Subtotal or total colectomy as surgical treatment of left-sided occlusive colon cancer

The treatment of acutely obstructed carcinoma of the left colon and sigmoid still represents a matter of controversy. The aim of this study was to assess retrospectively the results of its management by emergency subtotal or total colectomy with primary anastomosis. Sixty-seven patients were reviewed. There were 42 males and 25 females. The mean age was 70.5 years [range: 26-87 years]. Mean operative time was 210 minutes. There were five synchronous colon carcinomas [75%] and 23 [343%] synchronous tubulous and tubulovillous adenomas. No death was noted in the series. Ten postoperative complications [15%] occurred in nine patients including one postoperative peritonitis without evidence of anastomotic leak, one alithiasic cholecystitis, one evisceration and two intra-abdominal abscesses. The mean hospital stay was 11.4 days. Fifty-eight patients were assessed at three and twelve months for functional results. No fecal incontinence was encountered. The mean number of bowel movements per 24 hours was 3.2 at three months and 2 at twelve months. All patients were satisfied with their quality of life. Twelve patients [20.7%] occasionally needed anti-diarrheic medications. Urgent subtotal or total colectomy with primary anastomosis is a safe and efficient procedure in the management of acutely obstructed neoplasm of the left colon. It allows to treat in one stage the cancer and the obstruction, bearing no mortality, acceptable morbidity and satisfactory postoperative functional results

Perforation of the rectum and colon during barium enema examination. Report of four cases

Background The barium enema examination [BEE] is an important diagnostic study and considered to be safe without adverse effects. Perforation of the bowel is rare but is the most frequent complication of BEE and can be life-threatening. We report four cases of barium extravasation due to BEE treated at our institution, three rectal perforations and one perforation in the descending colon. The four patients underwent surgery because signs of peritonitis developed. Two of them recovered and two died from multiple organ failure. Perforation of the colon and rectum during BEE constitutes a surgical emergency in most cases. Prompt recognition and management are vital in decreasing morbidity and mortality

manifestations digestives de la dermatomyositis juvenile: a propos d'un cas avec revue de la litterature

Childhood dermatomyositis should be separated from the adult polymyositis and is characterized by the frequency of vasculitis and ulcerations of the gastrointestinal tract. The authors present a case of colonic perforation with a review of the different disorders of the gastrointestinal system secondary to this disease