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colonic perforation

Hanish Kataria, Abhinav Seth, Ashok Kumar Attri, Raj Pal Singh Punia
Amebiasis is common in tropical and developing countries with variable symptoms. Ameboma of the colon occurs rarely due to the annular growth of granulation tissue and can present as mass lesion simulating colonic carcinoma in elderly individuals. Due to diagnostic dilemma or in case of complications, for example, acute intestinal obstruction, perforation, or bleeding per rectum, the patient requires urgent surgical exploration and final diagnosis is made on histopathological examination.
January 2018: International Journal of Applied and Basic Medical Research
Asim Shuja, Amie Deutch
No abstract text is available yet for this article.
February 20, 2018: Digestive and Liver Disease
Maximilian Sohn, I Iesalnieks, A Agha, P Steiner, A Hochrein, J Pratschke, P Ritschl, F Aigner
PURPOSE: Optimal surgical management of perforated diverticulitis of the sigmoid colon has yet to be clearly defined. The purpose of this study was to evaluate efficacy of a "Damage Control Strategy" (DCS). MATERIALS AND METHODS: Patients with perforated diverticulitis of the sigmoid colon complicated by generalized peritonitis (Hinchey III and IV) surgically treated according to a damage control strategy between May 2011 and February 2017 were enrolled in the present multicenter retrospective cohort study...
March 14, 2018: World Journal of Surgery
M A Sohn, A Agha, P Steiner, A Hochrein, M Komm, R Ruppert, P Ritschl, F Aigner, I Iesalnieks
PURPOSE: Damage control strategy (DCS) is a two-staged procedure for the treatment of perforated diverticular disease complicated by generalized peritonitis. The aim of this retrospective multicenter cohort study was to evaluate the prognostic impact of an ongoing peritonitis at the time of second surgery. METHODS: Consecutive patients who underwent DCS for perforated diverticular disease of the sigmoid colon with generalized peritonitis at four surgical centers were included...
March 13, 2018: International Journal of Colorectal Disease
Motohiro Tamiya, Hidekazu Suzuki, Takayuki Shiroyama, Ayako Tanaka, Naoko Morishita, Norio Okamoto, Kenichi Sakai, Hironori Shigeoka, Kunimitsu Kawahara, Tomonori Hirashima
Background Bevacizumab (Bev) is generally well-tolerated, and Bev-associated intestinal perforation (BAP) is a rare albeit serious side effect in cases of non-small cell lung cancer (NSCLC). Therefore, the present study aimed to identify clinical predictors of BAP to help predict and manage the development of life-threatening intestinal complications among patients receiving Bev. Methods This retrospective study evaluated demographic, clinical, and treatment factors for patients with NSCLC who were treated with Bev between February 2010 and August 2015 at our center...
March 14, 2018: Investigational New Drugs
Taeyoung Yoo, Keun Ho Yang, Jungbin Kim, Inseok Park, Hyunjin Cho, Geumhee Gwak, Byung Noe Bae, Ki Hwan Kim
Purpose: The aim of this study is to determine the predictable factors that affect the clinical course, especially the hospital stay, the operation performed, and to determine factors that will be helpful in deciding whether in-hospital or outpatient treatment is appropriate. Methods: We retrospectively collected medical data for patients who had been diagnosed with acute diverticulitis at Inje University Sanggye Paik Hospital between January and December 2016. In total, 117 patients were enrolled in this study...
February 2018: Annals of Coloproctology
Jae Ho Park, Kyung Jong Kim
Purpose: The management of a colonoscopic perforation (CP) varies from conservative to surgical. The objective of this study was to evaluate the outcomes between surgical and conservative treatment of patients with a CP. Methods: From 2003 to 2016, the medical records of patients with CP were retrospectively reviewed. Patients were divided into 2 groups depending on whether they initially received conservative or surgical treatment. Results: During the study period, a total of 48 patients with a CP were treated...
February 2018: Annals of Coloproctology
Bryan R Anderson, Jaron Marriott, Chinthaka Bulathsinghala, Humayun Anjum, Salim Surani
Introduction: Gastrointestinal histoplasmosis (GH) is a well-described albeit uncommon disease. It is found almost exclusively in the immunocompromised host, especially those with untreated HIV and low CD4 counts. Presentation with intestinal perforation is seen mostly commonly in the colon. We present a patient with jejunal perforation, and there have been only 3 previous cases reported in the literature. Case: A 39-year-old male with known, untreated HIV presented to the ED with an acute abdomen after experiencing worsening intermittent abdominal pain for 2 months before that was associated with nausea, vomiting, diarrhea, and weight loss...
2018: Case Reports in Medicine
Reuban Toby D'cruz, Cheryl Chien-Li Lau, Thomas Paulraj Thamboo
Cytomegalovirus (CMV) typically causes gastrointestinal infections in immunocompetent patients. Colonic perforations secondary to CMV are exceeding rare. We describe a 88-year-old male presenting with a week-long history of intractable abdominal discomfort, bloating, nausea and diarrhea. Flexible sigmoidoscopy revealed significant ulceration with yellowish slough. Emergency surgery was performed subsequently in view of multiple perforations in the rectosigmoid junction. CMV gastrointestinal infections demonstrated an ischemic process secondary to vasculitis, which accelerated the pathway to colonic perforation...
March 12, 2018: Archives of Virology
Yukihiro Kaneko, Ken-Ichi Oinuma, Tsuneko Terachi, Yasuaki Arimura, Mamiko Niki, Koichi Yamada, Hiroshi Kakeya, Tetsu Mizutani
A 53-year-old woman was hospitalized due to septic shock after developing pneumococcal pneumonia after undergoing esophageal cancer surgery. Her transverse colon became perforated after receiving antimicrobial chemotherapy; therefore, emergency subtotal colectomy was performed. Fungi detected in both her colon tissue and a drainage sample indicated intestinal mucormycosis. Early intensive treatment with high-dose liposomal amphotericin B was successful, and she was subsequently discharged from the hospital...
March 9, 2018: Internal Medicine
Anthony B El-Khoueiry, Robert O'Donnell, Thomas J Semrad, Philip Mack, Suzette Blanchard, Nathan Bahary, Yixing Jiang, Yun Yen, John Wright, Helen Chen, Heinz-Josef Lenz, David R Gandara
PURPOSE: The insulin-like growth factor (IGF) pathway is activated in hepatocarcinogenesis. Cixutumumab is a monoclonal antibody against human insulin-like growth factor-1 receptor (IGF-1R). Given the cross-talk between the IGF and VEGF pathways, we performed a phase I study of the combination of cixutumumab and sorafenib in hepatocellular cancer (HCC). METHODS: Eligible patients with no prior systemic therapy for advanced HCC and Child-Pugh A to B7 were treated with sorafenib 400 mg BID and escalating doses of cixutumumab (2, 4, or 6 mg/kg IV weekly) in a 3 + 3 design...
March 8, 2018: Cancer Chemotherapy and Pharmacology
Susan Yoong, Ravi Kothari, Adam Brooks
INTRODUCTION: Whole body computed tomography has become standard practice in many centres in the management of severely injured trauma patients, however, the evidence for it's diagnostic accuracy is limited. AIM: To assess the sensitivity of whole body CT in major trauma. METHOD: Retrospective review of all patients with injury severity score (ISS) > 15 presenting with blunt trauma to a UK Major Trauma Centre between May 2012 and April 2014...
March 8, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Daryl Ramai, Andrew Ofosu, Madhavi Reddy
Gastric diverticula represent the rarest of gastrointestinal diverticula. While similar to duodenal, jejunal and colonic diverticula, gastric diverticula are found incidentally upon upper endoscopy and are mostly asymptomatic. However, larger diverticula can lead to symptoms such as upper abdominal pain, nausea, emesis, and dyspepsia. Some patients may present with dramatic presentations including ulceration, hemorrhage, or perforation. Clinicians should be aware that diagnostic imaging may not always detect the presence of gastric diverticula...
February 2018: Gastroenterology Research
George Tribonias, Niki Daferera, Margarita-Eleni Manola, Rikard Svernlöv, Simone Ignatova, Henrik Hjortswang
Background and study aims  We describe a case of perforation after colonic endoscopic mucosal resection (EMR) that was treated conservatively. We would like to highlight the importance of decision-making mainly based on the endoscopist's point of view in combination with the surgical consultation. Although the radiological imaging is always needed, it cannot solely lead to a decision for operation. Intraperitoneal gas in computed tomography is not always associated with a hole in the endoscopic field and could be possibly explained from a "balloon" phenomenon...
March 2018: Endoscopy International Open
C Sabbagh, N Siembida, T Yzet, B Robert, C Chivot, F Browet, F Mauvais, J M Regimbeau
AIM: In the presence of large bowel obstruction, the choice of treatment is determined by the patient's general status, tumour characteristics, and the perceived risk of of caecal perforation.. This study was designed to evaluate the t predictive factors of impending caecal perforation, and also investigated the the use of caecal volumetry. METHOD: From January 2011 to June 2016, patients with obstructive distal colon cancer, undergoing emergency laparotomy, for whom a pretreatment CT scan was available, were included in this retrospective, case control, two-centre study...
March 1, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Toshiaki Aida, Masayuki Shiobara, Kazuo Wakatsuki, Shuka Arai, Kosuke Suda, Kotaro Miyazawa, Tetsutaro Miyoshi, Yoshihisa Takahashi, Shigeru Yoshioka
The patient was a 70-year-old man. He was diagnosed with advanced transverse colon cancer. A computed tomography (CT)revealed liver metastasis and tumor thrombosis of portal vein. We started combination chemotherapy with capecita- bine/oxaliplatin(CapeOX). Perforation of the tumor was observed 5 days after CapeOX therapy was started. Treatment with abscess drainage and ileostmy, infection was controlled and general condition was improved. After 9 courses of CapeOX, we changed chemotherapy regimen to irinotecan/tegafur-gimeracil-oteracilpotassium (IRIS)due to strong side effects...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Teppei Kono, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Masaya Satake, Yasufumi Yamada, Arika Ida, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Kazuhiko Yoshimatsu, Takeshi Shimakawa, Takao Katsube, Hiroyuki Kato, Yoshihiko Naritaka
The patient was 55-year-old woman, undergoing Hartmann operation by the sigmoid colon diverticulum perforation, 2 years later visited our hospital with abdominal pain. Although lower endoscopy and histological examination could not be performed due to stoma stenosis, we diagnosed cecal carcinoma, liver metastasis, distant lymph node metastasis from CT and PET-CT, CapeOX plus Bmabtherapy and IRIS plus Bmabtherapy were performed. After that, repeated intestinal obstruction due to exacerbated stoma stenosis, metastatic lesion increased in CT examination, furthermore the patient had hope of stoma closure, we decided to resect the primacy tumor, performed subtotal colonectomy and stoma closure...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Megumi Sano, Kazuhiko Yoshimatsu, Shinichi Asaka, Yoshitomo Ito, Rie Imaizumi, Shota Mitsuboshi, Takako Matsumoto, Taro Koike, Yoshihiko Naritaka
INTRODUCTION: we examined the cases in which surgery was performed for the lower intestinal perforation due to peritoneal dissemination in our hospital. SUBJECTS: Four cases of lower intestinal perforation of patients with peritoneal dissemination who underwent emergency operation in our hospital were enrolled. RESULTS: Two males and 2 females patients with median age of 65.5 year old(63-71)were included. The perforated sites were 3 cases of small intestine and 1 case of ascending colon, and the APACHE II score at the visit was 14...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Masakazu Ikenaga, Katsuya Ohta, Masami Ueda, Hiroaki Itakura, Hirotoshi Takayama, Yujiro Tsuda, Shinsuke Nakashima, Shinichi Adachi, Shunji Endo, Terumasa Yamada
We studied the clinicopathological findings of 8 patients with perforated colorectal cancer. Four patients were male. In 7 patients, the primary cancer site was left side colon. Chief complaints were abdominal pain in 7 patients and diarrhea in 1 patient. The emergent operation was performed in all cases. The final stages of 8 patients were as follows: 5 patients with Stage II, 2 patients with Stage III, 1 patient with Stage IV. All patients were discharged from our hospital. Postoperative chemotherapy was performed for 5 patients...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Sala Abdalla, Rupinder Gill, Gibran Timothy Yusuf, Rosaria Scarpinata
While colonoscopy is generally regarded as a safe procedure, colonic perforation can occur and the risk of this is higher when interventional procedures are undertaken. The presentation may be acute or delayed depending on the extent of the perforation. Extracolonic gas following colonic perforation can migrate to several body compartments that are embryologically related and it has previously been reported in the thorax, mediastinum, neck, scrotum, and lower limbs. This review discusses in detail the anatomical pathways that led to a rare case of widespread subcutaneous emphysema, bilateral pneumothoraces, pneumomediastinum, and mediastinal shift from colonic perforation during a diagnostic colonoscopy...
January 2018: Surgery Journal
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