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At least 19 recordsLinked to original sources
PubMed2005

Right colon, sigmoid colon, and transverse colon diverticulitis in the same patient: report of a case.

Although sigmoid colon diverticulitis is frequently seen, right colon and transverse colon diverticulitis remain rare forms of the disease. This case report examined the disease course of a 46-year-old female who first presented to our institution in 1990 with perforated right-sided diverticulitis. During the next 11 years, she developed sigmoid colon diverticulitis and then transverse colon diverticulitis. The right and sigmoid colon diverticulitis were treated with surgery and the transverse colon diverticulitis was managed conservatively. This is the first reported case of a single patient who had separate episodes of diverticulitis in the right, transverse, and sigmoid colon. The evaluation and management of this patient has mirrored a trend in the literature and clinical practice.

Colon, Sigmoid↗
PubMed1987

Ion transport in human cecum, transverse colon, and sigmoid colon in vitro. Baseline and response to electrical stimulation of intrinsic nerves.

In a flux chamber study of ion transport in human colon, we compared baseline rates with those measured during electrical stimulation of intrinsic nerves. In baseline studies, sodium was absorbed throughout, but maximally in transverse colon. In cecum, sodium absorption accounted for the short circuit current and chloride was not absorbed. Chloride was absorbed in transverse and sigmoid colon, however. Residual current was minimal in cecum and transverse colon, but increased in sigmoid colon. Neural stimulation caused chloride secretion in cecum, reduced chloride absorption in sigmoid colon, but caused no change in transverse colon; sodium absorption decreased in cecum. A neurotransmitter of unknown identity affects baseline short circuit current in sigmoid colon. Half of the increase in short circuit caused by neural stimulation in sigmoid colon is mediated by muscarinic receptors. The identity of the other transmitter(s) is not known. It is not substance P or histamine. The three divisions of the colon differ in relative rates of baseline ion transport and in their transport responses to intrinsic nerve stimulation.

Cecum↗
PubMed2003

Laparoscopic sigmoidopexy by extraperitonealization of sigmoid colon for sigmoid volvulus: two cases.

Sigmoid colectomy-open or laparoscopic-has been advocated as the treatment of sigmoid volvulus. This has a higher incidence of morbidity and mortality. We have successfully treated 2 cases of recurrent sigmoid colon volvulus with laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon. Laparoscopic sigmoidopexy by this technique has not been reported before. The first patient was a 20-year-old male and the second was a 72-year-old female. In both patients, initial detorsion of volvulus was achieved by rectal tube. As the colon was nongangrenous, elective laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon was performed 4 days after the detortion. Operative times were 50 minutes and 70 minutes. Both patients were discharged from the hospital on the third postoperative day. There has been no recurrence of volvulus over a period of 6 and 7 months. There were no complications. In conclusion, laparoscopic sigmoidopexy by extraperitonealization of the sigmoid colon may become a superior alternative for the treatment of sigmoid volvulus with nongangrenous colon.

Adult↗
PubMedDate not supplied

Uninhibited sigmoid colon syndrome (sigmoid hyperreflexia): description of a new clinicopathological entity.

PURPOSE: To present 10 patients who complained of passage of frequent loose stools which was found to be due to sigmoid colon hyperreflexia, a condition that, to our knowledge, has not been described before. PATIENTS AND METHODS: Ten patients (6 women, 4 men, mean age 46.6 years) complaining of frequent loose stools of 5-8 years' duration and 10 healthy volunteers (controls) matching the patients in age and gender, were included in the study. Colonoscopy, barium enema and intestinal transit studies were normal in all. The anorectal physiological studies comprised: recording of rectal, anal and intra-abdominal pressures, EMG of the external and internal anal sphincters and levator ani muscles, sigmoidometry and determination of the sigmoido-rectal junction reflex. RESULTS: Apart from sigmoidometry, all the aforementioned anorectal physiological studies were in accordance with those of the controls. Sigmoidometry showed that balloon expulsion occurred at a distending volume of 32.4 ml and a sigmoid colon pressure of 86.4 cmH2O in the patients, and of 86.2 ml and 98.6 cmH2O, respectively, in the controls. The tone limb exhibited major fluctuations (mean pressure rise 43.8 cmH2O) in the patients, while it was smooth or showed minor fluctuations (insignificant pressure changes) in the controls. CONCLUSIONS: The sigmoid colon contractions produced by small volumes of stools and the lack of proper storage necessary for water absorption from the stools, are suggested to explain the frequent loose stools in the studied patients and to be the result of sigmoid colon hyperreflexia.

Adult↗
PubMedDate not supplied

[Volvulus of the sigmoid colon].

Sigmoid colon is the most frequent side for a volvulus. We present four cases of sigmoid volvulus admitted to our department during the period July 1994-December 1995. Intestinal volvulus, despite its benignity, has a quite high morbidity and mortality. Important factors such as the patient's features and frequent late diagnosis can influence the complicated outcome of the disease. Plane X-ray of the abdomen is helpful while barium enema can be therapeutical because of the pressure of the inflated air. Sigmoid resection is the most effective treatment for the disease.

Aged↗
PubMed1979

Volvulus of the sigmoid colon.

Sigmoid volvulus in children is quite rare and may occur in acute fulminating form requiring early diagnosis and surgery. In this case, bowel continuity after resection of the necrotic sigmoid was reestablished in a two-stage operation.

Child↗
PubMed2004

Extensive adult colo-colonic intussusception from ascending colon to sigmoid colon: report of a case.

Intussusception in adults is relatively rare. Here we report a 52-year-old man with an extensive colo-colonic intussusception caused by a polypoid mass in the ascending colon. The mass, which was 10 x 8 x 5 cm in size, had been palpated preoperatively and was suspected to be a sigmoid tumor. The patient was treated successfully by reduction of the invagination and subsequent right hemicolectomy.

Colectomy↗
PubMed1980

Intermittent volvulus of the sigmoid colon.

Three patients in the younger age group are described who are thought to have had intermittent volvulus of the sigmoid colon. Successful treatment was effected by sigmoid colectomy and end-to-end anastomosis. The incidence and aetiology of sigmoid volvulus are reviewed, with particular reference to its occurrence in younger patients.

Adult↗
PubMed2004

Study on the anatomical dimensions of the human sigmoid colon.

Although the sigmoid colon is commonly afflicted with disease, studies on its anatomical dimensions are scarce. It is suspected that dimensions of the sigmoid colon change with age. This study documents data on the anatomical measurements of the sigmoid colon in 70 Indian subjects (51 live and 19 cadavers). Seven parameters of sigmoid colon anatomy measured included length and width of the sigmoid colon and mesocolon at specific points. Three mesocolic indices (width to length ratios) were calculated. Comparisons of measurements in the live and cadaver subjects and in the two sexes were made. The relationship of change in parameters with age was assessed. Appropriate statistical methods were used and the differences were considered significant at P < or = 0.05. The study showed wide ranging variations in the values of various measured parameters of the sigmoid colon. Seven patterns of the shape of the sigmoid loop were identified. In the commonest pattern the sigmoid mesocolon was vertically longer than wide (dolichomesocolic), the sigmoid loop having its maximum convexity located just a little proximal to the apex. Patterns where the width of the mesocolon was greater than the vertical length (brachymesocolic) were also observed. The gender analysis showed that the sigmoid mesocolon of the female was brachymesocolic (wider than long), whereas that of the male was dolichomesocolic (longer than wide). This might explain the higher incidence of sigmoid volvulus in the male. This study also showed that the measurements of the sigmoid colon and its mesocolon do not change significantly within the age range of 16-60 years in the two sexes. Also noteworthy is the observation that in the cadaver the sigmoid colon shows considerable shrinkage, particularly of its mesocolon; consequently the data from cadaver subjects, though valuable for anthropometric use, have limitations when used for clinical applications.

Adolescent↗
PubMed2004

[Giant diverticulum of the sigmoid colon with jejunal fistula].

An 80-year-old woman with sigmoïd diverticula was treated by corticosteroid for Horton disease. She presented abdominal pain, and abdominal mass in left iliac fossa. Radiological examinations revealed a colo-jejunal fistula. At laparotomy it was a giant diverticulum of colon sigmoid with fistula in the jejunum. The pathogeny of giant diverticulum and the role of corticosteroid are discussed.

Aged↗
PubMed1990

Prognostic significance of nucleolar organizing regions (NORs) in carcinomas of the sigmoid colon and rectum.

The prognostic significance of silver-binding nucleolar organizing regions (AgNORs) has been evaluated in tissue sections of biopsies taken from 70 primary adenocarcinomas of the colon sigmoid (n = 25) and rectum (n = 45) prior to their curative resection. A significant correlation between five-year survival rate and the mean AgNOR number per tumour cell (p less than 0.001) and the mean size of silver stained dots (p less than 0.05) was found according to the univariate Kaplan-Meier survival analysis. There was no significant relationship between AgNOR content and grade of malignancy, pT categories or pN categories. Multivariate survival analysis of covariates (Cox regression model) revealed a set of five variables that significantly influenced the patients' outcome: pN categories, AgNOR content, pT categories, maximum grade of malignancy and number of inflammatory cells. From the clinical and pathological parameters studied, pN and pT categories as well as the mean AgNOR number were the most important variables predicting death from colorectal carcinoma. Since the analysis of AgNORs can be performed on routinely processed paraffin-embedded tissue, this method may be of potential use in pretherapeutic assessment of the biologic aggressiveness of the disease.

Adenocarcinoma↗
PubMed1990

[Injuries of the sigmoid colon following radiation therapy of carcinoma of the uterine cervix--a method of estimating the radiation dose to the sigmoid colon].

Grade 2 or 3 injuries of the sigmoid colon were observed in 4 out of 42 patients with carcinoma of the uterine cervix who were treated by radiation therapy. The irradiation was planned as the combination of the external irradiation (whole pelvic 30 Gy and 20 Gy with central shielding by 25 fractions, 5 weeks) and the intracavitary irradiation (RALS, 19 Gy at point A by 3 fractions). To analyze the causes of the radiation sigmoiditis, we have investigated the following factors: age, dose at point A, dose at point C, grade of tandem dislocation, uterine angle, obesity score, evidence of previous surgery to the pelvic cavity and hypertension. The dose at point C and the grade of tandem dislocation were determined from the confirming X-Ps at RALS therapy and external irradiation. The superimposition of these films was performed with corrections for the angle between the projection direction of the X-Ps and the vertical magnification factor of the central shielding area. Point C was defined as a point 2 cm anterior to the intersection of the tandem axis and a curvilinear line 1 cm outside from the margin of central shield on the X-Ps. Grades of tandem disclocation were decided as the number of tandem tips which were outside of the central shielding area on X-Ps. As the results, the doses at point C showed very high statistical significance (p less than 0.001) with the evidence of radiation sigmoiditis. All the cases with radiation sigmoiditis were received over 1290cGy at point C. Age had also some significance (p less than 0.05) with radiation sigmoiditis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMedDate not supplied

Management of sigmoid colon volvulus.

BACKGROUND/AIMS: Sigmoid colon is the most frequent site for a volvulus. The condition has been a formidable one, fraught with innumerable complications responsible for many deaths. In this report, we reviewed our experience with sigmoid colon volvulus. METHODOLOGY: We present our experience of 61 cases of sigmoid volvulus admitted to our department. Twenty-four patients were subjected to non-operative decompression and the others underwent emergency operation. RESULTS: Intestinal volvulus has quite a high morbidity and mortality. Mortality rate of elective resection following sigmoidoscopy was 7.6%. Mortality rate for emergency surgical detortion, primary resection and Hartman procedure were respectively 13%, 16.6% and 37.5%. Important factors such as the patient's features and frequent late diagnosis can influence the complicated outcome of the disease. Plain X-ray of the abdomen is helpful. CONCLUSIONS: Management with the conservative method of treatment in the form of detortion by sigmoidoscopy and rectal tube application is initially effective in most cases of volvulus of the sigmoid colon. On the other hand, elective or emergency sigmoid resection is the most effective treatment for the disease.

Adult↗
PubMed2002

Exaggerated motility of the descending colon with repetitive distention of the sigmoid colon in patients with irritable bowel syndrome.

BACKGROUND: Visceral hypersensitivity is one of the mechanisms of irritable bowel syndrome (IBS), but it does not explain the entire symptomatology, i.e., altered bowel habit with abdominal pain relieved by defecation. We tested our hypothesis that an abnormal link between luminal stimulation and mural response may have some role in the pathophysiology of IBS. METHODS: Patients with IBS (n = 10, median 21 years old, 5 male patients, 5 female patients) and healthy control subjects (n = 10, median 21 years old, 5 men, 5 women) were studied. A manometric catheter with three transducers was inserted to the descending colon and a balloon was placed in the distal sigmoid colon. Another catheter with three transducers was inserted to the duodenum. After baseline for 30min, the sigmoid colon was stimulated by balloon distention for 30min followed by recovery for 30min. Balloon distention was repeated 100 times, and each stimulation consisted of a 5-s inflation and a 10-s deflation, with a volume of 50ml maximum. The sensory threshold of balloon inflation was then examined, and plasma adrenocorticotropic hormone (ACTH) was measured with radioimmunoassay. RESULTS: Repetitive colonic distention induced a significant increase in motility indices (mmHg s/s%) of the descending colon in the IBS patients (from 118 +/- 25 to 333 +/- 108, P < 0.05) but not of those in controls (from 90 +/- 16 to 89 +/- 19). A significant group difference (P < 0.05), period effect (P < 0.02), and group x period interactions (P < 0.01) were detected with two-way ANOVA. Duodenal motility indices in controls were significantly reduced by colonic distention (from 169 +/- 25 to 104 +/- 14, P < 0.01), but those in the IBS patients were not (from 156 +/- 17 to 124 +/- 20). The sensory threshold of balloon inflation in the IBS patients (74 +/- 10ml) was significantly lower than that in controls (125 +/- 6ml, P < 0.001). There was no significant difference in plasma ACTH levels between the IBS patients and controls. CONCLUSIONS: Repetitive distention of the distal sigmoid colon below the sensory threshold induced orad exaggerated motility of the colon in IBS patients. The distention inhibited motility of the small intestine in healthy subjects, but this inhibition was blunted in IBS patients. These results suggest that IBS patients may have not only visceral hypersensitivity, but also an abnormal intestinal reflex.

Adolescent↗