This is a case report on a stercoral perforation of the descending colon that was not adequately treated in the first operation. Re-operation was required in order to revise the primary repair site and to remove the impacted fecaloma.
Colon, Descending

No abstract available.
Colon, Descending* ; Leiomyosarcoma*

No abstract available.
Carcinoma, Renal Cell* ; Colon, Descending* ; Neoplasm Metastasis*

Humans ; Colon, Descending ; Dendritic Cell Sarcoma, Follicular

Percutaneous cecostomy is an uncommon procedure but is reported as an effective temporising measure to achieve acute decompression of bowel obstruction. It has been reported as a safe procedure in the setting of bowel obstruction providing relief of symptoms. The insertion of a cecostomy in the distal colon is not routinely advised as it will not allow passage of formed faeces. Cases of antegrade stenting of proximal colonic obstruction via cecostomy have been described; however, antegrade stenting of the distal colon from access in the ascending colon can be technically challenging. We describe a case of a percutaneous colostomy inserted temporally at the splenic flexure, which provided close access to an obstructing descending colonic tumour, allowing definitive management with placement of a colonic stent. This technical feasibility case provides evidence that a temporary cecostomy placed in the distal colon can be performed as a measure to facilitate definitive management.
Cecostomy ; Colon* ; Colon, Ascending ; Colon, Descending ; Colon, Transverse ; Colostomy ; Decompression ; Stents*

BACKGROUND/AIMS: The purpose of this study was to discover the physiologic difference of a postprandial motor response in different segments of the colon between patients with irritable bowel syndrome and healthy subjects. METHODS: Irritable bowel syndrome patients are categorized into three groups according to their main symptoms; loose stool-dominant (A, n=5), abdominal pain-dominant (B, n=5), constipation-dominant (C, n=6) and the normal control group (n=5). The intraluminal pressure activity was measured with a colonoscopically positioned multilumen manometric catheter. The change of the colonic motility index (MI) is presented as a percent change (mean+/-SE%) over the basal period in response to a meal. RESULTS: 1) In the transverse, descending and sigmoid colon of healthy subjects, the percentage changes in the basal MI during the first 30 min after the meal are significantly increased (p < 0.05-0.01). 2) In the sigmoid colon, the percentage changes in the basal MI during the first 30 min after the meal were 62+/-18 in A, 29+/-18 in B, 12+/-8 in C and 306+/-102% in heathy subjects respectively, which shows a significant difference between the MI of control and healthy subjects (p < 0.05). 3) In B and C, the percentage changes in the basal MI during the first 30 min after the meal in the descending colon were 105+/-38, 11+/-7, respectively, which shows a significant difference between the two groups (p < 0.05). In A and C, the percentage changes in the basal MI during the first 30 min after the meal in the sigmoid colon was 62+/-18, 12+/-8, respectively, which shows a significant change between the two groups (p < 0.05). CONCLUSION: This study suggests that postprandial intraluminal pressure differences play a role in the pathophysiology of irritable bowel syndrome.
Catheters ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Humans ; Irritable Bowel Syndrome* ; Meals ; Motor Activity*

Malignant colonic obstruction can lead an emergency operation for decompression, and this can cause post-operative complications due to poor bowel preparation. Self-expandable metal stent (SEMS) insertion is useful for avoiding an emergency operation and unnecessary complications. However, SEMS insertion for dual malignant colonic obstructions is very rare. We report here on a case of two SEMS that were inserted in dual malignant colonic obstructions caused by synchronous colon cancer. A 66-year-old man visited our hospital due to abdominal distension. Sigmoidoscopy and an abdominopelvic computerized tomographic (CT) scan revealed synchronous colon cancer at the splenic flexure and distal descending colon with dual obstruction. The initial SEMS insertion on the descending colon was not effective for decompression due to the proximal obstruction. After the second SEMS insertion on the splenic flexure through the first stent, all the signs and symptoms due to obstruction disappeared. SEMS insertion is considered to be useful for treating dual malignant colonic obstruction caused synchronous colon cancer.
Aged ; Colon ; Colon, Descending ; Colon, Transverse ; Colonic Neoplasms ; Decompression ; Emergencies ; Humans ; Sigmoidoscopy ; Stents

PURPOSE: Depressed colorectal cancer is a newly recognized colorectal cancer. It has the characteristics of rapid growth and early invasion of the submucosa. Accordingly, recognition of that lesion is important. However, it is still rarely detected in Korea. This study was designed to evaluate the characteristics of depressed colorectal neoplastic lesions. METHODS: We experienced 22 cases of depressed neoplastic lesions from January 1997 to December 1998. All of them were detected by performing colonoscopy. Among them, 6 were early colorectal cancers. The twenty-two cases accounted for 1.3% of all neoplastic lesions but advanced colorectal cancers encountered during the same period, and the six accounted for 6.6% of all early colorectal cancers during that period. We reviewed and analyzed those 22 lesions with respect to their clinicopathologic characteristics, especially size and histology. RESULTS: The most common age group was the 6th decade. The male-to-female ratio was 2.7 to 1. The predilection of sites were the descending colon, the transverse colon, and the sigmoid colon in that order. The most common size was 3~4 mm, 9 lesions (40.9%) and the next was 5~6 mm, 7 lesions (31.8%). Twenty lesions (90.9%) were 8 mm or smaller in size. The overall malignancy rate was 27.3% (6/22), comprising 9.1% (2/22) for mucosal cancers, and 18.2% (4/22) for submucosal ones. The two lesions which were larger than 10 mm were submucosal cancers. Endoscopic mucosal resection (EMR) was the most common type of treatment, accounting for 59.1%. Two submucosal cancers and one mucosal cancer were operated on without any endoscopic treatment. That one mucosal cancer had initially been suspected of being a submucosal one upon endoscopic examination. There were neither complications nor recurrences during the average 10-month follow-up. CONCLUSIONS: The target for detecting and treating depressed colorectal cancer should be lesions below 10 mm in size, and the treatment of choice should be EMR.
Colon, Descending ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Colorectal Neoplasms ; Diagnosis* ; Follow-Up Studies ; Humans ; Korea ; Recurrence

BACKGROUND/AIMS: The aim of this study was to evaluate the role of an intraoperative colonoscopy for a single stage operation in patients with a left-side colon cancer obstruction. METHODS: From September 1999 to August 2002, 62 patients (mean age=61+/-14 year old, M:F=30:32) underwent an intraoperative colonoscopy during a single stage operation for a left side colon cancer. Intraoperative colonic irrigation method and colonoscopy with NICI (new intraoperative colonic irrigator, MITech Co., Ltd, Seoul, Korea) were used. RESULTS: The locations of the left-side colon cancers were the rectum in 33 (53.2%), sigmoid colon in 20 (32.3%), and descending colon in 9 (14.5%). Synchronous polyps were found in 31 patients (50%). Six patients (9.7%) had a synchronous colon cancer and 2 (3.2%) had a high grade dysplasia. Of these 62 patients, 11 (17.7%) required more extensive surgery than dictated by the primary tumor. Altered operative methods were a total colectomy in 2 patients, an extended resection in 8 patients, and a wedge resection in 1 patient. CONCULSIONS: An intraoperative colonoscopy in patients with a left-side colon cancer is a useful adjunct in diagnosing a synchronous lesions, which should allow a more appropriate surgical procedure.
Colectomy ; Colon* ; Colon, Descending ; Colon, Sigmoid ; Colonic Neoplasms* ; Colonoscopy* ; Humans ; Polyps ; Rectum ; Seoul

BACKGROUND/AIMS: Comparative studies of colon polyps between right and left colon in Korean population are limited. We investigated the clinical characteristics of the patients according to polyp location and compared the results of the morphological and histological analysis of right and left colon polyps. METHODS: The study was performed prospectively for the patients who underwent colon polypectomy for health check-ups in a single tertiary center. The patients were classified into three groups by the location of the polyps: right group (from the cecum to the splenic flexure), left group (from the descending colon to the anus), and total group. The size, the morphology, the location and the pathology of the polyps were evaluated. RESULTS: From June 2010 to June 2011, Overall 2596 polyps from 950 patients (male=646) were analyzed. Colon polyps were right side-shift with increased patients age (P<0.001). The incidence of polyps was most common in sigmoid colon (26.5%). Polyps less than 5 mm size were more common in left colon (P<0.001) and flat polyps larger than 1 cm in right colon (P=0.006), respectively. In histopathological findings, the distribution of advanced adenoma was not different according to the location, however tubular adenomas and serrated adenomas (P<0.001) were more common in right colon. Female was more distributed in right group, respectively (P<0.001). CONCLUSIONS: In a single center study, colon polyps were more distributed in right colon with age and in females. Also flat polyps larger than 1cm, tubular adenoma and serrated adenoma were found in larger proportion in right colon.
Adenoma ; Cecum ; Colon ; Colon, Descending ; Colon, Sigmoid ; Female ; Humans ; Incidence ; Polyps ; Prospective Studies