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PubMedDate not supplied

Polyps of the colon.

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Colonic Diseases↗
PubMed1984

Intraoperative fiberoptic endoscopy.

Conventional endoscopy is an indispensable tool in the diagnosis and management of many patients with gastrointestinal disease. Intraoperative use of the fiberoptic endoscope permits direct visualization of the mucosal surface, eliminating the need for enterotomy in many cases. Over a 4.5-year period, 32 patients underwent gastrointestinal endoscopy during laparotomy for a wide variety of surgical problems. In 15 cases, obscure or unknown sites of upper and lower gastrointestinal bleeding were localized. Replacement of percutaneously placed biliary drainage tubes was facilitated in four cases. In three patients artifactual lesions suggested by gastrointestinal (GI) contrast studies were excluded with intraoperative endoscopy at the time of exploratory laparotomy, and in four cases, retained foreign bodies were recovered easily without the need for enterotomy. In six additional patients intraoperative endoscopy was used to localize nonpalpable colon polyps or to determine the extent of mucosal ulceration. The average time for an intraoperative fiberoptic endoscopic examination was 20 minutes. No complications resulted from this technique. In summary, intraoperative fiberoptic endoscopy is of definite value in assessing selected patients with difficult GI surgical problems encountered during laparotomy. This technique enhances the surgeon's ability to identify and treat inaccessible and occult GI lesions.

Adult↗
PubMed1983

Endoscopic evaluation and therapy of periampullary adenoma.

Duodenoscopy has been helpful in the diagnosis and treatment of periampullary adenomas. Unlike colonic polyps, endoscopic appearance and histological classification is often difficult. A high incidence of carcinoma in these lesions requires their removal. Endoscopic polypectomy may be done, but only after documenting that the lesion does not contain ductal structures.

Adenoma↗
PubMed1980

[Endoscopic control of gastrointestinal bleeding by sclerosing injections. Application to peptic ulcers and polypectomies (author's transl)].

Three endoscopic methods are available to control gastrointestinal bleeding. Electrocoagulation suffers from two defects: the depth of cauterization is difficult to assess, and removal of the catheter, which sometimes adheres to the tissues, may cause re-bleeding. Laser coagulation is relatively more effective but costly. Sclerosing injections using 1% polidocanol are easier and cheaper. The authors have applied the latter method to 63 cases of gastrointestinal haemorrhage, including 37 peptic ulcers, 4 angiodysplasias of the stomach, 2 cases of Mallory-Weiss syndrome, 1 bleeding erosion and 19 haemorrhages consecutive to the excision of gastric or colonic polyps. Bleeding was stopped in 61 cases and remained under control in 52; it recurred in 9 patients. Two patients required emergency surgery.

Endoscopy↗
PubMedDate not supplied

Use of genetic markers during endoscopic screening and follow-up of gastrointestinal precancerous lesions.

A variety of premalignant lesions, including Barrett's esophagus, colonic polyps, ulcerative colitis, primary sclerosing cholangitis, intraductal mucin secreting papillomatosis are now well recognized and accessible to direct endoscopic assessment and biopsy or brushing. This review emphasizes the potential usefulness of genetic markers, in particular Ki-ras oncogene and p53 tumor suppressor gene mutations, in the endoscopic surveillance of these premalignant conditions. The adjunction of Ki-ras and p53 assays in material collected during endoscopic procedures may help the clinician detect earlier and with a higher accuracy neoplastic progression.

Digestive System Neoplasms↗
PubMedDate not supplied

Rationalisation of colonoscopy surveillance services: the need for clearer guidelines.

Colonoscopic surveillance in premalignant conditions and after resection of colorectal cancer is necessary. However, it is expensive, time-consuming and patients find it unpleasant. Furthermore, limited resources exist. Cost-effectiveness will depend upon a rational approach. This article is stimulated by the need for clearer guidelines.

Adenomatous Polyps↗
PubMedDate not supplied

[Possibility of presymptomatic diagnosis of familial polyposis coli].

Familial polyposis coli (FPC) is an autosomal dominant inherited disease characterized by an incidence of 1:7000-23000 born alive and by an onset of colorectal cancer in all untreated patients. This diagnosis is obtained mostly in presence of symptoms and in a low percentage after a screening, so it would be very important to have a clinical, biochemical or genetic marker to identify the affected subjects before the onset of the colonic polyps. In the last years many Authors have tested the hypertrophy of retinal pigmented epithelium (CHRPE) in the FPC affected families with interesting results. The aim of our study is to evaluate the predictive role of this clinical marker. 87 subjects have been submitted to ophthalmoscopy: 17 FPC affected patients, 40 first degree relatives and 30 no-polyposis colorectal cancer affected patients. The positivity (CHRPE +) was respectively 88.2%, 45% and 0. The first relatives degree aged more than ten years old have been submitted to the rectosigmoidoscopy and 8/9 CHRPE + persons resulted affected, while all CHRPE--examined were healthy. We have analysed the characteristics of CHRPE, its incidence and sensitivity and in FPC affected patients and in their first degree relatives, with positive results. At the end the CHRPE research and in our and in other experiences presents many advantages: low cost, easy feasibility, repeatability, high sensitivity and specificity. We consider that until the advent of valid routinary genetic tests it can be a good clinical marker in FPC affected families.

Adenomatous Polyposis Coli↗
PubMed1994

[Gastrointestinal complications in renal transplantation].

Seventy-nine gastrointestinal complications in 480 recipients of a renal transplant (RT) (16%) are described. The most frequent complication was high digestive haemorrhage (HDH) (19/480) (2.9%); other complications were: esophagitis, gastroenteritis, diverticulitis, cholecystitis, intestinal tuberculosis, rectal ulcer and colonic polyps. Mortality secondary to gastrointestinal complications was 1.1%. Sixty-seven percent of cases with peptic ulcer developed HDH, an incidence higher than that observed in the general population (20%). Twenty-one percent of transplanted patients with DH had ulcer background. Cholecystitis and diverticulitis were complications with a low incidence (0.2% and 0.6%, respectively) which do not seem to justify aggressive diagnostic and therapeutic manoeuvres prior to the transplant. Prevalence of intestinal tuberculosis in this series (0.4%) was higher to that described in the literature.

Adolescent↗
PubMedDate not supplied

Chronic intussusception in children: report of one case.

Chronic intussusception is defined as intussusception lasting for 14 days or more. Because the clinical manifestation is different from that of acute intussusception, the diagnosis is usually delayed or missed. Ultrasonography is of diagnostic value. We present a 8-year-old boy who had the complaints of marked body weight loss and intermittent abdominal pain for one month. Hydrostatic reduction failed in this case. Laparotomy revealed an ileo-colic intussusception, the leading point of which was a colonic polyp. We would like to emphasize that chronic intussusception frequently appears a nonacute abdominal condition, usually intermittent abdominal pain, and sometimes marked body weight loss and an abdominal mass. Surgical intervention is usually needed in older children because a high incidence of underlying lesions in them.

Child↗
PubMed1994

Genetic mechanisms of solid tumor oncogenesis.

The study of the genetic alterations of tumor suppressor genes and protooncogenes in solid tumors has greatly increased our understanding of cancer biology. These findings have extended epidemiologic associations of carcinogens with certain tumors. Further analysis of patterns of genetic changes may implicate carcinogenic substances in cases where epidemiology has not been able to do so. Identification of germline mutations in p53, APC, and NF1 has provided improved diagnosis and presymptomatic screening in cancer kindreds. The identification of additional alterations in tumor suppressor genes may further improve the ability to predict inherent cancer risk. Screening strategies based on detection of genetic abnormalities of preinvasive cancerous lesions, such as mutant ras in colonic polyps, may improve early diagnosis. Finally, strategies to replace lost tumor suppressor function may provide a future therapeutic modality.

Gene Expression Regulation, Neoplastic↗
PubMed1994

[Formation of a blind loop: an unusual bleeding site in chronic intestinal hemorrhage].

The blind-pouch-syndrome may display a variety of symptoms. But it rarely causes intestinal bleeding. In a patient suffering from anemia of chronic intestinal hemorrhage, a blind-pouch was diagnosed through the search for colon polyps. A hemicolectomy with a side-to-side ileocolic anastomosis was performed 30 years ago, but there were no symptoms of maldigestion or malabsorption. The explorative laparotomy revealed an anastomotic stricture with a lot of coproliths in the ileum-blind-pouch. The histological examination of the resected anastomosis showed an unspecific inflammation of the mucosa. Excluding other potential causes of intestinal hemorrhage, this mucosal irritation was presumed to be the bleeding site.

Adenoma, Villous↗
PubMed1993

[A meningioma in the posterior fossa without dural attachment: case report].

An extremely rare case of a meningioma in the posterior fossa without dural attachment has been reported. The patient was a 56-year-old male whose chief manifestation was the abnormality of his CT scan. His past history included gastric and colonic polyp when he was 54, 55 years old, and non-Hodgkin's lymphoma before hospitalization in our department. CT scan showed a small round non-enhancing lesion located at the lateral site of the right cerebellar cortex. T1 weighted image of MRI showed a homogeneous low intensity lesion with partial enhancing with Gd-DTPA. Proton image showed a remarkable low intensity lesion which showed an extramedullary mass. Right retromastoid craniectomy was performed. The mass was an extramedullary tumor which had no relation with the cerebellar cortex and dura matter. The arachnoid membrane around the tumor was intact. The tumor was totally resected and the patient had no neurological deficits. Histopathologically, the tumor was delineated into laminar structures by collagen fiber. Tumor cells were spindle in shape and made a whorling formation. There was no psammoma body and it had a hyperchromatic nuclei without mitotic features. Electron microscopic studies revealed no typical interdigitation but irregularity of the cell membrane. Abundant collagen fibers were in contact with basement membrane of the tumor. According to these findings, we diagnosed fibroblastic meningioma with atypical forms. Meningiomas without dural attachment are rare in adults, especially extremely rare of the posterior fossa. There are only 23 previous reports of "meningioma of the posterior fossa without dural attachment". Cantore divided these meningiomas into three groups (IV ventricle, inferior tela choroidea and cisterna magna).(ABSTRACT TRUNCATED AT 250 WORDS)

Cranial Fossa, Posterior↗