ABSTRACT
The possibility of giardiasis should be considered in any case in which the patient has watery diarrhea and malabsorption syndrome. Investigation should include examination of at least three separate fecal specimens for Giardia lamblis. In case of negative results, this examination should be followed by aspiration of duodenal contents to search for the trophozoites. Treatment with metronidazole in the case reported resulted in a good clinical response, with disappearance of the patient's chronic diarrhea and intestinal malabsorption.
Subject(s)
Giardiasis/complications , Intestinal Diseases, Parasitic/complications , Malabsorption Syndromes/etiology , Chronic Disease , Diarrhea/etiology , Female , Giardiasis/diagnosis , Humans , Intestinal Diseases, Parasitic/diagnosis , Middle AgedABSTRACT
This report covers a 2.5-year experience with colonoscopy in the management of 208 patients (104 men and 98 women, average age 58 years). Colonic bleeding of unknown cause and abnormal barium-enema findings were the most common indications for colonoscopic examination. During this period, 110 colonoscopic polypectomies were performed. Among the few complications was one case of perforation of the sigmoid from transcolonoscopic removal of a small carcinoma; the perforation was incidentally discovered at the time of subsequent laparotomy. Bleeding occurred in 6 patients, but only one of them required surgical intervention to arrest the hemorrhage. Colonoscopy is a safe, effective and reliable diagnostic and therapeutic procedure. Its use can reduce expense for the patient and obviate a long painful postoperative period.
Subject(s)
Colon , Colonic Diseases/diagnosis , Endoscopy , Rectal Diseases/diagnosis , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Sixty-five patients who had the documented histologic diagnosis of chronic ulcerative colitis were selected in order to study appendiceal involvement in this disease. There were 28 males and 37 female patients with an average age of 30 years. The incidence of appendiceal involvement involving the right colon was found to be 47 per cent. In all of these cases the appendiceal involvement occurred in association with the disease process in the cecum or the right colon. In seven patients a classic picture of ulcerative appendicitis in active phase was found. In 78 per cent of patients a similarity between the disease stages in the colon and in the appendix was observed.
Subject(s)
Appendicitis/pathology , Appendix/pathology , Colitis, Ulcerative/pathology , Adolescent , Adult , Aged , Appendectomy , Appendicitis/complications , Colectomy , Colitis, Ulcerative/surgery , Crohn Disease/pathology , Female , Humans , Male , Middle AgedSubject(s)
Colon , Colonic Neoplasms/surgery , Endoscopy , Intestinal Polyps/surgery , Adolescent , Adult , Aged , Colonic Diseases/diagnosis , Female , Humans , Male , Middle AgedABSTRACT
Our thirteen year experience with villous adenomas of the colon and rectum, embracing 264 patients, is reported. The average age of patients was sixty-two years with an almost equal sex distribution. Seventy-two per cent of the lesions occurred in the rectum and rectosigmoid and the most frequent symptoms were rectal bleeding and diarrhea. A positive correlation between size of adenoma and incidence of malignancy was noted. Although 55 per cent of the lesions were malignant, only 22 per cent harbored invasive carcinoma and only 10 per cent of the deaths were due to metastatic carcinoma. It is concluded that in the absence of invasive carcinoma, the clinical behavior of this tumor is relatively benign and a more conservative approach to the surgical management of this neoplasm should be encouraged.
Subject(s)
Adenocarcinoma/surgery , Adenoma/surgery , Colonic Neoplasms/surgery , Rectal Neoplasms/surgery , Adenocarcinoma/epidemiology , Adenocarcinoma/pathology , Adenoma/epidemiology , Adenoma/pathology , Adult , Aged , Colonic Neoplasms/epidemiology , Colonic Neoplasms/pathology , Female , Humans , Male , Middle Aged , Prognosis , Rectal Neoplasms/epidemiology , Rectal Neoplasms/pathology , TexasABSTRACT
During a 12-year period, 185 patients with papillary adenomas of the colon and rectum were treated. The average age was 63 years and there was a 10 per cent female preponderance. Seventy-one per cent of the lesions occurred in the rectum and rectosigmoid, and 40 per cent of the patients had rectal bleeding. Fifty-two per cent of the lesions were malignant: however, only 9 per cent of the patients died with metastatic carcinoma. The five-year survival rate in patients with papillary adenocarcinoma was 75 per cent. The results of this review indicate that a conservative approach to the surgical management of papillary adenoma of the colon and rectum should be encouraged, unless the tumor contains or is suspected to contain invasive carcinoma.
Subject(s)
Colonic Neoplasms/surgery , Cystadenoma/surgery , Rectal Neoplasms/surgery , Adult , Aged , Colonic Neoplasms/pathology , Cystadenoma/pathology , Female , Humans , Male , Middle Aged , Neoplasm Metastasis , Rectal Neoplasms/pathology , Retrospective Studies , TexasABSTRACT
A case of atraumatic rupture of the spleen originally presenting as ruptured sigmoid diverticulitis is described. The underlying disease was found to be myelofibrosis. Although progressive splenomegaly is always associated with this disease, spontaneous rupture of this organ is not reported in the literature. We also reviewed the literature in regard to unusual presentation of splenic rupture and we could not find any case simulating acute sigmoid diverticulitis. It is suggested that awareness and familiarity with this disease may enable the surgeon to suspect this diagnosis when dealing with an unusual acute abdominal emergency.
