 5-fluorouracil/l-leucovorin therapy].

A 79-year-old man was admitted for advanced transverse colon cancer with large bowel obstruction. Twelve years earlier he underwent a total gastrectomy with Roux-en Y reconstruction for gastric cancer. No metastasis was detected preoperatively. Exploratory laparotomy revealed massive direct invasion of the mesenterium of the jejunum for Roux-en Y reconstruction. The primary lesion was unresected and transverse colostomy was made. Systemic chemotherapy with 5-fluorouracil and l-leucovorin was scheduled for a total of 4 courses postoperatively. After completion of this chemotherapeutic regimen, a CT scan and colonofiberscopy revealed the primary lesions had disappeared, and a histological examination of biopsy confirmed that the patient had achieved a complete remission (CR). There was no severe side effect during chemotherapy. The patient is presently enjoying a good general condition and has been free from any sign of recurrence.

Adenocarcinoma↗

PubMed2006

Position changes improve visibility during colonoscope withdrawal: a randomized, blinded, crossover trial.

BACKGROUND: Adequate distension is essential to maximize neoplasia detection during colonoscope withdrawal. Position changes may improve distension but are often not performed in routine practice. OBJECTIVE: To assess whether routine position changes improve luminal distension during colonoscope withdrawal. DESIGN: Randomized, blinded, crossover trial. SETTING: Single tertiary-referral center, United Kingdom. PATIENTS: Fourteen patients attending for routine colonoscopy. INTERVENTIONS: Videotaped, back-to-back examination of colon proximal to rectosigmoid junction in left lateral position only, then with position changes: left lateral for the cecum to the hepatic flexure, supine for the transverse colon, and right lateral for the splenic flexure and the descending colon, or vice versa. MAIN OUTCOME MEASUREMENTS: Luminal distension as scored by a blinded video reviewer. Luminal distension was scored on a scale of 1 to 5 for each colonic area: 1, complete collapse; 5, widely distended to limit of view. A score of 2 or less was considered inadequate for diagnosis. RESULTS: Scores for the 2 examinations from the blinded video reviewer were significantly higher in the transverse, the splenic flexure, and the descending colon, P = .02, .002, and <.001, respectively. Without position changes, 6 of 14 of patients (43%) would have had a nondiagnostic distension score (1 or 2) in at least 1 colonic area, P = .03. LIMITATIONS: Nonvalidated scoring system for luminal distension, however, good agreement between endoscopist and blinded reviewer, weighted kappa 0.53, 95% confidence interval 0.38-0.69. CONCLUSIONS: Position change, a cost-neutral intervention, during colonoscope withdrawal improved luminal distension between hepatic flexure and sigmoid-descending junction and has the potential to reduce adenoma and early cancer miss rates.

Colon↗

PubMed2002

Colon atresia, facial hemiaplasia, and anophthalmia: a case report.

A case of a newborn with atresia of the transverse colon and right facial hemiaplasia, anophthalmia, and cerebral dysfunction is reported. Colon atresia is a rare cause of congenital bowel obstruction and often associated with other malformations such as abdominal wall defects, gastrointestinal, cardiac, urogenital, and musculosceletal lesions. Facial hemiaplasia may arise in frame of chromosomal defects or as a result of neurovascular compromise caused by congenital amniotic bands. However, the combination of colon atresia and facial hemiaplasia has not been reported before.

Abnormalities, Multiple↗

PubMed1981

[Giant spreading villous tumors of the colon and rectum].

Two rare observations in which villous tumors affected the mucous membranes of the rectum and transverse colon are described. In one case the lesions extended for 60 cm, in the other the neoplasm occupied the entire inner surface of the rectum and colon as well as the adjacent area of the ileum, whereas in the area of the liver and spleen bends there were areas of adenocarcinoma. Both observations were characterized by marked inflammatory infiltration in some parts of the villous tumor.

Adult↗

PubMedDate not supplied

[Lipoma of the colon. Its clinical significance and treatment].

The authors present the observation of a case of lipoma of the transverse colon. They review the latest literature confirming the rarity of this case and its clinical importance for diagnostic and therapeutic problems that it could give.

Colectomy↗

PubMed1976

Tension pneumoperitoneum: a report of 4 cases.

Four cases of tension pneumoperitoneum are described. In 3 patients this condition followed a perforation of a grossly distended caecum. In 2 of these patients there was an associated malignant neoplasm of the pelvic colon with obstruction. The third patient had a pseudo-obstruction of the transverse colon. The fourth patient had a tension penumoperitoneum with associated surgical emphysema in the neck and subcutaneous tissues of the abdomen and chest walls, following perforation of a duodenal ulcer. The aetiology, presentation and management, together with the mechanism of tension pneumoperitoneum, are discussed.

Aged↗

PubMedDate not supplied

MRI manifestations of gastrointestinal wall thickening.

The appearance of gastrointestinal wall thickening of various entities is demonstrated on magnetic resonance imaging (MRI). The entities include benign gastric ulcer, gastric carcinoma, pancreatic carcinoma with direct invasion of stomach, duodenal leiomyoma, radiation enteritis, peritonitis, colonic carcinoma, recurrent carcinoma at the gastrojejunal anastomosis with direct extension to the transverse colon, colocolic intussusception, sigmoid diverticulitis with pericolonic abscess and fistula into the urinary bladder, and lymphoma of the stomach, duodenum, small bowel, and colon. Air was introduced antegradedly or retrogradedly into the alimentary tract to act as a contrast agent. When the bowel was distended by air, the normal bowel wall was barely visible or even invisible. Abnormal focal or segmental wall thickening was outlined between the intraluminal air and extraluminal fat. In some instances, the thickenings were better demonstrated on coronal or sagittal sections. The proper muscular layer of the bowel has a low-signal intensity and was delineated between the thickened mucosa-submucosa and extramural fat. Interruption of this low-intensity zone might represent tumor invasion through the muscular layer.

Digestive System↗

PubMed2000

Effects of oral pinaverium bromide on colonic response to food in irritable bowel syndrome patients.

We have recently developed a simple method to investigate the colonic response to food (CRF). This study describes the modifications of CRF induced by treatment with oral pinaverium bromide in irritable bowel syndrome (IBS) patients. Thirty healthy subjects and 43 patients suffering from IBS were studied. Colonic transit time (CTT) was measured in fasting conditions and after eating a standard test meal. Colonic response to food was quantified by calculating the variation in number of markers in each zone of interest of the large bowel between the X-ray films of the abdomen taken before and after eating. CRF is characterized by caudal propulsion of colonic contents in the two groups. In controls, there is emptying of the caecum-ascending colon region and filling of the rectosigmoid. In IBS patients, only the left transverse colon and the splenic flexure empty. Pinaverium bromide exerts no effect in controls but reverses the CRF of the right colon in IBS patients by inhibiting right colon emptying. These results suggest that the inhibitory action of pinaverium bromide on CRF may support the clinical efficacy of this calcium channel blocker in the treatment of IBS.

Adult↗

PubMed2000

Complex long-segment intestinal dysganglionosis.

A case is reported with aganglionosis of the rectum, sigma, and descending colon; dysganglionosis with heterotopic ganglionic cells in the muscularis propria of the hypoganglionic transverse colon; and extreme hypoganglionosis (without detection of ganglionic cells) of the ascending colon and distal ileum. The ileum showed a transition zone with hypoganglionosis and intestinal neuronal dysplasia (IND) type B. As to the etiology of such complex intestinal innervation defects, pre- and perinatal perfusion deficits must be considered because their localization seems to be linked to the vascular anatomy of the colon. Early diagnosis may be difficult, causing a delay in operative treatment and multiple operations. Different manifestations of dysganglionosis may be found in the same patient. The classical continuum of distal aganglionosis followed by proximal hypo- or dysganglionosis and then normally innervated bowel may not always be present. Therefore, in children with recurrent (sub-)ileus after resection of an aganglionic bowel segment, additional dysganglionosis such as IND or hypoganglionosis or even complex intestinal dysganglionosis should be excluded by full-thickness colon and small bowel biopsies.

Hirschsprung Disease↗

PubMed2004

[Capillary hemangioma of the colon as a rare cause of intussusception in adults].

HISTORY AND ADMISSION FINDINGS: A 39-year-old patient presented with a history of constipation, abdominal pain and nausea. Magnetic resonance imaging showed a colonic tumour. Biopsy of the tumour did not reveal the diagnosis. INVESTIGATION: The abdomen was tense on palpation and inflammation parameters were elevated. On abdominal x-ray signs of obstructive colonic ileus could be seen. Endoscopic investigation revealed a tumorous stricture of the transverse colon presenting as intussusception with cockade phenomenon during sonography. TREATMENT AND CLINICAL COURSE: Because of obstructive ileus laparotomy was performed with extended right hemicolectomy and end-to-end ileotransversostomy. Histology showed the rare finding of colonic intussusception due to a capillary hemangioma. Post-operative clinical course was normal without any further signs or symptoms of systemic disease. CONCLUSION: Intussusception in adult patients can be a rare complication due to gastrointestinal hemangioma. Endoscopy and radiologic imaging may help to establish diagnosis. Surgical resection of the involved bowel segment seems to be a safe and effective treatment. Nevertheless congenital disease must be excluded to prevent further complications.

Adult↗

PubMed1982

Adenocarcinoma occurring in a hyperplastic (metaplastic) polyp of the colon.

A case of adenocarcinoma occurring in a hyperplastic (metaplastic) polyp of the colon is presented. The polyp, two cm in diameter, was located in the transverse colon of a 45-year-old male patient, and was removed endoscopically. From the periphery to the centre, the polyp showed epithelial changes progressing from hyperplastic to severely dysplastic, terminating in a central focus of invasive adenocarcinoma. It is suggested that the considerable number of absorptive cells in large hyperplastic polyps may occasionally result in an excessive absorption of carcinogen thus leading to dysplastic changes.

Adenocarcinoma↗

PubMed1989

[Surgical tactics in extensive necrosis of the sigmoid which had been brought downwards].

Since 1982 the authors perform early (on the 4th-10th day) reoperations in extensive necroses of the sigmoid colon which had been transposed downwards after abdomino-anal resection of the rectum. The reoperation consists in resection of the affected segment of the intestine (usually the whole remaining sigmoid colon) and downward retransposition of the descending or the left half of the transverse colon. Nine such operations were performed; in 8 patients the results were favorable, one 70-year-old female patient died. The first operations had been performed for carcinoma (5 patients), endometriosis (one patient), and anorectal developmental anomalies (3 adult females). It proved that it is advisable to undertake downward retransposition as an emergency manipulation immediately after diagnosing extensive necrosis of the downward transposed sigmoid colon, which usually happens on the 4th-6th day after the main operation. The intestinal wall is still not undergoing disintegration in this period and there is no purulent melting of the areolar tissue of the walls of the true pelvis, i.e., the danger of purulent complications developing after downward retransposition is relatively small, particularly if the cavity of the true pelvis is drained abundantly and lavaged regularly with antiseptic solutions in the postoperative period. Such reoperations are especially advisable in individuals under the age of 60, and usually ensure favorable immediate and late-term functional results.

Adult↗

PubMed1975

Spontaneous perforation of the proximal colon following lung surgery.

Three cases of spontaneous perforation of the proximal colon following lung surgery are reported. The caecum was the site of the lesion in two cases and transverse colon in one. Gastric inflation due to assisted artificail respiration resulting in over-distension of the colon is considered to be the cause of these complications. The treatment was by immediate laparotomy and suture of the perforation in two cases and transverse colostomy in one. All the patients made a complete recovery.

Adult↗

PubMed1982

Plasmacytoma of the colon: case report with lambda light chain, demonstrated by immunoperoxidase studies.

A case of solitary extramedullary plasmacytoma in the transverse colon of a 20-year-old woman is reported. This case is unusual in that the plasmacytomas are only rarely observed in the gastrointestinal tract and are especially uncommon in the colon and in young women. The lesion was composed of pleomorphic plasma cells and contained areas of extracellular amyloid deposition. Its neoplastic nature was verified by the use of immunoperoxidase studies which are positive only for lambda light chain. The subject of gastrointestinal plasmacytomas and the use of immunoperoxidase studies on plasmacytic lesions are discussed.

Adult↗

PubMed2006

Closure of duodenocutaneous fistula due to recurrent colon cancer with a pedicled jejunal seromuscular flap.

A new approach to closing a malignant enterocutaneous fistula is reported. Transverse colon cancer recurred around the superior mesenteric vein along with a duodenocutaneous fistula, thus causing severe dermatitis. The tumor was partially resected at the fascia level and the fistula measured 2.5 cm in diameter. A left rectus abdominis musculocutaneous flap failed to close the fistula because of graft necrosis. A jejunal flap measuring 8 cm in length was prepared by sacrificing about 15 cm of adjacent jejunum to create the pedicle. The mucosal layer of the flap was removed and the fistula was closed, then the tumor surface was covered. Two weeks later, the skin defect was covered with free skin grafting. The patient died of cancer 6 months after surgery, but there was no recurrence of the fistula.

Aged, 80 and over↗