Trombosis segmentaria sigmoidea consecuente a neoplasia maligna de colon. A propósito de un caso interesante / Sigmoid segmental thrombosis consequent to colon malignant neoplasia. On the purpose of a case

RESUMEN Se presentó un caso de una paciente de 78 años de edad, procedente del municipio de Calimete, con antecedentes patológicos personales de infarto agudo miocárdico sin elevación del segmento ST e hipertensión arterial. Llegó a la Unidad de Cuidados Intensivos de Emergencia, de Colón con un estado toxico infeccioso severo. Fue intervenida quirúrgicamente con el diagnóstico presuntivo de una trombosis mesentérica. Se constató dicho diagnóstico complementario a una neoplasia maligna de colon sigmoides. Falleció producto a un shock séptico refractario a aminas. En la necropsia se reportaron hallazgos de interés.

ABSTRACT The authors present the case of a 78-years-old female patient from the municipality of Calimete, with personal pathological antecedents of acute myocardial infarct without ST segment elevation and arterial hypertension. She arrived to the Emergency Intensive Care Unit of Colon with a severe toxic-infectious status. She underwent a surgery with a presumptive mesenteric thrombosis. It was stated that diagnosis, complementary to a sigmoid colon malignant neoplasia. She died as a product of an amine-refractory septic shock. The autopsy showed findings of interest.

An elderly man with gastric cancer, Saint's triad and Heyde's syndrome / Un anciano con cáncer gástrico, tríada de Saint y síndrome de Heyde

This case study describes a 71-year-old man with signet-ring cell gastric adenocarcinoma and malignant sigmoidal polyp; and typical features of Saint's triad and Heyde syndrome. He had digestive bleeding, two types of hernia, diverticulosis, arterial hypertension, malignant polyp, and antecedent of smoking, lung tuberculosis, and surgical correction of aortic valve stenosis. There is a hypothetical inverse relationship between herniosis and development of malignancy; however, the patient herein described presented gastric and sigmoidal cancers. Gastrointestinal malignancies are sometimes associated with paraneoplastic entities, isolated or manifested as syndromes, but neither Saint's triad or Heyde syndrome have been included. This patient persisted clinically stable during the preoperative period, but suddenly died; Trousseau's syndrome would be the most probable mechanism of sudden death in this setting. Case reports can stimulate further studies to get additional knowledge about unusual entities.

Este estudio de caso describe un hombre de 71 años de edad, con adenocarcinoma gástrico con células en anillo de sello y un pólipo maligno sigmoideo; y características típicas de la tríada de Saint y del síndrome de Heyde. Tuvo una hemorragia digestiva, dos tipos de hernias, divertículos, hipertensión arterial, y pólipo maligno; con antecedente de tabaquismo, tuberculosis pulmonar, y corrección quirúrgica de estenosis de la válvula aórtica. Hay una hipotética relación inversa entre hernioses y el desarrollo de malignidades; sin embargo, el paciente que se describe en el presente documento presentó cánceres gástrico y sigmoideo. Neoplasias gastrointestinales se asocian a veces con entidades para neoplásicas aisladas o manifiestan síndromes, pero ni la tríada de Saint ni el síndrome de Heyde se ha incluido. Este paciente persistió clínicamente estable durante el período preoperatorio, pero de repente murió; síndrome de Trousseau sería el mecanismo más probable de muerte súbita en esta situación. Los informes de casos pueden estimular más estudios para obtener un conocimiento adicional sobre esas entidades inusuales.

Prevalencia de adenomas y adenocarcinomas de recto-sigma en pacientes menores de 50 años que consultan por proctorragia / [Prevalence of rectosigmoid adenomas and adenocarcinomas in patients younger than 50 years old referred for proctorrhagia].

BACKGROUND: Rectal bleeding is a sign of colorectal cancer (CRC). Its early diagnosis decreases mortality and improves survival. In young population with no risk factors for the disease, CRC is infrequent. Moreover, benign anorectal disorders are most frequent causes of bleeding and generally, when anal pathology is identified, it is assumed as the origin of the sign. For all these reasons, rectal bleeding sometimes is sub-assessed in young patients. OBJECTIVE: Estimate the prevalence of adenomas and adenocarcinomas in sigmoid and rectum in patients younger than 50 years old referred for proctorrhagia. METHODS: The study design was descriptive, retrospective and cross-sectional. Procedures were performed under sedation and Olympus CF 160 y CF 180 scopes were used. Proctorrhagia was considered as rectal bleeding registered as indication of the procedure. Histology was established according to Vienna classification. Informed consent was signed before the procedures. Colonoscopy reports were reviewed. The study took place in an outpatient clinic in Buenos Aires city, between October 2010 and October 2011. High risk patients for CRC were excluded RESULTS: We included 1,203 from 1,257 reviewed VCC, 49

were female and the median age was 38 years old (range: 18-49 years old). The prevalence of adenomas and adenocarcinomas in sigmoid and rectum was 67

CI): 5.4-8.3] and 1.6

CI 1-2.5), respectively. CONCLUSIONS: Adenocarcinomas and adenomas are infrequent in a young population without risk factors for CRC. However, even when benign anal disorders are the most frequent cause for rectal bleeding, miss evaluation of this sign could have a serious impact in almost 10 of 100 individuals.

Perforated Sigmoid Colon Cancer within an Irreducible Inguinal Hernia: a Case Report

A perforated sigmoid colon cancer within an inguinal hernia is extremely rare. This unexpected finding is usually discovered during surgery and causes an unavoidable septic evolution. Here, we describe the case of an 84-year-old man who presented with fever, abdominal distension, and a painful, enlarged, left scrotum. A CT showed a left, incarcerated, inguinal hernia containing a perforated sigmoid adenocarcinoma (which was confirmed by histopathology). The possibility of an irreducible inguinal hernia in association with perforated sigmoid colon cancer should be considered in the array of diagnoses. A pre-operative CT scan would be helpful in facilitating an accurate diagnosis.

Neuroendocrine Carcinoma of the Sigmoid Colon / 대한소화기학회지

No abstract available.

The Association of Anisakiasis in the Ascending Colon with Sigmoid Colon Cancer: CT Colonography Findings

The association of anisakiasis of the colon with colon cancer is rare and difficult to diagnose. Only one case of this type has been reported to date. In this study, we report a case of synchronous colon cancer and colonic anisakiasis. A 50-year-old woman was admitted for abdominal pain, and a volume-rendered surface-shaded image of CT colonography (CTC) revealed a concentric narrowing in the sigmoid colon and a segmental fold thickening in the ascending colon. A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed. This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.

Streptococcus intermedius liver abscesses and colon cancer: a case report / Abscesos hepáticos por Streptococcus intermedius y cáncer de colon: reporte de un caso

Certain species of bacteria are known to be associated with colorectal cancer. We report a case of adenocarcinoma of the colon with bacteraemia and liver abscesses due to Streptococcus intermedius. The isolation of this organism should prompt investigation for colorectal neoplasm, which may be present but asymptomatic, without metastases, and therefore at a curative stage.

Se sabe que ciertas especies de bacterias están asociadas con el cáncer colorectal. El presente trabajo reporta un caso de adenocarcinoma del colon acompañado de bacteriemia y abscesos hepáticos debidos a Streptococcus del grupo intermedius. El aislamiento de este organismo debe impulsar la investigación del neoplasma colorectal, el cual puede estar hallarse presente pero de forma asintomática, sin metástasis, y por consiguiente en una fase en que la cura es aún posible.

Carcinoma of sigmoid colon presenting as abdominal wall abscess.

Abdominal wall abscess is a rare presentation of intra-abdominal disease. We describe a 69-year-old woman with a locally advanced carcinoma of the sigmoid colon presenting as abdominal wall abscess. The diagnosis was suggested by computed tomography of the abdomen. She was treated with resection of the tumor with closure of the rectal stump and proximal end colostomy. No adjuvant therapy was undertaken considering the extent of the disease. She survived for four months after the operation.

A case of sigmoid lipoma presenting with intussusception.

Colonic lipomas are rare, benign tumours that rarely produce symptoms. Presented here is a case where a sigmoid lipoma acted as lead point to produce intussusception.

Resección primaria con anastomosis en el cáncer oclusivo de colon izquierdo / Primary resection and anastomosis for acute obstruction of left colon cancer

Objetivo: Comunicar nuestra experiencia en pacientes portadores de cáncer de colon izquierdo obstruido y sometidos a resecciones primarias con anastomosis. Se evaluó la táctica quirúrgica, morbimortalidad, resultados funcionales de las colectomías totales y subtotales y el pronóstico ancológico. Material y Métodos: Con oclusión completa del colon izquierdo ingresaron 64 pacientes (Sexo: 31 varones - Edad: 32-84 promedio: 66,9 años), a los cuales se les realizó una resección primaria con anastomosis (RPA). Con fines comparativos fueron evaluados 67 pacientes (Sexo: 32 varones, Edad: 65,8 años) operados durante el mismo período, con tumores oclusivos del colon izquierdo y a los cuales se les realizó cirugía en tres etapas (CTE). Resultados: Se realizaron 29 colectomías izquierdas, 17 colectomías subtotales y 18 totales. La morbilidad con o sin lavado colónico intraoperatorio fue similar (2/10 vs 3/13). Sin mortalidad en ambos grupos. El promedio de deposiciones de los pacientes con colectomía total y subtotal fue de 3 por día, con un 96 por ciento de buena continencia. Los resultados oncológicos en ambos grupos por estadios y en pacientes operados con intención curativa, no demostraron diferencias estadísticamente significativas (RPA = 62,6 por ciento vs CTE = 43,4 por ciento, p = 0,065). Conclusiones: El lavado colónico intraoperatorio no demostró ser imprescindible. El resultado funcional de la colectomía total o subtotal fue muy bueno. La supervivencia de las resecciones primarias con anastomosis fue mejor que la de las resecciones en etapas, sin alcanzar significación estadística. La baja morbimortalidad observada justificaría el empleo de las resecciones primarias con anastomosis en pacientes seleccionados y operados por grupos entrenados

Synchronous adenocarcinoma and lymphoma of the colon.

Synchronous lymphoma and adenocarcinoma of the colon are extremely rare. A 32-year-old woman was referred to us for colon cancer. Investigations revealed two primary tumors, one in the cecum and the other in the sigmoid colon. Subtotal colectomy with ileorectal anastomosis was performed. Histology revealed the cecal tumor to be non-Hodgkin's lymphoma, diffuse small cell type with plasmacytoid features. The sigmoid colon tumor was moderately differentiated adenocarcinoma. The patient received 6 cycles of chemotherapy postoperatively for lymphoma but died of recurrent disease after 17 months.

Operación tipo Hartmann en la urgencia / Hartman technique in emergency

Se presentan 30 pacientes en los que se realizó una operación tipo Hartmann todas realizadas en la urgencia. Sus indicaciones fueron: enfermedad diverticular complicada en 17 casos, obstrucción intestinal por cáncer de colon izquierdo en 11 y megasigma volvulado en 2 pacientes. Se reconstruyeron 13 pacientes, 6 con sutura mecánica y 7 con sutura manual. Se analizan las indicaciones del procedimiento, así como también la mortalidad y tiempo de internación de ambos tiempos quirúrgicos; comparándola además, con otras técnicas

Celulite crepitante abdominal: uma rara forma de apresentaçäo do tumor do sigmóide / Crepitant abdominal cellulitis: a rare clinical presentation of sigmoid colon tumor

Uma infecçäo rara associada ao câncer colo-retal pode ser, por si só, um indício de malignidade. Estas infecçöes podem ser locais, ou seja, por invasäo de tecidos adjacentes ao tumor, ou metastáticas, por bacteremias causadas pela necrose tumoral. É apresentado um caso de celulite crepitante espontânea da parede abdominal associada a tumor do sigmóide. A paciente apresentava dor na fossa ilíaca esquerda, febre e necrose da pele e parede abdominal baixa há 4 horas. Na cirurgia foi realizado debridamento e excisäo do tecido necrosado com sigmoidectomia parcial, colostomia terminal e sepultamento do coto distal. A doente faleceu no nono mês de pós-operatório, devido a disseminaçäo tumoral. O exame anatomopatológico da peça revelou adenocarcinoma ulcerativo do sigmóide. A presença de celulite crepitante na parede abdominal inferior deve induzir a pesquisa de perfuraçäo intestinal