1/143. Small bowel carcinoid presenting as a barolith.Baroliths are rare complications of barium contrast roentgenography that occur almost exclusively in the colon. Baroliths are often asymptomatic, but may be associated with abdominal pain, appendicitis, bowel obstruction, or perforation. We present an unusual case of a barolith which developed within the lumen of the small bowel, and resulted in the detection of an otherwise occult carcinoid tumor of the ileum.- - - - - - - - - - ranking = 1keywords = colon (Clic here for more details about this article) |
2/143. Delayed presentation of splenic rupture after colonoscopy.splenic rupture is a rare but potentially deadly complication of colonoscopy. We present the case of a 70-year-old male who presented with abdominal pain, initially stable, almost 2 days after colonoscopy. The patient's clinical status deteriorated shortly after abdominal CT scan identified splenic rupture.- - - - - - - - - - ranking = 6keywords = colon (Clic here for more details about this article) |
3/143. Sigmoidofiberscopic incision plus balloon dilatation for anastomotic cicatricial stricture after anterior resection of the rectum.We describe the procedure and examine the therapeutic efficacy of a combination of sigmoidofiberscopic incision plus balloon dilatation for tubular stricture by thick, long scar tissue at the colorectal anastomosis after anterior resection for rectal cancer. Balloon dilatation alone does not always relieve the strictures, although this method is the usual therapy for this condition. Five patients were identified in whom the stricture was not improved with balloon dilatation alone. Of these five patients, three complained of difficulty defecating, a feeling of incomplete evacuation, residual feces, and lower abdominal fullness. The remaining two patients, who had transverse colostomy to treat major leakage at the anastomosis, showed no symptoms. All five patients underwent the combination therapy described below. Two or three small radial incisions were made in the scar of the stricture with electrocautery under fiberscopic vision. Then the strictural scar was split and loosened bluntly along the incisions over a 15- to 20-minute period with a balloon dilator. This procedure was performed once or twice at a 2-week interval. In all five patients the stricture was improved according to objective criteria. There was also an improvement in the subjective symptoms suffered by three patients. The improvements were maintained over observation periods of 9 to 15 months. No complications were observed. Sigmoidofiberscopic incision plus balloon dilatation is an effective, safe therapy for cicatricial strictures after anterior resection for rectal cancer when the strictures have failed to improve following balloon dilatation alone.- - - - - - - - - - ranking = 6.954004381585keywords = sigmoid (Clic here for more details about this article) |
4/143. Ileosigmoid knotting in a 6-year-old child.Ileosigmoid knotting occurs when the ileum wraps around the base of an elongated sigmoid colon, thus producing two closed-loop obstructions with the possibility of ischemia and necrosis of either the ileum or sigmoid colon. It occurs more commonly in African, Asian, and Middle Eastern countries, although there have been three Americans previously reported with this problem. The 6-year-old child presented here is the youngest person ever reported with ileosigmoid knotting.- - - - - - - - - - ranking = 57.63203505268keywords = sigmoid, colon (Clic here for more details about this article) |
5/143. Continuous inferior mesenteric ganglion block for the control of abdominal pain.BACKGROUND AND OBJECTIVES: A 71-year-old woman was referred for control of intractable left-sided abdominal pain and constipation caused by stage 2B rectosigmoid colon cancer. She was treated with an intravenous morphine sulfate infusion at 4 mg/h which made her drowsy and lethargic. Because the distal colon is innervated by the inferior mesenteric sympathetic ganglion, it was hypothesized that a continuous block of this ganglion would provide both pain control and increased intestinal motility. methods: The patient was placed in a prone position, and a Tuohy needle was placed at an entry site 7 cm lateral to the L3 spinous process. The needle was advanced 2 cm anterior to the L3 vertebral body with fluoroscopic guidance. An 18-gauge indwelling catheter was placed through the needle and a continuous infusion with 0.1% bupivacaine was maintained for 4 days. RESULTS: The patient obtained immediate pain relief and bowel motility. She remained awake and comfortable throughout the duration of therapy. She was discharged home 3 days after stopping the infusion and required a minimal amount of opioids. CONCLUSION: Continuous inferior mesenteric ganglion block may be an option in providing relief for pain caused by distal colon pathology.- - - - - - - - - - ranking = 9.954004381585keywords = sigmoid, colon (Clic here for more details about this article) |
6/143. diagnosis of Chilaiditi's syndrome with abdominal ultrasound.Chilaiditi's sign is a radiographic term used when the hepatic flexure of the colon is seen interposed between the liver and right hemidiaphragm. When symptomatic, this is Chilaiditi's syndrome. We report a case of a 70-year-old man who presented with abdominal pain, vomiting, singultus and constipation. Ultrasound was initially performed which showed an intestinal loop between the anterior surface of the right liver lobe and the diaphragm. The chest X-ray revealed colon gas under the right diaphragma and the abdominal CT-scan confirmed the hepatodiaphragmatic interposition of the colon. Colonic elongation and laxity of colonic and hepatic suspensory ligaments are the principal predisposing factors. The advantages of the abdominal ultrasound in the diagnosis and follow-up as well as possible complications and forms of therapy with this syndrome are discussed.- - - - - - - - - - ranking = 4keywords = colon (Clic here for more details about this article) |
7/143. Sigmoid colon carcinoma metastatic to the myometrium.Metastases to the uterus from extragenital cancers are significantly rarer than metastases to the ovaries. Of the approximately 200 cases of metastases to the uterus from extragenital cancers that have been reported in the literature, more than half are cases of metastases from breast carcinoma and only 16 are cases of metastases from colorectal carcinoma. A case of isolated metastases restricted to the myometrium of the right uterine comu from sigmoid colon carcinoma, without involvement of the ovaries, is described. The patient who six months previously had surgery for sigmoid colon carcinoma presented with right lower abdominal pain and a palpable mass in the region of the right uterine cornu. The diagnosis of isolated metastases restricted to the myometrium of the right uterine cornu was confirmed by total abdominal hysterectomy and bilateral salpingo-oophorectomy. This case illustrates that a growing uterine mass in a patient with a history of primary extragenital cancer, regardless of whether abnormal uterine bleeding is present or absent, should alert the physician to consider the possibility of uterine metastases.- - - - - - - - - - ranking = 19.90800876317keywords = sigmoid, colon (Clic here for more details about this article) |
8/143. angiolipoma of the colon with right lower quadrant abdominal pain.BACKGROUND/AIM: An angiolipoma is a common benign neoplasm with a characteristic vascular component that occurs in the subcutaneous tissue and rarely in the gastrointestinal tract. We report on a 69-year-old man with a submucosal angiolipoma in the cecum. methods: This patient was treated with a laparoscopy-assisted ileocecostomy, and a side-to-side anastomosis was performed extracorporeally. RESULTS: A light microscopic study supported the diagnosis of an angiolipoma of the colon. After 5 years of follow-up, the patient has no symptoms or signs of recurrence. CONCLUSION: The colonic angiolipoma was successfully removed using a minimally invasive laparoscopic technique. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 6keywords = colon (Clic here for more details about this article) |
9/143. An unusual cause of recurrent abdominal pain.abdominal pain is a common complaint with diverse etiologies. We describe an unusual case of recurrent abdominal pain in an adult due to lead poisoning, a condition usually associated with childhood. A previously healthy 42-yr-old man presented with 2 days of severe crampy abdominal pain and a 1-month history of constipation. physical examination was remarkable for diffuse abdominal pain but peritoneal signs were not present. blood tests were remarkable for hematocrit of 33 and mean cell volume of 78, with ovalocytes and basophilic stippling on blood smear. Abdominal x-ray showed stool throughout the colon and a nonspecific bowel gas pattern. The patient was treated with intravenous fluids and enemas, and his symptoms resolved within 2 days. Repeat history taking revealed he had been stripping paint from an old Victorian house in the preceding few months. He was discharged after a blood lead level was obtained. Before his clinic appointment he was readmitted 2 days later with recurrent abdominal pain. His blood lead level was elevated at 110 microg/dl (toxic range). After consultation with the occupational health and safety Administration and local poison control service, he was treated with intravenous calcium edetate disodium and intramuscular dimercaprol. He was asymptomatic at discharge, with a level of 56 microg/dl. Two weeks later, a repeat level was elevated at 72 microg/dl, for which he received a 3-wk course of oral dimercaptosuccimer. Subsequent levels were unremarkable, and the patient remains asymptomatic. abdominal pain secondary to lead poisoning in adults is uncommon. This case highlights the importance of taking a detailed occupational history and appropriately using "routine" blood tests to diagnose a rare condition that presented with a common complaint.- - - - - - - - - - ranking = 1keywords = colon (Clic here for more details about this article) |
10/143. Asymptomatic giant gastric lipoma: What to do?Gastrointestinal (GI) lipomas are benign, usually single, slowly growing tumors. Their occurrence in the GI tract is most common in the colon, but they can be found also in the small bowel and very rarely in the stomach, where they account for 5% of all GI lipomas. Although most gastric lipomas (GL) are usually detected incidentally, they can cause severe symptoms such as obstruction, invagination, and life-threatening hemorrhages. To date, only three cases of GL have been reported in childhood. We describe the case of an 11-yr-old girl with asymptomatic giant GL, who has not received any treatment until now. New diagnostic insights, therapeutic options, and indications for treatment in asymptomatic patients are discussed.- - - - - - - - - - ranking = 1keywords = colon (Clic here for more details about this article) |
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