Adenocarcinoma of the descending colon

An 80-year-old woman presented to a regional emergency department with postprandial pain, weight loss and diarrhoea for 2 months and a Computed Tomography (CT) report suggestive of descending colon malignancy. Subsequent investigations revealed the patient to have chronic mesenteric ischaemia (CMI) with associated bowel changes. She developed an acute-on-chronic ischaemia that required emergency transfer, damage control surgery and revascularisation. While the patient survived, this case highlights the importance of considering CMI in elderly patients with vague abdominal symptoms and early intervention to avoid potentially catastrophic outcomes.

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Colonoscopic Instillation of Coca-Cola for Evacuation of Large Fecaloma: A Report of Two Cases and Review of Literature

Journal of Health and Allied Sciences NU ◽

10.1055/s-0041-1734340 ◽

2021 ◽

Author(s):

Avnish Kumar Seth ◽

Mahesh Kumar Gupta ◽

Rinkesh Kumar Bansal ◽

Radha Krishan Verma ◽

Gursimran Kaur

Keyword(s):

Sigmoid Colon ◽

Pelvic Mass ◽

Large Mass ◽

Review Of Literature ◽

Lower Abdomen ◽

Fecal Matter ◽

Rectal Examination ◽

Descending Colon ◽

Phosphate Enema ◽

Conventional Methods

Abstract Introduction Fecaloma is a large mass of organized hardened feces causing impaction, usually in rectum and sigmoid colon. Medical management usually entails digital evacuation, use of clearance enema, and oral laxatives. We report two patients managed successfully with colonoscopic instillation of Coca-Cola and review the literature. Case Report Patient 1: A 37-year-old male presented with firm, nontender, pitting mass over lower abdomen for 2 months and inability to pass stool for 1 month. Per-rectal examination and imaging confirmed presence of solid stool with gross distension of rectum and sigmoid colon. Attempts at clearance of stool with conventional methods were unsuccessful. At colonoscopy, 4 L of Coca-Cola was instilled into descending and sigmoid colon, leading to evacuation of 10 L of fragmented and liquid stool.Patient 2: A 72-year-old diabetic lady presented with constipation and tender, firm pelvic mass extending till mid-abdomen for 6 months. Per-rectal examination revealed presence of hard stool. Imaging confirmed large amount of fecal matter in dilated rectum, sigmoid, and descending colon. Attempts at evacuating stool with digital evacuation, sodium phosphate enema, and oral polyethylene glycol were unsuccessful. At colonoscopy, two sittings of instillation of 990 mL of Coca-Cola Light each were done into sigmoid colon over 2 days, resulting in clearance. Conclusion Colonoscopic instillation of Coca-Cola may be effective in evacuation of large fecaloma from rectum, sigmoid, and descending colon when refractory to use of conventional methods like digital disimpaction, rectal enema, and oral laxatives.

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Carl Toldt Centennial, Surgeon and Anatomist

The American Surgeon ◽

10.1177/0003134821991979 ◽

2021 ◽

pp. 000313482199197

Author(s):

Giuseppe Serena ◽

Leonardo Nardi ◽

Michael J. Schmeisser ◽

L. D. George Angus

Keyword(s):

Abdominal Surgery ◽

Scientific Community ◽

Anatomical Landmark ◽

Macroscopic Anatomy ◽

White Line ◽

Descending Colon ◽

Historical Article ◽

Research Studies

Carl Florian Toldt was an Austrian anatomist who made meaningful contributions worldwide and defined what is one of the most important surgical landmarks in abdominal surgery. Through his research studies, the embryologic dissection plane known as the “White Line of Toldt” represents an important anatomical landmark that helps to mobilize either the ascending or descending colon. His career spanned over 45 years, beginning in Verona and continuing to Prague and Vienna. He was an author of several innovative books and scientific articles regarding micro- and macroscopic anatomy. In addition, he received numerous recognitions and prizes for his work, making him an essential figure in the medical scientific community. Even a street in Vienna, Karl-Toldt-Weg, is named in his honor. The purpose of this historical article is to celebrate and honor Toldt 100 years following his death, remembering his scientific contributions to the medical and surgical fields and giving thanks for his numerous accomplishments. This article brings light to the man behind the eponym.

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The Genes Encoding Small Leucine-Rich Proteoglycans Undergo Differential Expression Alterations in Colorectal Cancer, Depending on Tumor Location

Cells ◽

10.3390/cells10082002 ◽

2021 ◽

Vol 10 (8) ◽

pp. 2002

Author(s):

Maria Pilar Solis-Hernandez ◽

Carla Martín ◽

Beatriz García ◽

Natalia Pérez-López ◽

Yolanda García-Mesa ◽

...

Keyword(s):

Protein Expression ◽

Survival Data ◽

Tumor Cell Line ◽

Tumor Location ◽

Anatomical Location ◽

Cell Interior ◽

Expression Of Genes ◽

Genes Encoding ◽

Descending Colon

Small leucine-rich proteoglycans (SLRPs) regulate different processes and undergo significant alterations in various diseases. Colon carcinomas (CCs) are heterogeneous pathologies with important clinical and molecular differences depending on their location, which makes it interesting to analyze the alterations in SLRPs in right- and left-sided tumors (RS- and LSCCs). SLRP transcription levels were studied in 32 CCs using qPCR compared to healthy colon mucosae samples from the same patients, 20 of them from LSCCs and the remaining 12 from RSCCs. Protein expression of genes with significant differences in their transcriptions was analyzed by immunohistochemistry. The alterations observed were related to survival data. The arrangement of transcription of SLRPs was quite similar in ascending and descending colon, but RS- and LSCCs displayed different patterns of alteration, with a greater number of deregulations occurring in the latter. The analysis of protein expression also indicated changes in the location of these molecules, largely moving to the cell interior. While podocan underexpression showed a trend toward better outcomes, no differences were observed in terms of overall survival. In vitro studies using the HT29 tumor cell line suggest that deregulation of SLRPs could affect cell proliferation. SLRPs constitute new differential markers of RS- and LSCCs, showing differences dependent on the anatomical location of the tumor.

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Fecal Calprotectin, CRP and Leucocytes in IBD Patients: Comparison of Biomarkers With Biopsy Results

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwaa009 ◽

2020 ◽

Author(s):

Barry D Kyle ◽

Terence A Agbor ◽

Shajib Sharif ◽

Usha Chauhan ◽

John Marshall ◽

...

Keyword(s):

Ulcerative Colitis ◽

Fecal Calprotectin ◽

Dependent Manner ◽

Ascending Colon ◽

C Reactive Protein ◽

Concentration Dependent Manner ◽

Reactive Protein ◽

Inflammatory Bowel ◽

Descending Colon ◽

Active Inflammation

Abstract Background This study aimed to compare fecal calprotectin (FC) levels with other commonly used parameters as part of patient care during evaluation for inflammatory bowel disease (IBD). Methods We recruited adult IBD patients with ulcerative colitis (UC) and Crohn’s disease (CD) and compared the results of the patient’s biopsy results (i.e., inflamed versus noninflamed) for six sites (i.e., ileum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum) with concentrations of C-reactive protein (CRP), total leucocytes and fecal calprotectin (FC). Results We found that FC was significantly elevated in a concentration-dependent manner that correlated with the number of active inflammation sites reported in biopsy. Although CRP and leucocyte measurements trended upwards in line with inflammation reported from biopsy, the results were highly variable and highlighted poor reliability of these biomarkers for indicating IBD inflammation. Conclusions These results strongly suggest that FC correlates best with biopsy reports and is a superior marker than CRP and leucocytes.

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