scholarly journals Giant Symptomatic Rectal Mucocele following Subtotal Colectomy

2018 ◽  
Vol 12 (1) ◽  
pp. 143-146
Author(s):  
Romano Schneider ◽  
Marko Kraljević ◽  
Markus von Flüe ◽  
Ida Füglistaler
Keyword(s):  
Subtotal Colectomy ◽  
Proximal Colon ◽  
Anal Stenosis ◽  
Total Proctocolectomy ◽  
Pathology Report ◽  
Mucus Production ◽  
Hartmann Procedure ◽  
Endoscopic Control ◽  
Colon And Rectum ◽  
Descending Colon

Introduction: Rectal mucoceles rarely occur and only a few cases are described in the literature. They usually appear after subtotal colectomy or Hartmann procedure originating from persisting rectal mucus production and simultaneous stenosis of the anal canal. Case Presentation: A 74-year-old female patient presented with the feeling of an abdominal growing mass. Complex medical history included a subtotal colectomy with an end ileostomy and a mucous fistula at the descending colon due to Crohn disease at the age of 16 years. MRI showed a massive dilatation of the remaining colon and the rectum. Endoscopy failed due to complete anal stenosis and stenosis of the descending colon at the stoma site. A total proctocolectomy was performed. The pathology report showed a dilated rectum and sigma with large amounts of partly calcified mucus. There was no evidence of dysplasia, malignancy, or Crohn manifestation in the completely obliterated proximal colon and the anus. Conclusion: Our case report underlines the importance of active endoscopic surveillance of the remaining colon and rectum in patients with diverting stomas and inflammatory bowel disease in order to detect stenosis. If endoscopic control is not possible due to obliteration, surgical therapy must be discussed due to the risk of developing cancer.

A Radiographic Study of the Gastrointestinal-Tract of Potorous-Tridactylus, With a Suggestion as to the Role of the Foregut and Hindgut in Potoroine Marsupials

1986 ◽  
Vol 34 (4) ◽  
pp. 463 ◽  
Author(s):  
PB Frappell ◽  
RW Rose
Keyword(s):  
Gastrointestinal Tract ◽  
Contrast Medium ◽  
Barium Sulphate ◽  
Proximal Colon ◽  
Radiographic Study ◽  
Colon And Rectum ◽  
Descending Colon ◽  
New Interpretation ◽  
Potorous Tridactylus

The gastric distribution of barium sulphate and its subsequent intestinal passage were examined by radiography in Potorous tridactylus. Barium sulphate administered in association with solid food passed to the sacciform forestomach from the tubiform forestomach. However, ingested barium sulphate suspension mainly entered the hindstomach via the gastric sulcus. Barium sulphate which entered the sacciform forestomach remained for no more than 1 h before passing to the hindstomach via the tubiform forestomach. The passage of contrast medium through the intestine was followed in adults administered barium sulphate suspension only. Contrast medium which entered the hindstomach was not detectable there after 10 min. Barium sulphate first arrived at the caecum and proximal colon after 20 min, and by 45 min the majority had reached these organs. It persisted in the caecum and proximal colon for several hours, during which there was some movement into the descending colon and rectum. These results lead towards a new interpretation of the role of the potoroine foregut and hindgut.

NITROGEN KINETICS IN THE LARGE INTESTINE OF SHEEP GIVEN BROMEGRASS PELLETS

1984 ◽  
Vol 64 (1) ◽  
pp. 103-111 ◽  
Author(s):  
R. M. DIXON ◽  
L. P. MILLIGAN
Keyword(s):  
Large Intestine ◽  
Proximal Colon ◽  
Direct Transfer ◽  
Irreversible Loss ◽  
Pool Model ◽  
Colon And Rectum ◽  
N Metabolism ◽  
Descending Colon ◽  
Microbial N

Six sheep fed 606 g of pelleted bromegrass (Bromus inermis) hay per day were used in acute experiments to study nitrogen (N) metabolism. With three sheep (15NH4)2SO4 was infused into the caecum and with another three sheep a mixture of 14C- and 15N-urea was infused into the blood. Samples were obtained before infusions commenced and on tracer plateau before slaughter for determination of blood urea N and rumen ammonia N concentrations, enrichments and specific radioactivities. Digesta were also obtained at slaughter from the rumen, abomasum, ileum and five segments of the large intestine for determination of concentrations and enrichments of ammonia N, microbial N and nonurea nonammonia N (NU-NAN). Urine was obtained from the bladder at slaughter. Flows of N calculated from these data were represented by an eight-pool model. There was negligible transfer of endogenous urea into the caecum and proximal colon either via ileal digesta or by direct transfer across the gut wall. Approximately 9% of caecal ammonia N was derived from blood urea. Approximately 0.61 g endogenous non-urea N/day was secreted into the caecum and proximal colon. Proteolysis and deamination produced 1.21 g ammonia N/day in the caecum and proximal colon. Absorption of ammonia from the caecum and proximal colon was 0.80 g N/day, while at least 0.80 g ammonia N was absorbed from the spiral colon descending colon and rectum. Ammonia N (0.40 g N/day) was incorporated into microbial N in the caecum. Microbial N constituted 49% of the NU-NAN in digesta flowing from the caecum; some 72% of this microbial N was excreted in the faeces. The rate of irreversible loss of the blood urea pool measured with 14C-urea (6.52 ± 0.76 g N/day) was greater (P < 0.05) than that measured with 15N-urea (5.20 ± 0.32 g N/day). Caecal ammonia contributed 10% of the N entering the blood urea pool and 2% of that entering the rumen ammonia pool. Key words: Sheep, large intestine, nitrogen kinetics, models

scholarly journals High incidence of postoperative silent venous thromboembolism in ulcerative colitis: a retrospective observational study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Norimitsu Shimada ◽  
Hiroki Ohge ◽  
Hiroki Kitagawa ◽  
Kosuke Yoshimura ◽  
Norifumi Shigemoto ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Venous Thromboembolism ◽  
Total Colectomy ◽  
Univariate Analysis ◽  
Operation Time ◽  
High Serum ◽  
Total Proctocolectomy ◽  
Colon And Rectum ◽  
Predictive Risk ◽  
D Dimer

Abstract Background The incidence of postoperative venous thromboembolism (VTE) is high in patients with inflammatory bowel disease. We aimed to analyze the incidence and predictive factors of postoperative VTE in patients with ulcerative colitis. Methods Patients with ulcerative colitis who underwent colon and rectum surgery during 2010–2018 were included. We retrospectively investigated the incidence of postoperative VTE. Results A total of 140 colorectal surgery cases were included. Postoperative VTE was detected in 24 (17.1 %). Portal–mesenteric venous thrombosis was the most frequent VTE (18 cases; 75 %); of these, 15 patients underwent total proctocolectomy (TPC) with ileal pouch–anal anastomosis (IPAA). In univariate analysis, VTE occurred more frequently in patients with neoplasia than in those refractory to medications (27.2 % vs. 12.5 %; p < 0.031). TPC with IPAA was more often associated with VTE development (28 %) than total colectomy (10.5 %) or proctectomy (5.9 %). On logistic regression analysis, TPC with IPAA, total colectomy, long operation time (> 4 h), and high serum D-dimer level (> 5.3 µg/mL) on the day following surgery were identified as predictive risk factors. Conclusions Postoperative VTE occurred frequently and asymptomatically, especially after TPC with IPAA. Serum D-dimer level on the day after surgery may be a useful predictor of VTE.

scholarly journals Diurnal variations in the concentrations of volatile fatty acids in the alimentary tracts of wild rabbits

1972 ◽  
Vol 27 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Susan J. Henning ◽  
F. J. R. Hird
Keyword(s):  
Fatty Acids ◽  
Volatile Fatty Acids ◽  
Distal Colon ◽  
Proximal Colon ◽  
Diurnal Variations ◽  
Gut Contents ◽  
Excretion Pattern ◽  
Colon And Rectum ◽  
High Concentrations

1. Wild rabbits were caught during both phases of the excretory cycle and their gut contents were analysed for volatile fatty acids (VFA).2. All rabbits were found to have high concentrations of VFA in the caecum and in the proximal colon. Acetic was the most abundant acid followed by n-butyric, then propionic.3. VFA concentrations in the caecum and in the proximal colon of rabbits caught during the day and during the night were similar. Hard pellets from the distal colon and rectum of rabbits caught during the night had considerably less VFA than did the soft pellets from rabbits caught during the day.4. Owing to the ingestion of soft faeces, the VFA content of stomach material was greater in rabbits caught during the day than in those caught at night.5. The results are discussed in terms of the mechanism of the diurnal excretion pattern and the role of coprophagy in the rabbit.

scholarly journals Colonization of Cattle Intestines by Campylobacter jejuni and Campylobacter lanienae

2005 ◽  
Vol 71 (9) ◽  
pp. 5145-5153 ◽  
Author(s):  
G. Douglas Inglis ◽  
Lisa D. Kalischuk ◽  
Hilma W. Busz ◽  
John P. Kastelic
Keyword(s):  
Beef Cattle ◽  
Campylobacter Jejuni ◽  
Large Intestine ◽  
Initial Study ◽  
Beef Steers ◽  
Ascending Colon ◽  
Tissue Samples ◽  
Real Time Quantitative Pcr ◽  
Colon And Rectum ◽  
Descending Colon

ABSTRACT The location and abundance of Campylobacter jejuni and Campylobacter lanienae in the intestines of beef cattle were investigated using real-time quantitative PCR in two studies. In an initial study, digesta and tissue samples were obtained along the digestive tract of two beef steers known to shed C. jejuni and C. lanienae (steers A and B). At the time of slaughter, steer B weighed 540 kg, compared to 600 kg for steer A, yet the intestine of steer B (40.5 m) was 36% longer than the intestine of steer A (26.1 m). In total, 323 digesta samples (20-cm intervals) and 998 tissue samples (3.3- to 6.7-cm intervals) were processed. Campylobacter DNA was detected in the digesta and in association with tissues throughout the small and large intestines of both animals. Although C. jejuni and C. lanienae DNA were detected in both animals, only steer A contained substantial quantities of C. jejuni DNA. In both digesta and tissues of steer A, C. jejuni was present in the duodenum and jejunum. Considerable quantities of C. jejuni DNA also were observed in the digesta obtained from the cecum and ascending colon, but minimal DNA was associated with tissues of these regions. In contrast, steer B contained substantial quantities of C. lanienae DNA, and DNA of this bacterium was limited to the large intestine (i.e., the cecum, proximal ascending colon, descending colon, and rectum); the majority of tissue-associated C. lanienae DNA was present in the cecum, descending colon, and rectum. In a second study, the location and abundance of C. jejuni and C. lanienae DNA were confirmed in the intestines of 20 arbitrarily selected beef cattle. DNA of C. jejuni and C. lanienae were detected in the digesta of 57% and 95% of the animals, respectively. C. jejuni associated with intestinal tissues was most abundant in the duodenum, ileum, and rectum. However, one animal contributed disproportionately to the abundance of C. jejuni DNA in the ileum and rectum. C. lanienae was most abundant in the large intestine, and the highest density of DNA of this bacterium was found in the cecum. Therefore, C. jejuni colonized the proximal small intestine of asymptomatic beef cattle, whereas C. lanienae primarily resided in the cecum, descending colon, and rectum. This information could be instrumental in developing efficacious strategies to manage the release of these bacteria from the gastrointestinal tracts of cattle.

Cyclic Adenosine 3′, 5′ Monophosphate: A Possible Indicator of Premalignant Changes in the Large Bowel

1979 ◽  
Vol 16 (1-6) ◽  
pp. 127-130 ◽  
Author(s):  
A. L. Latner ◽  
G. A. Turner ◽  
D. Tregoning
Keyword(s):  
Cyclic Amp ◽  
Large Bowel ◽  
Colonic Mucosa ◽  
Rectal Adenocarcinoma ◽  
Rectal Mucosa ◽  
Normal Colonic Mucosa ◽  
Colon And Rectum ◽  
Inflammatory Bowel ◽  
Descending Colon ◽  
Malignant Changes

Cyclic adenosine 3′, 5′ monophosphate (cyclic-AMP) has been estimated in mucosal biopsy samples removed from the descending colon and rectum at endoscopy to investigate the possibility of using this substance for monitoring pre-malignant changes in the large bowel. Four groups of patients have been studied: those with normal large bowel and rectal mucosa; those with non-malignant inflammatory bowel disease; those with an adenomatous polyp in the descending colon or sigmoid colon; and those with a rectal adenocarcinoma. No difference was found in the cyclic-AMP content of ‘normal’ rectal mucosa, ‘normal’ colonic mucosa, ‘diseased’ colonic mucosa, carcinomas, and uninvolved mucosa adjacent to the polyps. Less cyclic-AMP was found in the polyps than in adjacent uninvolved mucosa. Conversely, more cyclic-AMP was found in the carcinomas than in adjacent uninvolved mucosa. It is concluded that although cyclic-AMP may be a very useful parameter for delineating the extent of the disease in individual patients, it is not a suitable biochemical marker for the screening of neoplastic changes in the large bowel in the population as a whole.

scholarly journals An effective rectal administration method in the left semiprone position

2013 ◽  
Author(s):  
Satoshi Awazu ◽  
Risa Araki ◽  
Toshihiko Awazu
Keyword(s):  
Rectal Administration ◽  
Lateral Position ◽  
Proximal Colon ◽  
Contrast Enema ◽  
Hepatic Flexure ◽  
Rectosigmoid Colon ◽  
Left Lateral Position ◽  
Administration Method ◽  
Descending Colon ◽  
Air Insufflation

A previous study has shown barium is instilled in the left lateral position or the prone position. However, we previously reported that the colonoscope can be readily inserted into the descending colon in the left semiprone position. Indeed, when the colonoscope was inserted in the left semiprone position, the lumen of the sigmoid colon was observed linearly and the colon position lowered toward the oral side. In addition, it was often observed that the rectosigmoid colon nearly overlapped with the sigmoid-descending colon junction when the patient was placed in the left semiprone position in the single-contrast enema examination. Therefore, we considered that the rectosigmoid colon is located in the highest position while the sigmoid-descending colon junction is located in the lowest position and various kinds of drugs can be readily administered into the proximal colon in the left semiprone position. Our new barium instillation method was devised and this method was performed to determine whether barium can be readily instilled into the proximal colon. Barium (300 ml) passed the hepatic flexure before air insufflation in 32 (67%) of the 48 patients by using our new barium instillation method. By contrast, barium (300 ml) passed the hepatic flexure before air insufflation in 3 (6%) of the 48 patients by using our conventional barium instillation method. These results suggest that effective rectal administration is possible by using our new barium instillation method compared with our conventional barium instillation method.

scholarly journals Symptomatic overlap in patients with diarrhea predominant irritable bowel syndrome and microscopic colitis in a sub group of Bangladeshi population

2012 ◽  
Vol 38 (1) ◽  
pp. 33-38 ◽  
Author(s):  
MA Rahman ◽  
ASMA Raihan ◽  
DS Ahamed ◽  
H Masud ◽  
ABM Safiullah ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Proximal Colon ◽  
Microscopic Colitis ◽  
Clinical Feature ◽  
Normal Colonic Mucosa ◽  
Colon And Rectum ◽  
Bangladeshi Population ◽  
Irritable Bowel ◽  
Medical University ◽  
Rule Out

Microscopic Colitis (MC) and diarrhea predominant irritable bowel syndrome (IBS-D) has almost similar clinical feature but MC is diagnosed by histologic criteria and IBS is diagnosed by symptombased criteria. There is ongoing debate about the importance of biopsies from endoscopically normal colonic mucosa in the investigation of patients with IBS-D. Aim of this study was to assess the prevalence of MC in patient with IBS-D and to determine the distribution of MC in the colon. This observational study was conducted in department of Gastroenterology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2008 to December 2009. Patients were evaluated thoroughly & who meet Rome–II criteria with normal routine laboratory tests, were included in the study. Colonoscopy was done and biopsies were taken from the caecum, transverse colon, descending colon, and rectum. Out of total 60 patients, 22 had Lymphocytic Colitis (LC), 28 had nonspecific microscopic colitis (NSMC) and 10 had irritable bowel syndrome noninflamed (IBSNI). The distribution of LC was restricted to proximal colon in 15 patients, in the left colon in 2 patients and diffuses throughout the colon in 5 patients. There is considerable symptom overlap between the patients of IBS-D and patients with microscopic colitis. Without colonoscopic biopsy from multiple sites, possibility of MC cannot be excluded in patients with IBS-D and it can be said that clinical symptom based criteria for irritable bowel syndrome are not sufficient enough to rule out the diagnosis of microscopic colitis. DOI: http://dx.doi.org/10.3329/bmrcb.v38i1.10450 Bangladesh Med Res Counc Bull 2012; 38: 33-38

scholarly journals On the nature of high-amplitude propagating pressure waves in the human colon

2020 ◽  
Vol 318 (4) ◽  
pp. G646-G660 ◽  
Author(s):  
Natalija Milkova ◽  
Sean P. Parsons ◽  
Elyanne Ratcliffe ◽  
Jan D. Huizinga ◽  
Ji-Hong Chen
Keyword(s):  
Healthy Subjects ◽  
Motor Pattern ◽  
High Amplitude ◽  
Proximal Colon ◽  
Pressure Waves ◽  
Sphincter Pressure ◽  
Average Amplitude ◽  
Colonic Motor ◽  
Balloon Distention ◽  
Descending Colon

Characterization of high-amplitude propagating pressure waves (HAPWs or HAPCs) plays a key role in diagnosis of colon dysmotility using any type of colonic manometry. With the introduction of high-resolution manometry, more insight is gained into this most prominent propulsive motor pattern. Here, we use a water-perfused catheter with 84 sensors with intervals between measuring points of 1 cm throughout the colon, for 6–8 h, in 19 healthy subjects. The catheter contained a balloon to evoke distention. We explored as stimuli a meal, balloon distention, oral prucalopride, and bisacodyl injection, with a goal to optimally evoke HAPWs. We developed a quantitative measure of HAPW activity, the “HAPW Index.” Our protocol elicited 290 HAPWs. 21% of HAPWs were confined to the proximal colon with an average amplitude of 75.3 ± 3.3 mmHg and an average HAPW Index of 440 ± 58 mmHg·m·s. 29% of HAPWs started in the proximal colon and ended in the transverse or descending colon, with an average amplitude of 87.9 ± 3.1 mmHg and an average HAPW Index of 3,344 ± 356 mmHg·m·s. Forty-nine percent of HAPWs started and ended in the transverse or descending colon with an average amplitude of 109.3 ± 3.3 mmHg and an average HAPW Index of 2,071 ± 195 mmHg·m·s. HAPWs with and without simultaneous pressure waves (SPWs) initiated the colo-anal reflex, often abolishing 100% of anal sphincter pressure. Rectal bisacodyl and proximal balloon distention were the most optimal stimuli to evoke HAPWs. These measures now allow for a confident diagnosis of abnormal motility in patients with colonic motor dysfunction. NEW & NOTEWORTHY High-amplitude propagating pressure waves (HAPWs) were characterized using 84 sensors throughout the entire colon in healthy subjects, taking note of site of origin, site of termination, amplitude, and velocity, and to identify optimal stimuli to evoke HAPWs. Three categories of HAPWs were identified, including the associated colo-anal reflex. Proximal balloon distention and rectal bisacodyl were recognized as reliable stimuli for evoking HAPWs, and a HAPW Index was devised to quantify this essential colonic motor pattern.

scholarly journals Colonic Carcinoma Masquerading as Scrotal Swelling: A Case Report and Review of Literature

2007 ◽  
Vol 7 ◽  
pp. 855-859 ◽  
Author(s):  
Sharath C. V. Paravastu ◽  
Meenakshi Batra ◽  
Krishnan Ananthakrishnan
Keyword(s):  
Case Report ◽  
Gastrointestinal Tract ◽  
Spermatic Cord ◽  
Incidental Finding ◽  
Pathology Report ◽  
Review Of Literature ◽  
Rare Presentation ◽  
Scrotal Swelling ◽  
Descending Colon ◽  
Unusual Situation

Tumours of the spermatic cord are rare. Most tumours of the spermatic cord are metastatic and are typically an incidental finding at orchidectomy for other pathology. Primary pathology is usually from the gastrointestinal tract. We report a very rare presentation of an asymptomatic gastrointestinal tumour as a spermatic cord mass.male patient presented with a painless scrotal swelling. Radical orchidectomy revealed an adenocarcinoma in the spermatic cord. Further investigations disclosed an adenocarcinoma of the descending colon, metastasing to the spermatic cord that gave a false notion of a scrotal swelling secondary to infection. This unusual situation reminds us that spermatic cord metastases are rare. In the event of nonresponding scrotal swelling to antibiotics, further investigations would be prudent, whilst awaiting the definitive pathology report from the radical orchidectomy.

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