Subject(s)
Digestive System Surgical Procedures/adverse effects , Hyaluronic Acid/therapeutic use , Intestinal Obstruction/prevention & control , Laparoscopy/methods , Postoperative Complications/prevention & control , Aged , Aged, 80 and over , Female , Humans , Intestinal Obstruction/etiology , Intestine, Small/pathology , Male , Medical Illustration , Membranes, Artificial , Middle Aged , Peritoneal Cavity/surgery , Postoperative Complications/etiology , Tissue Adhesions/etiology , Tissue Adhesions/prevention & controlABSTRACT
We report a case of sigmoido-vesical fistula due to sigmoid diverticulitis. Magnetic resonance imaging enabled us to visualize the fistula itself in the bladder wall. Magnetic resonance imaging was highly effective in making a precise diagnosis and also provided important additional information for the preoperative work-up of the patient.
Subject(s)
Diverticulitis, Colonic/pathology , Intestinal Fistula/pathology , Magnetic Resonance Imaging , Sigmoid Diseases/pathology , Urinary Bladder Fistula/pathology , Diverticulitis, Colonic/surgery , Humans , Intestinal Fistula/etiology , Intestinal Fistula/surgery , Male , Middle Aged , Preoperative Care , Sigmoid Diseases/etiology , Sigmoid Diseases/surgery , Urinary Bladder Fistula/etiology , Urinary Bladder Fistula/surgeryABSTRACT
BACKGROUND: In recent studies a high frequency of microsatellite instability among colorectal cancers in young patients has been reported, but the frequency of microsatellite instability (MSI) and chromosomal instability among colorectal cancers in young patients has not yet been fully elucidated. Only one report showed an increased loss of heterozygosity (LOH) ratio at 9p locus, which harbors tumor suppressor genes p16. The LOH and MSI status among colorectal cancers in young patients was examined. METHODS: Twenty-five patients under 40 years of age diagnosed with colorectal cancer were examined for MSI and LOH using 17 microsatellite markers, and also p16 expression patterns were evaluated by immunohistochemistry and methylation status of the p16 gene was assessed by methylation-specific PCR. RESULTS: MSI was observed in only one case (4%). LOH at 2p, 5q, 9p, 11q, 17p, and 18q was observed in 41%, 59%, 42%, 35%, 46%, and 56% of cases, respectively. Eighty-three percent of patients showed p16-positive expression patterns. Fifty percent of colorectal cancers in young patients exhibited p16 methylation (3/6). CONCLUSIONS: Our study demonstrated that colorectal cancers in young patients without MSI showed a high frequency of LOH at the 9p locus. However, LOH status at 9p and p16 expression pattern did not show a significant correlation. Other tumor suppressor genes on the 9p, with the exception of p16, may play an important role in the carcinogenesis of colorectal cancers in young patients.
Subject(s)
Adenocarcinoma/genetics , Colorectal Neoplasms/genetics , Genes, p16 , Loss of Heterozygosity , Microsatellite Repeats/genetics , Adult , DNA Methylation , Female , Gene Expression , Humans , Immunohistochemistry , Male , Polymerase Chain ReactionABSTRACT
We examined microsatellite instability (MSI) in nonfamilial multiple synchronous colorectal cancer (multiple CC) patients. We divided the patients into two groups, those with and without extracolonic primary malignancies, and compared the frequency of MSI between the two groups. A colectomy was performed in 52 multiple CC patients between 1985 and 1998. Of them, 10 patients had extracolonic malignancies, while the other 42 patients did not. The MSI frequency was higher in the patients with extracolonic malignancies than in those without extracolonic malignancies, although it was not statistically significant (40% vs 19%, P = 0.21). Regarding the lesions, MSI frequency of cancers was higher in the multiple CC with extracolonic malignancies than in those without extracolonic malignancies (33% vs 13%, P = 0.033). From our results, there was statistically no difference in the existence of extracolonic malignancies between the patients with at least one MSI-positive cancer and those patients without any MSI-positive cancers. On the other hand, there was a significant correlation between MSI-positivity and the existence of extracolonic malignancies.
