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At least 1,225 records · Page 68Linked to original sources
PubMed2006

A new gastrointestinal finding in Proteus syndrome: report of a case of multiple colonic hemangiomas.

A patient with Proteus syndrome presented with lower gastrointestinal bleeding due to multiple colonic hemangiomas, a finding which has not been described previously in this syndrome. The patient was a 20-year-old man with features fulfilling the diagnostic criteria for Proteus syndrome. He fulfilled both general criteria (mosaic distribution of the lesions, progressive course and sporadic occurrence) and specific criteria (including epidermal nevus, disproportionate overgrowth of limbs and vascular malformations). Fiberoptic colonoscopy revealed multiple hemangiomas, 0.5-1 cm in diameter, on the left side of the colon. Some gastrointestinal complications have been reported in patients with Proteus syndrome, including rectal polyps, colonic lipomatosis, atrophy of the intestinal villi and intestinal affection with fatty wall thickening but, as far as we are aware, colonic hemangiomas have not previously been reported in this syndrome.

Adult↗
PubMed2006

Colonoscopic polypectomy: a critical review of recent literature.

Colonoscopic polypectomy continues to be a major activity of gastrointestinal endoscopists, based upon the belief that ridding the colon of polyps prevents colon cancer. We review recent literature bearing on this assumption, emphasizing the benefits and limitations of colonoscopy for screening and surveillance of polyps. CT colonography has developed as an alternative or adjunct to colonoscopy but has not surpassed it in accuracy or therapeutic potential. Other recent technologic developments, such as magnification and chromoendoscopy, are reviewed, and an attempt is made to put them in perspective.

Colonic Neoplasms↗
PubMed2001

MR colonography without colonic cleansing: a new strategy to improve patient acceptance.

OBJECTIVE: MR colonography permits accurate detection of colonic polyps larger than 8 mm. Patient acceptance remains limited because of the need for bowel cleansing. The aim of this study was to develop and assess a strategy obviating colonic cleansing by performing MR colonography in conjunction with fecal tagging based on the oral administration of barium. SUBJECTS AND METHODS: Six healthy volunteers and six patients with suspected colorectal tumors, undergoing conventional colonoscopy within 1 week of MR imaging, were included in this study. For fecal tagging, 200 mL of a barium-containing contrast agent was ingested with each of four principal meals preceding the examination. For MR colonography, the colon was filled with a barium and water mixture while gadobenate dimeglumine (0.2 mmol/kg) was injected IV. RESULTS: The combination of fecal tagging and colonic filling with barium resulted in a homogeneously low signal throughout the colonic lumen in all 12 subjects. IV injection of gadolinium caused avid enhancement of the colonic wall. Similarly, lesions arising from the colonic wall enhanced avidly. In the six evaluated patients, MR colonography correctly identified two colonic carcinomas in two patients and one polyp in each of another two patients. CONCLUSION: Fecal tagging obviates bowel cleansing and should, therefore, enhance patient acceptance for MR colonoscopy. Barium used as the tagging agent is promising because it is inexpensive, commercially available, and characterized by an excellent safety profile.

Adult↗
PubMed1988

Proliferation patterns and aneuploidy in adenomatous polyps of the colon.

The frequency of aneuploidy and the proliferative activity of 57 colorectal adenomatous polyps was investigated by static cytophotometry and compared with 43 adenocarcinomas and 60 samples of normal mucosa. Twenty per cent of the adenomas contained aneuploid cells compared with 63 per cent of the adenocarcinomas. Except in the case of villous adenomas, there was a general increase in the proliferative activity of the diploid adenomas with increasing degrees of dysplasia. All of the adenomas showed an increase in proliferation compared with normal mucosa. There was a positive correlation between the size of the diploid adenomas and proliferative activity (P less than 0.001).

Adenocarcinoma↗
PubMed1996

Florid oral manifestations in an atypical familial adenomatous polyposis family with late presentation of colorectal polyps.

Early identification and prophylactic surgery are essential in preventing development of malignancy in colorectal polyps in familial adenomatous polyposis (FAP). Previous studies indicate a 100% cumulative risk of developing colonic polyps in individuals with FAP by the age of 34 yr. However, we have previously reported late-onset and non-penetrance of polyposis in four families. We describe here in detail one of these families with florid oral manifestations detectable on panoramic radiography of the jaws, which were instrumental in the diagnosis of FAP in the index patient and for ascertainment of her family for screening. The pathological adenomatous polyposis coli (APC) gene mutation in this family was shown to segregate with dento-osseous changes. Panoramic jaw radiography is a common examination carried out prior to dental or oral surgical procedures. This case illustrates the importance of appropriate investigations, including family history and colonoscopy, even in relatively older patients with radiological findings such as those described here and in members of their families at risk of FAP.

Adenomatous Polyposis Coli↗
PubMed1997

Laparoscopic bowel mobilization combined with intraoperative colonoscopic polypectomy in patients with an inaccessible polyp of the colon.

BACKGROUND: The purpose of this report was to describe a simple technique suitable for polyps where circumstances of the bowel anatomy prevent complete access and control of the colonoscopic procedure. METHODS: By combining laparoscopic mobilization of the bowel with colonoscopic polypectomy, previously inaccessible polyps could be snared in two patients. RESULTS: Both patients had 3-cm large sessile adenomas in the sigmoid colon safely removed, and they returned home within a day. CONCLUSIONS: The described procedure increases the safety of the otherwise difficult polypectomy and also avoids laparotomy with enterotomy or bowel resection as the alternative.

Adenoma, Villous↗
PubMed1983

An unusual hamartomatous malformation of the rectosigmoid presenting as an irreducible rectal prolapse and necessitating rectosigmoid resection in a 14-week-old infant.

A 14-week-old female infant presented with an irreducible rectal prolapse and a large polypoid tumor at the tip of the prolapsed mucosa. The tumor and prolapsed rectum were resected. Four weeks after the operation, profuse rectal bleeding occurred and a second similar tumor was diagnosed by endoscopy in the sigmoid colon. Laparotomy, rectosigmoid resection, and endorectal pull-through were performed. At operation, the serosal surface showed ragged polypoid lesions and an abnormal angiomatous vascularization. The postoperative course was uneventful. The histology suggested a congenital mucosal malformation. This pathology is unique in our experience and we have been unable to find anything resembling it in the literature. At age two years a Sertoli cell tumor developed in the girl with pubertas precox and a recurrent colonic polyp of the Peutz-Jeghers type.

Colon, Sigmoid↗
PubMed1978

Comparative clinicopathological and bacteriological studies in schistosomiasis mansoni.

FIFTY MALE Egyptian inpatients with active colonic mansoniasis were studied clinicopathologically, endoscopically, radiologically and bacteriologically. This was done to find out the pattern of colonic and urinary enterobacteria and serum antisalmonella agglutinins in various stages of mansoniasis. Cases are divided into three groups (A, B and C) according to the stage of their hepato-splenomegally. Their clinical presentations were dysentery, rectal bleeding, abdominal distension, anaemia, endocrinal changes and general weakness. Oesophageal varices were diagnosed in 19.8% of group C patients. Distal colonic polyps were noticed in 25% and 4% of group A and B cases respectively, while colonic ulcers were found in 20% of patients of either group. The total number of bilharzia ova per gram of fresh colonic biopsy was highest in group A and lowest in group C subjects. Mucosal and submucosal bilharzial granulation tissue formation together with mucosal hypertrophy were conspicuous among group A and B patients. Hematoxylin and eosin stain was of good diagnostic value and the rest of the stains used did not show any fungi or fibrinoid deposits.

Adolescent↗
PubMed1977

Management of hereditary site-specific colon cancer.

A family with site-specific colon cancer and discrete adenomatous colon polyps in certain members has provided a prototype for the study and clinical management of hereditary cancer. Analysis of this kindred showed an autosomal dominant mode of inheritance, early onset of cancer with predilection for the right colon, and frequent extraprimary cancers of the colon. Knowledge of these phenomena are critical to the management of this hereditary cancer syndrome. On our recommendation, two brothers of the family who were treated for colon cancer by hemicolectomy underwent prophylactic total colectomy. The resected colon from one of these patients had an occult adenocarcinoma in a villoglandular polyp.

Adult↗
PubMed1973

Pseudo-carcinomatous invasion in adenomatous polyps of the colon and rectum.

The histology of pseudo-carcinomatous invasion in adenomatous polyps of the colon and rectum is described and the appearances are contrasted with those seen in malignant polyps. The recognition of pseudo-carcinomatous invasion is important in the differential diagnosis of benign and malignant polyps of the large bowel. Failure to distinguish it from carcinoma may lead to wrong treatment and false reports of the incidence and prognosis of cancer of the colon and rectum. The evidence suggests that pseudo-carcinomatous invasion may be the result of repeated twisting of the stalk of a polyp which causes haemorrhage and this facilitates the passage of non-malignant adenomatous epithelium through the muscularis mucosae.

Adenocarcinoma↗
PubMed1987

Signet ring cell carcinoma in a polyp of the colon. A case report of a six-year-old boy.

Undifferentiated adenocarcinoma of the colon occurring in a 6-year-old boy was presented. The tumor characterized by the signet ring cell appearance developed in a polyp of the descending colon. The signet ring cell carcinoma is in general a rare morphologic form of colonic carcinoma. According to our review of the literature there have been described 16 patients under 10 years of age with colonic or rectal carcinoma, disclosing 2 cases of undifferentiated or signet ring cell carcinoma including the present case. In children, mucin producing adenocarcinoma is the most predominant type of colonic carcinoma, and 48% of the colonic carcinomas are of signet ring cell carcinoma in children under 17 years of age.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

[Neoplastic polyps of the colon].

We report all patients with neoplastic polyps endoscopically excised during 10 years, performed in different hospitals in Mexico City. All ages, both sexes and socio-economic levels were seen in several endoscopy services both, public and private. We find 190 patients (100 females) with 268 polyps and a mean age of 54.5 (range 18-86). Tubulo-villous adenomas have the less frequency (8%). Villous adenomas were the largest and had a 11% frequency, almost all were confined to recto-sigmoid region its mean age was 6 years. Villous adenomas were the most frequent (69%) distributed in all colonic segments, its mean age was 54.5 years with the widest range (18-80 years); they have highest dysplasia rate (8.1%). Carcinomas arising in polyps were all located in recto-sigmoid region, with female predominance (2.3:1) and oldest mean age of presentation (66.3 years). Neoplastic polyps in Mexico City general population has a low frequency; endoscopic polypectomy is safe and had a low morbi-mortality rate.

Adult↗
PubMed1992

Expression and different polarity of aminopeptidase N in normal human colonic mucosa and colonic tumors.

Expression and cellular localization of brush-border enzymes (aminopeptidase N, dipeptidylpeptidase IV, lactase, maltase) in normal human colon, colonic polyps and malignant intestinal tumors were investigated with a panel of monoclonal antibodies reacting with either native or denatured proteins. The enzymes were detected on cryostat sections by indirect immunofluorescence staining, or affinity-purified and analyzed by gel electrophoresis and immunoblotting. Dipeptidylpeptidase IV, lactase and maltase were absent from all samples examined, while aminopeptidase N (APN) was detected at the basal membrane of the epithelial cells in most specimens of colon obtained from individuals free of intestinal tumors. In contrast, APN was frequently localized at the luminal membrane of the surface epithelium in large-intestinal mucosa distal to tumors, adenomas and hyperplastic polyps, and from members of hereditary colon cancer syndrome families. APN was also expressed in colonic tumors, where it was present in an apical cell membrane location in 3/23 adenomas and 14/35 adenocarcinomas examined. No correlation was found between tumor-cell invasiveness (classified by "Dukes" stage) and expression or cellular location of aminopeptidase N. Histologically, all positive tumors were moderately or well differentiated. These results suggest that aminopeptidase N is normally expressed in adult human colon, but epithelial cells in the large and small intestine differ in their ways of sorting this enzyme intracellularly and eventually inserting it into different aspects of their surface membrane, a process which may be altered at an early stage of carcinogenesis.

Aminopeptidases↗
PubMed2000

Colonic neoplasia in patients with nonspecific GI symptoms.

BACKGROUND: The purpose of this study was to determine the prevalence rate of colonic polyps or masses 1 cm or greater in diameter in patients with nonspecific abdominal symptoms, from diverse practice settings, using a national endoscopic database. METHODS: Consecutive patients undergoing colonoscopy were included based on procedure indication. Endoscopic data were generated with a computer database at each practice site, transmitted to a central data bank and merged with data from multiple sites for analysis. Group 1 patients had nonspecific abdominal symptoms, which were defined as pain, constipation and diarrhea. Group 2 patients had a positive fecal occult blood test. Group 3 patients were asymptomatic, undergoing screening colonoscopy. Serious colon pathology was defined as a polyp or mass greater than 9 mm in size. RESULTS: Data were collected from 31 practice sites in 21 states during a period of 18 months. Of the 20,745 colonoscopy examinations, 9.2% were performed to evaluate patients with nonspecific abdominal symptoms, excluding other indications. Among patients with nonspecific symptoms 7.27% had polyp(s) 1 cm or greater in diameter compared with 17.05% of patients with positive fecal occult blood test (odds ratio 2.12: CI [1.73, 2.60]; p < 0.001). Patients with nonspecific symptoms had similar rates of large polyps as asymptomatic patients (7.27% vs. 6.45%, p = 0.32). Multivariate analysis identified several independent variables including increasing age, male gender and practice site at a Veterans Affairs Medical Center. CONCLUSIONS: In diverse, practice-based settings, patients with nonspecific abdominal symptoms who are referred for colonoscopy do not have a higher risk of serious colonic pathology than asymptomatic patients.

Abdominal Pain↗