A report of a 67-year-old man, who had been suffering from an enterocutaneous fistula after a left hemicolectomy due to colon cancer is presented. He had sudden intermittent upper abdominal pain and a high amylase level in the drainage fluid. The fistulogram showed a colocutaneous fistula with an abnormal cavity in the left upper quadrant. ERCP was performed to demonstrate the relationship between the pancreatic duct and the colocutaneous fistula connected with the abnormal cavity, and showed a pancreatico-colo fistula which was connected with the abnormal cavity. From the results of the above two studies, a diagnosis of the pancreatico-colocutaneous fistula could be drained, and a distal pancreatectomy, splenectomy and closing of the colonic opening were performed. After the operation, the patient was discharged without problem. We report herein a case of pancreaticocolocutaneous fistula which was confirmed by ERCP preoperatively and surgically treated successfully.
Aged ; Colonic Diseases/*radiography/surgery ; Fistula/*radiography/surgery ; Humans ; Male ; Pancreatic Fistula/*radiography/surgery

The definition of volvulus is an axial twist of a portion of the gastrointestinal tract along its mesentery. The involved bowel is obstructed partially or completely with a variable degree of arterial and venous occlusion. The colon is the most common site for volvulus. The splenic flexure is the least common site of colonic volvulus. We experienced a case of the volvulus of the splenic flexure. It will be the 30th case of the volvulus involving the splenic flexure in the English literature, to our knowledge. A 30-year-old woman was admitted due to abdominal pain and distention with vomiting. An emergency barium study revealed characteristic "bird beak" sign. Surgery was performed resecting the involved colon of splenic flexure. The result was excellent.
Adult ; Barium Sulfate/diagnostic use ; Case Report ; Colonic Diseases/*radiography ; Female ; Human ; Intestinal Obstruction/*radiography

The association of anisakiasis of the colon with colon cancer is rare and difficult to diagnose. Only one case of this type has been reported to date. In this study, we report a case of synchronous colon cancer and colonic anisakiasis. A 50-year-old woman was admitted for abdominal pain, and a volume-rendered surface-shaded image of CT colonography (CTC) revealed a concentric narrowing in the sigmoid colon and a segmental fold thickening in the ascending colon. A total colectomy was performed and the diagnosis of synchronous sigmoid colon cancer and anisakiasis of the ascending colon was confirmed. This case is the first reported visualization of synchronous colon cancer and colonic anisakiasis on a CTC.
Adenocarcinoma/*complications/*radiography/surgery ; Anisakiasis/*complications/*radiography/surgery ; Colectomy ; Colonic Diseases/*complications/*radiography/surgery ; *Colonography, Computed Tomographic ; Female ; Humans ; Middle Aged ; Sigmoid Neoplasms/*complications/*radiography/surgery

Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by multiple gas filled cysts in the intestinal wall. The diagnosis of PCI is usually made by colonoscopy, histology, or radiologic findings. We report a case of PCI in a 35-year-old man. The patient initially complained of watery diarrhea and abdominal bloating for 2 weeks. Simple abdominal X-ray demonstrated numerous, small, round, air densities on the right upper abdomen along the ascending and proximal transverse colon. Colonoscopy revealed numerous, 5-20 mm sized, sessile polypoid, balloon-like distended, protruding subepithelial masses covered with normal colonic mucosa from cecum to proximal transverse colon. We performed a CT colonoscopy and confirmed PCI with multiple air-filled cystic masses along the colonic wall from cecum to proximal transverse colon. The patient was treated with antibiotics and oxygen inhalation for 2 weeks. Follow-up CT colonoscopy revealed marked regression in the number and size of the air-filled cystic masses. Herein, we report the first case of the PCI in Korea diagnosed by CT colonoscopy. Follow-up evaluation with CT colonoscopy was performed after the treatment of the PCI. CT colonoscopy is a useful non-invasive diagnostic tool for the diagnosis of pneumatosis cystoides intestinalis.
Adult ; Colonic Diseases/pathology/radiography ; *Colonography, Computed Tomographic ; Humans ; Intestinal Mucosa/pathology ; Male ; Pneumatosis Cystoides Intestinalis/*pathology/radiography

No abstract available.
Acidosis ; Adult ; Colonic Diseases/radiography ; Gastrointestinal Tract/*surgery ; Humans ; Intestinal Fistula/*radiography/*surgery ; Male ; *Tomography, X-Ray Computed

A broad spectrum of colonic complications can occur in patients with colon cancer. Clinically, some of these complications can obscure the presence of underlying malignancies in the colon and these complications may require emergency surgical management. The complications of the colon that can be associated with colon cancer include obstruction, perforation, abscess formation, acute appendicitis, ischemic colitis and intussusception. Although the majority of these complications only rarely occur, familiarity with the various manifestations of colon cancer complications will facilitate making an accurate diagnosis and administering prompt management in these situations. The purpose of this pictorial essay is to review the CT appearance of the colonic complications associated with colon cancer.
Abdominal Abscess/complications/radiography ; Adult ; Aged ; Aged, 80 and over ; Appendicitis/complications/radiography ; Colitis, Ischemic/complications/radiography ; Colon/*radiography ; Colonic Diseases/complications/radiography ; Colonic Neoplasms/*complications/*radiography ; Female ; Humans ; Intestinal Diseases/*complications/*radiography ; Intestinal Obstruction/complications/radiography ; Intussusception/complications/radiography ; Male ; Middle Aged ; Tomography, X-Ray Computed/*methods

Intestinal malrotation is a congenital disorder that results from the failure of normal bowel rotation and fixation during the 5th gestational week. The incidence of intestinal malrotation is <0.2%, but prompt diagnosis is important because this anomaly can cause midgut volvulus and lead to fatalities. Compared to infants presenting with acute symptoms, such as abdominal pain, vomiting, or diarrhea, adult patients complain of intermittent self-limited abdominal pain. We present a case of intestinal malrotation complicated by midgut volvulus improved with conservative care in a 70-year-old man. The diagnosis was suggested on the basis of imaging findings.
Aged ; Angiography ; Colonic Diseases/*diagnosis/radiography ; Diagnosis, Differential ; Humans ; Intestinal Volvulus/*diagnosis/radiography ; Male ; Mesenteric Artery, Superior/radiography ; Tomography, X-Ray Computed

OBJECTIVE: We wanted to evaluate the efficacy of stent placement using the coaxial technique with a stiff, long introducer sheath in patients with technical failure using an angiographic catheter for the obstructions proximal to the descending colon. MATERIALS AND METHODS: Self-expandable metallic stent placement was attempted under fluoroscopy-guidance in 77 consecutive patients who had malignant colorectal obstruction. Stent placement was performed using an angiographic catheter and a guide wire. If the angiographic catheter could not be advanced over the guide wire into the obstructive lesions proximal to the descending colon, then a 6-Fr introducer sheath was used. The technical success rate, the clinical success rate and the complications were analyzed. RESULTS: Successful stent placement was achieved in 75 of 77 patients (97%). The angiographic catheter failed to advance into the obstructive lesions of 11 patients (M:F = 7:4; mean age, 65.5 years) whose lesions were at the level of the splenic flexure or transverse colon. Therefore, the coaxial technique was implemented in all these 11 patients using a 6-Fr stiff introducer sheath and then the stent placement was successful. There were no complications related to the use of a stiff introducer sheath. Clinical success, which was defined as relief of clinical obstructive bowel symptoms, was obtained within 24 hours in all of patients. CONCLUSION: The coaxial technique using a stiff introducer sheath can increase the technical success of fluoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon.
Adult ; Aged ; Aged, 80 and over ; *Catheters ; *Colon, Descending ; Colonic Diseases/etiology/*therapy ; Colonic Neoplasms/complications ; Female ; *Fluoroscopy ; Humans ; Intestinal Obstruction/etiology/*therapy ; Male ; Middle Aged ; *Radiography, Interventional ; *Stents

Primary adenosquamous carcinoma of the liver is generally considered as an extremely rare subtype of cholangiocarcinoma. It has been reported mostly in a form of case studies. As far as we know, there was only one case report on tumor related with biliary fistula. Recently, we experienced a case of primary adenosquamous carcinoma of liver with a formation of tumor-colonic fistula. A 54-year-old man was transferred to our hospital due to liver mass detected by abdominal ultrasonogram. Dynamic computed tomogram of liver showed a large irregular hypodense mass without rim enhancement in right lobe of liver and also suggested a fistula formation between the tumor and hepatic flexure of right colon. Colonoscopic examination showed a large colonic wall defect in hepatic flexure and a friable, nodular mucosa around the defected colonic wall. Extended right lobectomy and right hemicolectomy were done. Microscopically, the tumor was composed of squamous cell carcinoma mainly with foci of the adenocarcinoma component.
Carcinoma, Adenosquamous/*pathology/radiography/surgery ; Colonic Diseases/*pathology ; Colonoscopy ; Humans ; Intestinal Fistula/*pathology ; Liver Neoplasms/*pathology/radiography/surgery ; Male ; Middle Aged ; Tomography, X-Ray Computed

No abstract availble
Adenocarcinoma/*diagnosis/radiography ; Aged ; Anus Diseases/complications ; Colon, Ascending ; Colonic Neoplasms/*diagnosis/radiography ; *Colonography, Computed Tomographic ; *Colonoscopy ; Constriction, Pathologic ; Humans ; Male ; Tomography, X-Ray Computed