The occurrence of a fistula between the duodenum and the colon is very rare, although these two structures commonly lie in intimate relationship to each other. It is not uncommon for tumor of the right colon and proximal transverse colon to involve the duodenum by continuity, but fistulous connection between the duodenum and colon are infrequent In most of the reported malignant cases, the fistulas follow carcinomas of the transverse colon or the hepatic flexure of the colon. We report a rare case of malignant duodenocolic fistula which was first suspected by endoscopic examination and confirmed by operation.
Colon ; Colon, Transverse ; Duodenum ; Endoscopy* ; Fistula*

When patients present with malignant cologastric fistulas, the tumor stage is often advanced and management is only palliative. We report the case of a 75-year-old man with a symptomatic cologastric fistula arising from an advanced tumor in the transverse colon, previously stented owing to malignant obstruction. An 8-cm-long covered self-expanding metal stent (COMVI enteral colonic stent; Taewoong Medical) was placed inside the primary stent, which sealed the fistula and completely alleviated the symptoms. Considering the successful outcome, we propose that insertion of a covered stent be considered in the palliative management of patients with malignant cologastric fistulas.
Aged ; Colon ; Colon, Transverse ; Fistula* ; Humans ; Stents*

A colon lipoma is a remarkably rare tumor. In most cases, the tumors are asymptomatic and small in size, need to be differentiated from malignant tumors, and do not need any special treatment. Selection of the right surgical strategy depends on the status of bowel, as well as the size and the location of tumor. We encountered two patients with giant submucosal lipomas that had induced intussusceptions: one with a lipoma in the transverse colon and the other with a lipoma in the ascending colon. The diagnoses were made by using histological examinations. We report the clinical features, diagnoses, and treatments of, as well as our experience with, these two uncommon cases, and we present a review of the literature on this subject.
Colon* ; Colon, Ascending ; Colon, Transverse ; Diagnosis ; Humans ; Intussusception* ; Laparoscopy ; Lipoma*

Intestinal intussusception in adults is a rare disease. Most of the cases of adult intussusception are secondary to a definable lesion, and so surgical treatment generally needed. Intussusception that occurs after colonoscopic polypectomy is apparently a rare malady. A 77-year old man undergoing colonoscopic polypectomy was diagnosed as having colonic intussusception at the hepatic flexure. As there was no clinical improvement with conservative treatment, he underwent segmental resection of the ascending and transverse colon. Pathologic examination revealed that the colonoscopic polypectomy site was a leading point of the intussusception.
Adult ; Colon ; Colon, Transverse ; Colonoscopy ; Humans ; Intussusception ; Rare Diseases

The association of congenital colonic atresia with imperforate anus is extremely rare. The authors were able to find only three case on our investigation of the English literature. We have recently managed a female infant with imperforate anus associated with atresia of the transverse colon.
Anus, Imperforate* ; Colon* ; Colon, Transverse ; Female ; Humans ; Infant

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*

PURPOSE: Colonoscopy is a relatively safe procedure. However, various complications, such as hemorrhage or perforation, can occur, and among them, perforation can lead to death. This study was designed to evaluate the clinical characteristics and the treatment of colonoscopic perforation, as well as the availability of conservative treatment as the initial management. METHODS: We reviewed the medical records of the 11 patients who had been treated for colonoscopic perforation from May 2003 to April 2005. RESULTS: Six perforations were related to diagnostic colonoscopy whereas five occurred from therapeutic colonoscopy. The sigmoid colon was the most common perforation site (6 patients), followed by the cecum 2 patients and the transverse colon, splenic flexure, and the rectum 1 patient each. Five patients were diagnosed during colonoscopy. Six patients were diagnosed 12~48 hours after the colonoscopy. Three patients who showed definite signs of peritonitis underwent emergency operations. A conservative treatment was done in eight patients; among them, one patient had an operation on the 3rd. day after the perforation. The remaining seven patients underwent conservative treatment and were followed for up to 1 month without complications. Among these patients, one patient had a recurrent perforation on the 33rd day after the initial perforation, and an operation was done. CONCLUSIONS: These results suggest that conservative treatment in patients with colon perforations is safe and effective unless there are obvious signs of generalized peritonitis.
Cecum ; Colon ; Colon, Sigmoid ; Colon, Transverse ; Colonoscopy ; Emergencies ; Hemorrhage ; Humans ; Medical Records ; Peritonitis ; Rectum

We report herein three cases of inflammatory myoglandular polyp (IMGP) presenting as hematochezia. The polyps had pedunculated, red, and smooth features, and were 12, 12, and 15 mm in diameter and located in the sigmoid colon, transverse colon, and rectum, respectively. Endoscopic polypectomies were performed. Histologic examination of the recovered specimens revealed inflammatory granulation in the lamina propria mucosa, proliferation of smooth muscle, and hyperplastic glands with cystic dilatation. The three colon polyps were finally diagnosed both clinically and histologically as IMGP. Endoscopists should bear in mind that a polyp featuring endoscopic findings of pedunculation or semipedunculation; a red, smooth, spherical, and hyperemic surface; and patchy mucosa exudation and erosion is likely to be an IMGP.
Colon ; Colon, Sigmoid ; Colon, Transverse ; Dilatation ; Gastrointestinal Hemorrhage ; Mucous Membrane ; Muscle, Smooth ; Polyps ; Rectum ; Ursidae

The condition of an idiopathically dilated colon appears to be clinically heterogenous, very uncommon, and subsequently often poorly managed. Recently, one case of idiopathic megacolon presented by constipation was investigated. The patient was abruptly constipated 6 months prior to the hospital visit. The results of a barium enema and colonoscopy were nonspecific. On plain abdominal radiographs, the ascending and transverse colon were markedly dilated, and the descending colon was not visible. During the conservative management, which included laxative and prokinetic medication, the clinical symptoms and the colonic dilatations on plain radiographs were reduced, and discharged. After that however, repetitive admissions due to abdominal distension and constipation ensued, and therefore a total colectomy was performed in order to improve the patient's quality of life.
Barium ; Colectomy ; Colon ; Colon, Descending ; Colon, Transverse ; Colonoscopy ; Constipation* ; Dilatation ; Enema ; Humans ; Megacolon* ; Quality of Life

The condition of an idiopathically dilated colon appears to be clinically heterogenous, very uncommon, and subsequently often poorly managed. Recently, one case of idiopathic megacolon presented by constipation was investigated. The patient was abruptly constipated 6 months prior to the hospital visit. The results of a barium enema and colonoscopy were nonspecific. On plain abdominal radiographs, the ascending and transverse colon were markedly dilated, and the descending colon was not visible. During the conservative management, which included laxative and prokinetic medication, the clinical symptoms and the colonic dilatations on plain radiographs were reduced, and discharged. After that however, repetitive admissions due to abdominal distension and constipation ensued, and therefore a total colectomy was performed in order to improve the patient's quality of life.
Barium ; Colectomy ; Colon ; Colon, Descending ; Colon, Transverse ; Colonoscopy ; Constipation* ; Dilatation ; Enema ; Humans ; Megacolon* ; Quality of Life