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Objetivo: Reporte de dos casos en que se extrajo por vía anal con colonoscopía, cuerpos extraños injeridos por vía oral. Material y Método: Discusión del cuadro clínico, imágenes, y manejo. En ambos casos luego de la confirmación imagenológica de la presencia de los cuerpos extraños en el tracto digestivo bajo se procedió a su extracción con colonoscopía. Resultados: Ambos casos se presentaron de forma inusual, se confirmo la presencia y ubicación de los cuerpos extraños con imagenología y colonoscopía. Se realizó la extracción por vía endoscópica sin incidentes. Discusión: Nuestros dos casos son inusuales, con escasa evidencia en la literatura internacional, en ambos casos se pudieron presentar complicaciones importantes y requerir cirugía. Afortunadamente se pudieron resolver por vía endoscópica. Conclusión: Los cuerpos extraños del tracto digestivo bajo, injeridos por vía oral son infrecuentes, la imagenología y la sospecha clínica son esenciales para su correcto diagnóstico y planificación terapéutica. Consideramos que la extracción con colonoscopía es una estrategia a considerar en estos casos.
Objective: Report of two cases in which foreign bodies ingested orally were extracted through the anal route with colonoscopy. Material and Method: Discussion of the clinical picture, images, and management. In both cases, after imaging confirmation of the presence of foreign bodies in the lower digestive tract, they were extracted with colonoscopy. Results: Both cases presented in an unusual way, the presence and location of the foreign bodies were confirmed with imaging and colonoscopy. Endoscopic removal was performed without incident. Discussion: Our two cases are unusual, with little evidence in the international literature, in both cases important complications could have occurred and surgery was required. Fortunately they could be resolved endoscopically. Conclusion: Orally ingested foreign bodies in the lower digestive tract are rare; imaging and clinical suspicion are essential for correct diagnosis and therapeutic planning. We believe that extraction with colonoscopy is a strategy to consider in these cases.
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RESUMEN Introducción: el cáncer colorrectal se desarrolla a partir de lesiones precursoras a nivel del colon, recto y ano, siendo responsable del 16,9 % de todas las muertes por cáncer y en los hombres es la tercera neoplasia maligna más común a nivel mundial. Objetivo: caracterizar a los pacientes postoperados de cáncer colorrectal del Servicio de Coloproctología del Hospital Nacional, Itauguá Paraguay en el periodo entre 2015 y 2018. Metodología: estudio observacional descriptivo, retrospectivo de corte transversal. Se utilizaron fichas de pacientes postoperados de cáncer colorrectal del Servicio de Coloproctología del Hospital Nacional, Itauguá Paraguay en el periodo entre 2015 y 2018. Resultados: del total de las 26 fichas de pacientes revisadas, el 70 % fue de sexo masculino y el rango etario más común fue entre 60 - 71 años (52 %); el tipo histológico de cáncer más frecuente fue el adenocarcinoma moderadamente diferenciado 78 %, el estadio más común fue adenocarcinoma de tipo II A (clasificación de la American Joint Committe on Cancer (AJCC-TNM) 65 %, presentó metástasis a distancia 3,81 % y la ubicación de cáncer más frecuente fue el recto 34,78 %. El motivo de consulta más frecuente fue hemorragia 70 %, la complicación más común fue la dehiscencia y no hubo óbitos. Conclusión: el mayor porcentaje de pacientes pertenece al sexo masculino y al grupo etario de mayores a 60 años, fue frecuente el adenocarcinoma moderadamente diferenciado y el estadio más común de tipo II A, la ubicación más frecuente fue el recto y motivo de consulta fue hemorragia (rectorragia)., por lo cual se deberían implementar medidas para la prevención de esta patología.
ABSTRACT Introduction: colorectal cancer develops from precursor lesions in the colon, rectum and anus, being responsible for 16,9 % of all deaths from cancer and in men it is the third most common malignant neoplasm worldwide. Objective: to characterize postoperative colorectal cancer patients of the Coloproctology Service of the Hospital Nacional, Itauguá - Paraguay in the period between 2015 and 2018. Methodology: descriptive, retrospective, cross-sectional observational study. Cards of postoperative colorectal cancer patients from the Coloproctology Service of the Hospital Nacional, Itauguá - Paraguay in the period between 2015 and 2018 were used. Results: of the total of the 26 patient files reviewed, 70 % were male and the most common age range was between 60 - 71 years (52 %); the most frequent histological type of cancer was moderately differentiated adenocarcinoma 78 %, the most common stage was adenocarcinoma type II A (classification of the American Joint Committee on Cancer (AJCC-TNM) 65 %, present distant metastases 3,81 % and the most frequent location of cancer was the rectum 34,78 % .The most frequent reason for consultation was hemorrhage 70 %, the most common complication was dehiscence and there were no deaths. Conclusion: the highest percentage of patients belongs to the male sex and to the age group over 60 years old, moderately differentiated adenocarcinoma was frequent and the most common stage was type II A, the most frequent location was the rectum and the reason for consultation was hemorrhage (rectorrhagia), for which measures must be implemented to prevent this pathology.
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Objective To observe the effect of acupuncture on cystathionine gamma-lyase(CSE)and myeloperoxidase (MPO) in the colonic tissues of rats and to explore its mechanism for recovering the function of interstitial cells of Cajal(ICCs)in rats after colonic anastomosis . Methods Thirty SD rats were randomized into normal control group, model group(receiving colonic anastomosis) and acupuncture group. The acupuncture group received foot three-needle therapy on bilateral Zusanli(ST36), Sanyinjiao(SP6) and Taichong(LR3), once a day for 3 days after colonic anastomosis. And then the propulsive rate of the small intestine was measured. The count of ICCs with positively expressive c-kit in rat colonic tissues was measured by immunohistochemistry, the activity of CSE was observed by enzyme-linked immunosorbent assay (ELISA) and the activity of MPO was tested by biochemical method. Results Compared with the normal control group, the small intestinal propulsive rate in the model group was decreased, the number of ICCs with positively expressive c-kit was reduced, while the activities of CSE and MPO were increased(P<0.05). The acupuncture group had higher intestinal propulsive rate, more ICCs with positively expressive c-kit, and lower CSE and MPO activities than the model group(P<0.05).Conclusion Acupuncture can promote the recovering of postoperative gastrointestinal function, and its mechanism may be related to the regulation of CSE and MPO activities in the colonic tissues and to the restoration of ICCs function in the focus with positive c-kit.
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Objective To investigate the effect of Yiqi Huoxue Huatan Decoction(YHHD) on gene expression of vascular endothelial growth factor(VEGF), intercellular adhesion molecule 1(ICAM-1) in the colonic mucosa of ulcerative colitis rats. Methods Sixty rats were divided into six groups, namely normal control group, model control group, low-, middle- and high-dose Y HHD group(gastric gavage of YHHD in the dosage of 13, 26, 52 g·kg-1·d-1 respectively) , and Mesalazine(0.5 g·kg-1·d-1 ) group. T he rat model of ulcerative colitis was established by enema with 2, 4, 6-trinitrobenzene sulfonic acid(TNBS)mixture(2.5%TNBS and 50% ethanol). The changes in rat body weight were monitored. After treatment, pathological features of the colonic mucosa were observed under light microscope, and VEGF and ICAM-1 gene expression levels in the colonic mucosa were measured by reverse t ranscripti on polymerase chai n reaction(RT-PCR). Results Body weight was lighter, and relative gene expression levels of VEGF and ICAM-1 in the model group were significantly higher than those in the normal control group, and pathological features of the colonic mucosa was obvious, the differences being significant between the two groups(P<0.01). Compared with the model group, body weight was increased , pathological features of the colonic mucosa were relieved, and relative gene expression levels of VEGF and ICAM-1 were significantly decreased in YHHD groups(P<0.01), and high-dose YHHD showed the strongest effect. Conclusion YHHD can down-regulate the gene expression of VEGF and ICAM-1, which may be one of its therapeutic mechanisms for ulcerative colitis.
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Objective To investigate influence of Qi-strengthening,blood-activating and toxin-removing therapy on plasma and colonic P-selectin in ulcerative colitis(UC) rats.Methods Trinitrobenzene sulfonic acid(TNBS) was used for the establishment of SD rat models of UC.UC rats were randomized into the model group,western medicine group(gastric gavage of suspension of Olsalazine Sodium Capsules 0.266 g?kg-1?d-1),and herbal medicine group(gastric gavage of Kuijie Fufa Recipe 20 g?kg-1?d-1).Meanwhile,a normal control group was set up.After medication for 10 and 30 days,and after drug withdrawal for 10 days,plasma P-selectin level was detected by enzyme-linked immunosorbent assay,and colonic P-selectin expression was detected by immunohistochemical assay.Results Plasma P-selectin level was increased in the model group in different time(P
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Objective To observe the effect of Changji'an Prescription(CP) on T lymphocytes count and 5-hydroxytryptamine(5-HT) secretion in rats with diarrhea predominant irritable bowel syndrome(IBS).Methods Forty-six neonatal SD rats were randomized into normal group,model group,low-,middle-and high-dose CP groups(0.94,1.88 and 3.76g?kg-1?d-1 respectively),and Bupi Yifei Pills group(6.76g?kg-1?d-1).Continuous internal rectal stimulation with acetate was used to induce the rat model of intestinal hypersensitive IBS.Flow cytometer was used for the quantitative analysis of peripheral levels of T lymphocytes subsets CD+3,CD+4 and CD+8,and immunohistochemical method was used to observe 5-HT-positive cells number and the immunostaining intensity in the bowels of rats.Results In the model group,the defecation volume and the intestinal sensitivity were increased,CD+4 level and CD+4/CD+8 decreased,CD+8 level increased,5-HT-positive cells number and the immunostaining intensity elevated(P