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1.
Annals of Surgical Treatment and Research ; : 139-145, 2020.
Article in English | WPRIM | ID: wpr-811107

ABSTRACT

PURPOSE: Radical lymph node dissection for right-sided colon cancer is technically challenging. No clear guideline is available for surgical resection of clinical stage I right-sided colon cancer. This study was designed to review the pathologic stage of clinical stage I right-sided colon cancer and determine the relevant extent of surgical resection.METHODS: Patients were treated for clinical stage I right-sided colon cancers (cecal, ascending, hepatic flexure, and proximal transverse colon) between July 2006 and December 2014 at a tertiary teaching hospital. Open surgery was not included because laparoscopic surgery is an initial major procedure in the institution.RESULTS: During the study period, 80 patients diagnosed with clinical stage I right-sided colon cancer were classified into 2 groups according to the pathology: stage 0/I and II/III. Tumor sizes were larger in the stage II/III group (P = 0.003). The stage II/III group had higher rates of vascular (P = 0.023) and lymphatic invasion (P = 0.023) and lower rates of well differentiation (P = 0.022). During follow-up, 1 case of local and 4 cases of systemic recurrences were found. Multivariate analysis to confirm odds ratios affecting change from clinical stage I to pathological stage II/III showed that tumor size (P = 0.010) and the number of retrieved lymph nodes (P = 0.046) were risk factors.CONCLUSION: For right-sided colon cancer, even with clinical stage I included, radical lymph node dissection should be performed for exact staging with sufficient number of lymph nodes. This will help determine appropriate adjuvant treatment, especially in large tumor sizes.


Subject(s)
Humans , Colon , Colon, Ascending , Colon, Transverse , Colonic Neoplasms , Follow-Up Studies , Hospitals, Teaching , Laparoscopy , Lymph Node Excision , Lymph Nodes , Multivariate Analysis , Odds Ratio , Pathology , Recurrence , Retrospective Studies , Risk Factors
2.
Article | IMSEAR | ID: sea-211406

ABSTRACT

Situs inversus totalis is a rare congenital condition that occurs in one out of 4,000-20,000 people, characterized by complete transposition of the thoracic and abdominal viscera that creates a mirror image. The etiologic nature of this anomaly is not known. Situs inversus totalis is typically associated with normal life expectancy unless a gastrointestinal or cardiac anomaly is present. This anomaly is not a premalignant condition. Association between colorectal cancer and situs inversus totalis is rare. The transposition of the organs imposes special demands on the diagnostic and technical skills of the surgeon. We report a case of colorectal cancer and situs inversus totalis in a 51-year-old male presenting with intermittent left lower abdominal pain and change of bowel habit since 9 months before admission. We found a palpable solid mass on the left paraumbilical region, mobile, with no tenderness. Laboratory results show moderate anemia with high CEA level. Fecal Occult Blood Test (FOBT) was positive. Plain chest radiography showed suspected situs inversus. We found descending colon tumor on colonoscopy, with histopathology result intramucosal carcinoma. The contrast abdomen CT scan showed situs inversus and irregular thickening on ascending colon with partial stenosis. We performed extended left hemicolectomy and intraoperative we found a mass in the hepatic flexure of the colon with no sign of lymph node and liver metastases. The histopathologic diagnosis was adenocarcinoma moderately differentiated. The patient was diagnosed with adenocarcinoma of ascending colon T3N0M0, stage II.

3.
Annals of Coloproctology ; : 286-291, 2018.
Article in English | WPRIM | ID: wpr-718753

ABSTRACT

PURPOSE: Stage-IIIC colon cancer is an advanced disease; however, its oncologic outcomes and prognostic factors remain unclear. In this study, we aimed to determine the predictors of disease-free survival (DFS) in patients with stage-IIIC colon cancer. METHODS: From a multicenter database, we retrospectively enrolled 611 patients (355 men and 256 women) who had undergone a potentially curative resection for a stage-IIIC colon adenocarcinoma between 2003 and 2011. The primary end-point was the 5-year DFS. RESULTS: The median age was 62 years; 213 and 398 patients had right-sided colon cancer (RCC) and left-sided colon cancer (LCC), respectively. The 5-year DFS in all patients was 52.0%; median follow-up time was 35 months (range, 1–134 months). A multivariate Cox regression revealed that female sex (hazard ratio [HR], 1.50; 95% confidence interval [CI], 1.19–1.90; P < 0.01), right-sided tumor location (HR, 1.65; 95% CI, 1.29–2.11; P < 0.01), lymphatic invasion (HR, 1.52; 95% CI, 1.08–2.15; P < 0.01) and a high (≥0.4) metastatic lymph node ratio (HR, 3.72; 95% CI, 2.63–5.24; P < 0.01) were independent predictors of worse 5-year DFS. Female patients with RCC were 1.79 fold more likely to experience recurrence than male patients with LCC. CONCLUSION: Female sex and right-sided tumor location are associated with higher tumor recurrence rates in patients with stage-IIIC colon cancers. Aggressive treatment and close surveillance should be planned for patients in these groups.


Subject(s)
Female , Humans , Male , Adenocarcinoma , Colon , Colon, Ascending , Colon, Descending , Colonic Neoplasms , Disease-Free Survival , Follow-Up Studies , Lymph Nodes , Prognosis , Recurrence , Retrospective Studies
4.
ABCD (São Paulo, Impr.) ; 31(2): e1381, 2018. graf
Article in English | LILACS | ID: biblio-949234

ABSTRACT

ABSTRACT Background : Complete esophago-gastric necrosis after caustic ingestion is a challenging surgical scenario for reconstruction of the upper digestive transit. Aim : To present a surgical technique for reconstruction of the upper digestive tract after total esophagectomy and gastrectomy due to esophageal and gastric necrosis Method: The transit was re-established by means of a pharyngo-ileo-colic interposition with microsurgical arterial and venous anastomosis for augmentation of blood supply. Colo-duodeno-anastomosis and ileo-transverse colic anastomosis were performed for complete digestive transit reconstruction. Result: This procedure was applied in a case of 41 years male attempted suicide by ingesting alkali caustic liquid (concentrated sodium hydroxide). Total necrosis of the esophagus and stomach occurred, which required initially total esophago-gastrectomy, closure at the level of the crico-pharyngeal sphincter and jejunostomy for enteral feeding with a highly deteriorated quality of life . The procedure was performed later and there were no major early and late postoperative complications and normal nutritional conditions were re-stablished. Conclusion: The procedure is feasible and must be managed by multidisciplinary team in order to re-establish a normal quality of life.


RESUMO Racional: A necrose esofagogástrica completa após ingestão cáustica é um cenário cirúrgico desafiador para a reconstrução do trânsito digestivo alto. Objetivo: Apresentar uma técnica cirúrgica para reconstrução do trato digestivo superior após esofagectomia total e gastrectomia por necrose esofágica e gástrica. Método: O trânsito foi restabelecido por interposição faringo-íleo-cólica com anastomose arterial e venosa microcirúrgica com aumento do suprimento sanguíneo. Adicionalmente, anastomose colo-duodeno-anastomótica e íleo-transversa foram realizadas para reconstrução completa do trânsito digestivo. Resultado: Este procedimento foi aplicado em um homem de 41 anos com tentativa de suicídio pela ingestão de líquido cáustico alcalino (hidróxido de sódio concentrado). Ocorreu necrose total do esôfago e do estômago, o que exigiu inicialmente esofagogastrectomia total, fechamento ao nível do esfíncter cricofaríngeo e jejunostomia para alimentação enteral produzindo qualidade de vida altamente deteriorada. O procedimento foi realizado mais tardiamente e não houve maiores complicações pós-operatórias precoces e tardias e condições nutricionais normais foram restabelecidas. Conclusão: O procedimento é viável e deve ser manejado por equipe multidisciplinar a fim de restabelecer a qualidade de vida normal.


Subject(s)
Humans , Male , Adult , Burns, Chemical/surgery , Caustics/toxicity , Esophagectomy , Colon/surgery , Esophagus/surgery , Esophagus/injuries , Pharynx/surgery , Stomach/surgery , Stomach/blood supply , Stomach/injuries , Stomach/pathology , Suicide, Attempted , Burns, Chemical/etiology , Anastomosis, Surgical , Esophagus/blood supply , Esophagus/pathology , Microvessels , Gastrectomy , Ileum/surgery , Necrosis
5.
Rev. bras. parasitol. vet ; 26(1): 47-53, Jan.-Mar. 2017. graf
Article in English | LILACS | ID: biblio-844138

ABSTRACT

Abstract Toxoplasmosis, a disease caused by Toxoplasma gondii, is an important health problem, especially in immunocompromised hosts. T. gondii uses the gut wall as an infection gateway, with tropism for muscular and nervous tissues causing intestinal alterations, including some in the enteric nervous system. This study aims at investigating the colon of rats infected by T. gondii in order to understand how the amount of oocysts influences in myenteric neuronal changes. Sixty Wistar rats (Rattus norvegicus) were divided into six groups. One group remained as a control and the others received inocula of 10, 50, 100, 500 or 5,000 oocysts of T. gondii. The animals were euthanized after 30 days of infection. The total neuronal population and the nitrergic subpopulation in the colon myenteric plexus of each animal was counted. The data were statistically analyzed showing less weight gain in rats with 10, 500 and 5,000 oocysts. A decrease in the number of total neurons with 50, 100 or 5,000 oocysts and an increase in the nitrergic population with 10, 100, 500 or 5,000 oocysts were verified. These results show that neuronal alterations are more significant when the infection is induced by larger inocula and reinforces the suspicion that neuronal loss is directed at cholinergic neurons.


Resumo A toxoplasmose, doença causada pelo Toxoplasma gondii, é um importante problema de saúde, principalmente em imunocomprometidos. T. gondii utiliza a parede do intestino como porta de entrada no hospedeiro e tem tropismo pelos tecidos muscular e nervoso provocando alterações intestinais, inclusive no sistema nervoso entérico. Este estudo buscou analisar o cólon de ratos infectados por T. gondii para entender como a quantidade de oocistos influencia nas alterações neuronais mientéricas. Foram utilizados 60 ratos Wistar (Rattus norvegicus) em seis grupos. Um dos grupos permaneceu como controle e os demais receberam inóculos de 10, 50, 100, 500 ou 5.000 oocistos de T. gondii. Os animais foram submetidos a eutanásia após 30 dias de infecção. No plexo mientérico do cólon dos animais foram quantificadas a população neuronal total e a subpopulação nitrérgica. Os dados foram analisados estatisticamente demonstrando inferior ganho de peso nos ratos com 10, 500 e 5.000 oocistos. Verificamos diminuição no número de neurônios totais com inóculos de 50, 100 ou 5.000 oocistos e aumento da população nitrérgica com 10, 100, 500 ou 5000 oocistos. Estes resultados mostram que alterações neuronais são mais significativas quando a infecção é induzida por inóculos maiores e reforça a suspeita de perda neuronal direcionada a neurônios colinérgicos.


Subject(s)
Animals , Rats , Toxoplasmosis, Animal/complications , Colon/parasitology , Neurons/parasitology , Parasite Egg Count/veterinary , Toxoplasma , Rats, Wistar , Colon , Neurons/pathology
6.
Journal of Rural Medicine ; : 73-75, 2016.
Article in English | WPRIM | ID: wpr-378467

ABSTRACT

<p>A 74-year-old man with diabetes underwent colonoscopy as routine screening for coloncancer. An <i>Anisakis</i> larva was found incidentally during colonoscopy usingthe retroflexion technique in the ascending colon, and was removed using a forceps.Asymptomatic colonic anisakiasis is very rare, and few reports have described diagnosisand treatment of anisakiasis during colonoscopy by the retroflexion technique in theascending colon. We have reported this rare case along with a literature review.</p>

7.
The Korean Journal of Gastroenterology ; : 90-98, 2015.
Article in Korean | WPRIM | ID: wpr-47869

ABSTRACT

BACKGROUND/AIMS: There have been several studies showing that retroflexion (RF) in the right colon (RC) could reduce the polyp miss rate of proximal colon during colonoscopy. This study was conducted to evaluate the additional benefit of RF technique in the RC. METHODS: Patients who underwent colonoscopy from May 2008 to April 2011 were enrolled in the study. Data were obtained by retrospectively reviewing the medical records. RF was attempted in every patients undergoing colonoscopy since May 2008 except in cases of small RC vault, co-morbidity, severe diverticulosis, failed RF despite two trials, complaints of severe abdominal pain, or time burden. At first, RC was examined under direct vision. It was then examined by RF to detect missed polyps during the initial observation. Finally, the RC was re-examined with direct view. RESULTS: The cumulative RF success rate in the RC was 78.84% (1,805 of 2,319). The RF success rate increased with the number of cases (50% at 160 cases, 70% at 400 cases, and reached near 90% over 1,000 cases). Few polyps (4.88%) were detected only with RF and the additional adenoma detection rate was 3.32%. The additional polyp/adenoma detection rates were higher in the old age group (p<0.01). There were no RF associated perforation or severe complication. CONCLUSIONS: Using RF examination, additional 4.88% of polyps could be detected in the RC. This technique could be a useful and safe method to detect hidden polyp during colonoscopy.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenoma/diagnosis , Colon, Descending/pathology , Colonic Neoplasms/diagnosis , Colonic Polyps/diagnosis , Colonoscopy , Retrospective Studies
8.
GED gastroenterol. endosc. dig ; 33(4): 155-158, out.-dez. 2014. ilus
Article in Portuguese | LILACS | ID: lil-763847

ABSTRACT

As hérnias pelo forame de Winslow fazem parte de uma condição extremamente rara, compreendendo apenas 0,08% de todas as hérnias já descritas. O diagnóstico pré-operatório dessa afecção é infrequente (menos de 10% das vezes) e por isso atinge altas taxas de mortalidade, em torno de 36% a 49% dos casos. Apresentamos o caso de paciente, 92 anos, sexo feminino, com quadro de náuseas, vômitos, dor e distensão abdominal de rápida evolução sem melhora ao tratamento clínico, caracterizando diagnóstico sindrômico de abdome agudo obstrutivo. Exames laboratoriais e de imagem foram pouco elucidativos, sendo indicado uma abordagem cirúrgica por meio de uma laparotomia exploradora. Os achados cirúrgicos definiram o diagnóstico etiológico de encarceramento do ceco e cólon ascendente na retrocavidade através do forame de Winslow. O quadro clínico dessa afecção é muito variável, refletindo sintomas de acordo com o conteúdo herniado e o tempo de evolução. Trata-se de uma patologia de difícil suspeição, sendo que o diagnóstico definitivo é geralmente realizado durante o ato operatório. A lembrança dessa hipótese diagnóstica como diagnóstico diferencial de quadros de abdomes agudos oclusivos deve ser adequadamente pensada para que se possa propor o melhor e mais específico tratamento, a fim de se evitar maiores complicações de um diagnóstico tardio.


Herniations through foramen of Winslow are part of a extremely rare condition, establishing only 0.08% of all descripted hérnias. The pre operative diagnosis is uncommon (less than 10%) and this condition allows mortality rates to reach high levels, beetween 36 to 49% of the cases. The presente case reports a 92 years of age woman, presenting náuseas, vomits, distension and abdominal pain, persisting through hours with no positive response to clinical treatment, this way featuring an abdominal urgency syndrom. Laboratorial e image exams had no great findings; surgical treatment was so proposed. Surgical findings have defined the condition as being a cécum and ascending colon herniation through foramen of Winslow in retrocavity. Clinical findings of this condition are variable, reflecting sympthons of which content is herniated as well as duration of the herniation process. It is a hard suspicion patology, as most of the cases diagnosis are made during the surgery, only. The knowledge about this diagnosis hypothesys may be of great importance while maneging abdominal pain patients, this way porpousing best exams procedures and precocious treatment, avoiding late diagnosis complications.


Subject(s)
Humans , Female , Aged, 80 and over , Cecum , Colon, Ascending , Hernia
9.
Article in English | IMSEAR | ID: sea-150724

ABSTRACT

The rate of parastomal hernia reported varies from 5% to 80%. It forms when the abdominal wall defect is continually stretched by the tangential forces applied along the circumference of the abdominal wall opening. The presence of parastomal hernia along with intraperitoneal ascending colon, caecum and terminal ileum along with ileal perforation is a rare entity.

10.
Journal of Surgical Academia ; : 32-34, 2014.
Article in English | WPRIM | ID: wpr-629417

ABSTRACT

Intestinal malrotations are associated with various anatomical anomalies. We report a unique case wherein the caecum was located in the right lumbar region instead of the right iliac fossa. The ileo-caecal junction was also placed higher up. The appendix was ‘uncinate’ shaped, highly coiled and retroperitoneal with the absence of mesoappendix. Both, the caecum and appendix were supplied by ascending branch of the ileocolic artery instead of the descending branch. Further, we also observed that the ascending colon was very short and sub-hepatic in position. Such type of variations is of clinical and surgical importance in diagnosis and treatment of appendicitis.

11.
The Korean Journal of Gastroenterology ; : 98-102, 2014.
Article in Korean | WPRIM | ID: wpr-22046

ABSTRACT

Primary squamous cell carcinoma of the colon is an extremely rare malignancy. A 48-year-old male visited our hospital for screening colonoscopy. Colonoscopic examination showed a 1 cm sized sessile polyp in the ascending colon. The patient underwent endoscopic mucosal resection (EMR) without any complication. The pathologic findings were compatible with squamous differentiation of tumor cells in inflammatory colonic mucosa. The tumor was confined to the mucosa and the margins of the excised tissue were found to be free of the tumor. There were no other primary sites and no distant metastases in the extensive evaluation using a whole body CT scan and PET-CT. Additional surgical resection was not done. Follow-up colonoscopy performed eight month later showed a whitish scar without evidence of local recurrence and follow-up PET-CT demonstrated no evidence of recurrence. Herein, we report a case of primary squamous cell carcinoma of the ascending colon presenting as a sessile polyp which was removed by EMR.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Asian People , Carcinoma, Squamous Cell/diagnosis , Colon, Ascending , Colonic Neoplasms/diagnosis , Colonoscopy , Intestinal Mucosa/pathology , Positron-Emission Tomography , Republic of Korea , Tomography, X-Ray Computed
12.
The Korean Journal of Parasitology ; : 287-290, 2014.
Article in English | WPRIM | ID: wpr-190466

ABSTRACT

Human cases of echinostomiasis have been sporadically diagnosed by extracting worms in the endoscopy in Korea and Japan. Most of these were caused by Echinostoma hortense infection. However, in the present study, we detected 2 live worms of Echinostoma cinetorchis in the ascending colon of a Korean man (68-year old) admitted to the Gyeongsang National University Hospital with complaint of intermittent right lower quadrant abdominal pain for 5 days. Under colonoscopy, 1 worm was found attached on the edematous and hyperemic mucosal surface of the proximal ascending colon and the other was detected on the mid-ascending colon. Both worms were removed from the mucosal surface with a grasping forceps, and morphologically identified as E. cinetorchis by the characteristic head crown with total 37 collar spines including 5 end-group ones on both sides, disappearance of testes, and eggs of 108x60 microm with abopercular wrinkles. The infection source of this case seems to be the raw frogs eaten 2 months ago. This is the first case of endoscopy-diagnosed E. cinetorchis infection in Korea.


Subject(s)
Aged , Animals , Humans , Male , Colon/parasitology , Colonoscopy , Echinostoma/anatomy & histology , Echinostomiasis/diagnosis , Korea
13.
Annals of Coloproctology ; : 83-86, 2013.
Article in English | WPRIM | ID: wpr-56845

ABSTRACT

An adenosquamous carcinoma is a malignancy that has both glandular and squamous histologic components. Both components are malignant and have potential to metastasize. An adenosquamous carcinoma of the large bowel is rare, and its clinicopathologic behavior is not fully understood. It is reported to be more aggressive and have a worse prognosis when it is compared with an adenocarcinoma alone. We present a case of an adenosquamous carcinoma in the ascending colon which was laparoscopically resected and followed by adjuvant chemotherapy.


Subject(s)
Adenocarcinoma , Carcinoma, Adenosquamous , Chemotherapy, Adjuvant , Colon, Ascending , Prognosis
14.
Annals of Coloproctology ; : 209-212, 2013.
Article in English | WPRIM | ID: wpr-135299

ABSTRACT

Diverticular disease of the colon is a common disease, and its incidence is increasing gradually. A giant colonic diverticulum (GCD) is a rare entity and is defined as a diverticulum greater than 4 cm in size. It mainly arises from the sigmoid colon, and possible etiology is a ball-valve mechanism permitting progressive enlargement. A plain abdominal X-ray can be helpful to make a diagnosis initially, and a barium enema and abdominal computed tomography may confirm the diagnosis. Surgical intervention is a definite treatment for a GCD. We report a case of an ascending GCD presenting with intussusception in a young adult.


Subject(s)
Humans , Young Adult , Barium , Colon , Colon, Ascending , Colon, Sigmoid , Diverticulum , Diverticulum, Colon , Enema , Incidence , Intussusception
15.
Annals of Coloproctology ; : 209-212, 2013.
Article in English | WPRIM | ID: wpr-135298

ABSTRACT

Diverticular disease of the colon is a common disease, and its incidence is increasing gradually. A giant colonic diverticulum (GCD) is a rare entity and is defined as a diverticulum greater than 4 cm in size. It mainly arises from the sigmoid colon, and possible etiology is a ball-valve mechanism permitting progressive enlargement. A plain abdominal X-ray can be helpful to make a diagnosis initially, and a barium enema and abdominal computed tomography may confirm the diagnosis. Surgical intervention is a definite treatment for a GCD. We report a case of an ascending GCD presenting with intussusception in a young adult.


Subject(s)
Humans , Young Adult , Barium , Colon , Colon, Ascending , Colon, Sigmoid , Diverticulum , Diverticulum, Colon , Enema , Incidence , Intussusception
16.
Gut and Liver ; : 395-398, 2012.
Article in English | WPRIM | ID: wpr-119843

ABSTRACT

Carcinosarcoma of the colon is rare. Seventeen cases have been reported in the English literature. Most cases occurred in the left side of the colon. Indeed, there is only one reported case of cecal carcinosarcoma. Carcinosarcoma has a tendency to distantly metastasize and shows dismal prognosis. We report a case of carcinosarcoma in the cecum and review the literature describing colonic carcinosarcoma.


Subject(s)
Carcinosarcoma , Cecum , Colon , Colon, Ascending , Prognosis
17.
Korean Journal of Gastrointestinal Endoscopy ; : 49-53, 2010.
Article in Korean | WPRIM | ID: wpr-194416

ABSTRACT

Malignant rhabdoid tumors were first described in 1978 by Beckwith and Palmer as a rare variant of Wilms' tumors with a "rhabdomyosarcomatoid" pattern and a particularly poor prognosis. Week reclassified this disease as a distinct disease in 1989 and thereafter, there have been several reports about malignant rhabdoid tumor that occurred in various organs, including the colon. The histologic characteristics of rhabdoid tumor are noncohesive or loosely cohesive cells with high cellularity, an eccentric large nucleus and eosinophilic cytoplasm, and the cytoplasm is usually positive for vimentin and it contain hyaline inclusions. On immunohistochemical staining, the cells are usually positive for vimentin and cytokeratin and they are negative for desmin. This tumor progresses rapidly and it has a very poor prognosis, but survival is better if there is no lymphatic or distant metastasis. We experienced a patient who suffered with undifferentiated adenocarcinoma with rhabdoid features in the ascending colon.


Subject(s)
Humans , Adenocarcinoma , Colon , Colon, Ascending , Colonic Neoplasms , Cytoplasm , Desmin , Eosinophils , Hyalin , Keratins , Neoplasm Metastasis , Prognosis , Rhabdoid Tumor , Vimentin , Wilms Tumor
18.
Rev. bras. colo-proctol ; 29(3): 386-388, jul.-set. 2009. ilus
Article in Portuguese | LILACS | ID: lil-533549

ABSTRACT

INTRODUÇÃO: A eficácia da ressecção em bloco duodenopancreático para tumores infiltrativos não periampulares ainda não está bem definida³, mas sabe-se que em tumores colorretais localmente avançados, a ressecção multivisceral é, na maioria das vezes, a chance de melhor qualidade de vida4. OBJETIVO: apresentar um caso de neoplasia de cólon direito com invasão duodenopancreática tratado com gastroduodenopancreatectomia. RELATO DE CASO: Paciente de 73 anos, branco, que há oito meses apresentava astenia, adinamia e emagrecimento de aproximadamente 20 kg. Ao exame físico: IMC: 20,3, descorado ++/4. Abdome com massa palpável em flanco direito de aproximadamente 15cm. A colonoscopia demonstrou tumor de cólon direito e o anátomo-patológico evidenciou adenocarcinoma moderadamente diferenciado. A Tomografia computadorizada demonstrou os vasos mesentéricos livres de invasão. No intra-operatório se observou massa tumoral envolvendo cólon ascendente até ângulo hepático invadindo segunda para terceira porção duodenal. Foi realizada colectomia direita associadaà gastroduodenopancreatectomia em bloco. O anátomo-patológico da peça revelou adenocarcinoma moderadamente diferenciado de intestino grosso com metástases em tecido duodenal e pancreático com infiltração angio-linfática. O paciente sobreviveu por 8 meses. CONCLUSÃO: A gastroduodenopancreatectomia deve ser considerada para tumores não periampulares na ausência de metástases à distância e quando a condição clinica do paciente permitir e foi a conduta adequada para este paciente.


INTRODUCTION: The effectiveness of duodenopancreatic ressection in block for infiltrative periampolar tumors are not yet know, but it is known that in local advanced colorretais tumors, the multivisceral ressection is, most of the time, the possibility of better quality of life. OBJECTIVE: To present a case of right colon neoplasm with duodenopancreatic invasion treated with gastroduodenopancreatectomy. CASE REPORT: Man,73 years old, white, that for eight months presented asthenia,and lost approximately 20kg. Physical examination: mass in right flank of approximately 15cm. The colonoscopy demonstrated right tumor of colon, adenocarcinoma. Durin a surgery it was observed ascending tumoral mass involving colon until hepatic angle invading the second to the third duodenal portion. Right colectomy associated with gastroduodenopancreatectomy was performed. The pathological exam differentiated adenocarcinoma of duodenal and pancreatic thick intestine with metastasis and angio-lymphatic infiltration. The patient survived for 8 months. CONCLUSION: The gastroduodenopancreatectomy must be considered the absence of distant metastasis and when the clinical condition of the patient not to allow and was the behavior adjusted for this patient.


Subject(s)
Aged , Colon, Ascending , Colorectal Surgery , Pancreatectomy
19.
Korean Journal of Gastrointestinal Endoscopy ; : 127-131, 2008.
Article in Korean | WPRIM | ID: wpr-53497

ABSTRACT

Anisakiasis in the gastrointestinal tract is caused by the ingestion of raw marine fish that contain Anisakis lavae. In rare cases, Anisakiasis is found as an eosinophilic granuloma that mimics a submucosal tumor. The diagnosis is usually made after surgical resection. Several cases of gastric anisakiasis imitating a submucosal lesion have been reported. However, colonic anisakiasis forming a submucosal lesion is very rare and only a few cases have been reported. All of the cases were confirmed after surgery. Recently, we encountered a male patient with a submucosal lesion on the ascending colon during a health screening. Several biopsies were performed on the same site as the lesion. The pathological finding was eosinophilic granuloma. We tentatively diagnosed the patient with eosinophilic granuloma due to Anisakis as the patient consumed raw seafood and eosinophilia was detected on a laboratory test. We decided not to perform any procedure. One month later, the eosinophilic granuloma disappeared as seen on a follow-up colonoscopy.


Subject(s)
Humans , Male , Anisakiasis , Anisakis , Biopsy , Colon , Colon, Ascending , Colonoscopy , Eating , Eosinophilia , Eosinophilic Granuloma , Eosinophils , Follow-Up Studies , Gastrointestinal Tract , Mass Screening , Seafood
20.
Arq. ciênc. vet. zool. UNIPAR ; 9(2): 135-140, jul.-dez. 2006.
Article in English | LILACS | ID: lil-453728

ABSTRACT

O objetivo deste estudo foi estudar os efeitos da desnutrição protéica e da carência de vitaminas do complexo B sobre o plexo mioentérico do colo ascendente de Rattus norvegicus. Vinte ratos foram divididos em dois grupos, sendo que, para um dos grupos foi oferecida ração com teor protéico de 22% (controle) e, para outro, ração com teor protéico de 8% com menor teor de vitaminas do complexo B, durante 120 dias. Coramos os preparados de membrana do colo ascendente pelo método de Giemsa e pela técnica da NADH-diaforase. Os ratos desnutridos apresentaram peso corporal 14,8% menor que o grupo controle, média da área do colo 54,2% menor, e a média da densidade neuronal foi 26,7% maior com a técnica de Giemsa e 27% com a técnica da NADH-diaforase. Como a redução da área não foi acompanhada por um aumento inversamente proporcional na densidade de neurônios, sugere-se que a condição imposta causou perda de neurônios mioentéricos.


This study was performed in order to study the effects of protein desnutrition and vitamin B complex deficiency on the myenteric plexus of the ascending colon of Rattus norvegicus. Twenty rats were divided into two groups; one had been fed with a 22%-protein-level ration, and the other with a 8%-protein-level without vitamin-B-complex supplementation, for 120 days. The whole-amounts of the ascending colon were stained with either Giemsa or NADH-diaphorase technique. The disnurtured rats showed a 14.8% smaller body weight than the control group, and the area of colon of the sample group was 54.2% smaller. The average neuronal density was 26.7% greater with the Giemsa technique and 27% greater with the NADH-diaphorase technique. As the decrease in area was not accompanied by an inversely proportional increase in neuronal density, it is suggested that the experimental condition led to a myenteric neuron loss.


El objetivo de este estudio fue analisar los efectos de la desnutrición proteica y de la carencia de vitaminas del complejo B sobre el plexo mioentérico del regazo ascendiente de Rattus norvegicus. Veinte ratones fueron divididos en dos grupos, siendo que, para uno de los grupos se ofreció ración con contenido proteico de 22% (control) y, para el otro, ración con contenido proteico de 8% con menor contenido de vitaminas del complejo B, durante 120 días. Coloreamos los preparados de membrana del regazo ascendiente por el método de Giemsa y por la técnica de la NADH-diaforasis. Los ratones desnutridos presentaron peso corporal 14,8% menor que el grupo control, promedio del área del regazo de 54,2% menor, y el promedio de la densidad neuronal fue 26,7% mayor con la técnica de Giemsa y 27% con la técnica de la NADH-diaforasis. Como la reducción del área no fue acompañada por un aumento inversamente proporcional en la densidad de neuronas, se cree que la condición impuesta causó pérdida de neuronas mioentéricos.


Subject(s)
Animals , Vitamin B Deficiency/complications , Vitamin B Deficiency/veterinary , Protein Deficiency/complications , Protein Deficiency/veterinary , Animal Nutritional Physiological Phenomena , Rats , Myenteric Plexus/anatomy & histology
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