ABSTRACT
Barotrauma or cat scratch is an unusual finding on colonoscopy. The etiology is unknown, but insufflation associated with increased rigidity of the colonic wall due to various pathological processes has been postulated as a pathogenic mechanism. Some authors observed the same associated with collagenous colitis, IBD(Inflammatory Bowel Diseases), intestinal ischemia, shunt colitis and intake of NSAIDs (Non-steroidal anti-inflammatory drugs). In all the cases described, Co2 was used for insufflation.
Subject(s)
Cat-Scratch Disease , Colitis, Collagenous , Colitis , Humans , Colitis/complications , Colitis/pathology , Colonoscopy , Colitis, Collagenous/pathology , Anti-Inflammatory Agents, Non-Steroidal/therapeutic useABSTRACT
INTRODUCTION: The endoscopic placement of self-expanding metallic stents (SEMS) emerges as a therapeutic option for neoplastic colonic obstruction in two situations: as palliative treatment and as a bridge to surgery. The latter can avoid emergency surgery, thus decreasing the rate of ostomies and the mortality and morbidity associated with them. OBJECTIVES: To evaluate the feasibility, safety and benefits of SEMS placement for the treatment of neoplastic colorectal obstruction. MATERIALS AND METHODS: Between August 2008 and June 2012, we included in this prospective, longitudinal, descriptive and observational study all the patients suffering from colorectal neoplasia who were subjected to SEMS placement by the same group ofendoscopists. Nitinol SEMS were inserted under endoscopic vision and radioscopic control. RESULTS: Twenty seven SEMS were inserted in 27 patients, 61% of them were male and the average age was 70 years old. Symptoms of colonic suboclussion or obstruction were found in 92% of patients, 88% of the lesions were located in the left-side colon, 41% of cases were performed on an ambulatory basis and 65% of stenting was carried out for palliative purposes. The average time of hospitalization was 6,46 days. Technical and clinical success were 93% and 100%, respectively. Minor complications were observed in 11% of patients. Colonic stenting was followed by elective surgery within one month, by a laparoscopic technique in most cases. CONCLUSION: The placement of SEMS arises as a safe and effective alternative to palliative surgery or as a bridge to elective surgery.
Subject(s)
Colorectal Neoplasms/complications , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Stents , Adult , Aged , Aged, 80 and over , Colonoscopy/methods , Female , Humans , Longitudinal Studies , Male , Middle Aged , Palliative Care , Prospective Studies , Treatment OutcomeABSTRACT
INTRODUCTION: The endoscopic placement of self-expanding metallic stents (SEMS) emerges as a therapeutic option for neoplastic colonic obstruction in two situations: as palliative treatment and as a bridge to surgery. The latter can avoid emergency surgery, thus decreasing the rate of ostomies and the mortality and morbidity associated with them. OBJECTIVES: To evaluate the feasibility, safety and benefits of SEMS placement for the treatment of neoplastic colorectal obstruction. MATERIALS AND METHODS: Between August 2008 and June 2012, we included in this prospective, longitudinal, descriptive and observational study all the patients suffering from colorectal neoplasia who were subjected to SEMS placement by the same group ofendoscopists. Nitinol SEMS were inserted under endoscopic vision and radioscopic control. RESULTS: Twenty seven SEMS were inserted in 27 patients, 61
of them were male and the average age was 70 years old. Symptoms of colonic suboclussion or obstruction were found in 92
of the lesions were located in the left-side colon, 41
of cases were performed on an ambulatory basis and 65
of stenting was carried out for palliative purposes. The average time of hospitalization was 6,46 days. Technical and clinical success were 93
, respectively. Minor complications were observed in 11
of patients. Colonic stenting was followed by elective surgery within one month, by a laparoscopic technique in most cases. CONCLUSION: The placement of SEMS arises as a safe and effective alternative to palliative surgery or as a bridge to elective surgery.
Subject(s)
Colorectal Neoplasms/complications , Intestinal Obstruction/surgery , Intestinal Obstruction/etiology , Stents , Adult , Colonoscopy/methods , Palliative Care , Longitudinal Studies , Prospective Studies , Female , Humans , Aged , Male , Middle Aged , Treatment OutcomeABSTRACT
INTRODUCTION: The endoscopic placement of self-expanding metallic stents (SEMS) emerges as a therapeutic option for neoplastic colonic obstruction in two situations: as palliative treatment and as a bridge to surgery. The latter can avoid emergency surgery, thus decreasing the rate of ostomies and the mortality and morbidity associated with them. OBJECTIVES: To evaluate the feasibility, safety and benefits of SEMS placement for the treatment of neoplastic colorectal obstruction. MATERIALS AND METHODS: Between August 2008 and June 2012, we included in this prospective, longitudinal, descriptive and observational study all the patients suffering from colorectal neoplasia who were subjected to SEMS placement by the same group ofendoscopists. Nitinol SEMS were inserted under endoscopic vision and radioscopic control. RESULTS: Twenty seven SEMS were inserted in 27 patients, 61
of them were male and the average age was 70 years old. Symptoms of colonic suboclussion or obstruction were found in 92
of patients, 88
of the lesions were located in the left-side colon, 41
of cases were performed on an ambulatory basis and 65
of stenting was carried out for palliative purposes. The average time of hospitalization was 6,46 days. Technical and clinical success were 93
and 100
, respectively. Minor complications were observed in 11
of patients. Colonic stenting was followed by elective surgery within one month, by a laparoscopic technique in most cases. CONCLUSION: The placement of SEMS arises as a safe and effective alternative to palliative surgery or as a bridge to elective surgery.
Subject(s)
Colorectal Neoplasms/complications , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Stents , Adult , Aged , Aged, 80 and over , Colonoscopy/methods , Female , Humans , Longitudinal Studies , Male , Middle Aged , Palliative Care , Prospective Studies , Treatment OutcomeABSTRACT
La invaginación de colon es una causa poco frecuente de oclusión intestinal en el adulto, en los casos que se presenta, en su mayoría, es por patología orgánica y en general el diagnóstico se hace durante la cirugía. En este trabajo se presentan dos casos de intususcepción colónica secundarios a patología neoplásica y su resolución. Consideramos que la resección quirúrgica es el tratamiento de elección.
Colonic intussusception is a rare cause of bowel obstruction in adults. Mostly it is secondary to organic pathology and diagnosis is usually made during surgery. We present two cases of colonic intussusception due to neoplastic disease and its resolution. Surgical resection was the treatment of choice.
