Vesicocolonic fistula is an uncommon but significant complication of inflammatory and neoplastic disease. We report two cases of vesicocolonic fistula in adenocarcinoma of the sigmoid colon with turbid urine and irritative voiding symptoms. A literature review of vesicoenteric fistula is presented.
Adenocarcinoma ; Colon, Sigmoid ; Colonic Neoplasms ; Fistula*

Lumbosacral radiculoplexopathy in colon cancer treatment is a very rare but serious complication after radiation. We report here a 66-year-old man with slowly progressive lower limb weakness which arose 30 years after local radiation treatment for colon cancer. Electrophysiological studies revealed signs of denervation confined to the lower limbs. Other causes were excluded by clinical presentation, serological, cerebrospinal fluid and imaging studies. This case shows that delayed radiation-induced lumbosacral radiculoplexopathy can occur 30 years after the initial treatment.
Colonic Neoplasms

The use of colonoscopy is important to prevent colon cancer. Despite the safety of the colonoscopy procedure, the most common complication of a colonoscopy is perforation, which occurs with a rate of approximately 0.3% during diagnostic colonoscopy and occurs with a rate of approximately 1.1% with the use of therapeutic colonoscopy. Surgery is the treatment of choice for most cases of colonic perforation. With the development of endoscopic devices and techniques, conservative treatment of colonic perforation has been reported by the use of endoscopic clipping. We report here a patient with iatrogenic perforation of the sigmoid colon that was caused by diagnostic colonoscopy. The perforation presented as pneumoretroperitoneum, which was successfully treated with endoscopic clipping.
Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonoscopy ; Humans ; Intestinal Perforation ; Retropneumoperitoneum

PURPOSE: Small (6 to 10 mm) and diminutive colon polyps (below 5 mm) are routinely removed at the time of colonoscopy for the prevention of colon cancer. Our aims in this study were to determine clinicopathologic features and frequency of significant synchronous neoplastic lesions of small colon polyps and diminutive colon polyps and to investigate development of colorectal carcinoma via surveillance colonoscopy. METHODS: We evaluated medical reports of all patients undergoing total colonoscopic examination over a 12-month period. Three hundred thirty nine small colorectal polyps, removed during colonoscopy, have been analyzed. We investigated the result of surveillance colonoscopy, also. Using this database, all adenomas were categorized into two groups: Group I, < or =5 mm diameter (diminutive polyp), Group 2, 6 to 10 mm diameter (small polyp). Significant synchronous adenomas were defined as adenoma over 6 mm diameter, dysplasia or cancer. RESULTS: The most common age group was the sixth decade. The male-to-female ratio was 2.1 : 1. Of the small colorectal polyps, 180 (53.1%) were adenomatous, 32 (10.0%) were hyperplastic, 119 (34.9%) were chronic nonspecific inflammation, 3 (0.9 %) were lymphoid hyperplasia, and 4 (1.1%) were cancerous. The most frequent sites of these lesions were rectum and sigmoid (60.2%). Recognizable endoscopic features of polyps were redness (35.8%) and nodule (26.3%). The prevalence of advanced proximal synchronous polyps was 20.7% among patients with distal small lesions. And we detected 2 cases (25%) had new small polyps in follow up colonoscopic examination. CONCLUSIONS: All polyps should be removed when encountered during colonoscopy due to the higher prevalence of adenoma among these lesions. Effort to find new polyps via surveillance colonoscopy is needed.
Adenoma ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Hyperplasia ; Inflammation ; Polyps* ; Prevalence ; Rectum

A 54-year-old man was transferred with sigmoid colon cancer combined with multiple bilobar liver metastases. Nine metastases were in the left lobe and 5 metastases were in the right lobe. After low anterior resection, all 9 lesions in the left lobe were completely removed by wedge resections. Because the remnant liver volume after multiple wedge resection of the left lobe was not sufficient to perform a right hepatectomy simultaneously, we planned a two-stage hepatectomy. Right portal vein embolization was performed one week after the first liver operation. A right hepatectomy was safely performed 22 days after the first hepatectomy. A recurrent mass developed in the segment III 18 months after the right hepatectomy. Radiofrequency ablation (RFA) was performed to remove that lesion. Five other metastases developed 18 months after RFA whereby multiple wedge resections were performed. The patient has survived for more than 7 years after the first liver operation.
Colon ; Colonic Neoplasms ; Colorectal Neoplasms ; Hepatectomy ; Humans ; Liver ; Middle Aged ; Neoplasm Metastasis ; Portal Vein ; Sigmoid Neoplasms

Transumbilical single-port laparoscopic surgery (SPLS) is a newly emerged and rapidly evolving, minimally invasive treatment method. Transumbilical SPLS produces minimal parietal injury and can achieve cosmetic advantages by reducing additional trocar placement. The in-line or chopstick arrangement of laparoscopic instruments can make the operative procedures somewhat strange and inconvenient at first, but experienced laparoscopic surgeons can achieve the same coverage as conventional laparoscopic surgery with time. Here, we report the first case of transumbilical SPLS anterior resection (SPLS-AR) with transanal retrieval of aspecimen and intracorporeal single stapling anastomosis. The operating time was 270 min. There were no intraoperative or postoperative complications. Transumbilical SPLS resulted in a 1.5-cm wound with early recovery. Transumbilical SPLS-AR with transanal retrieval and intracorporeal anastomosis for sigmoid colon cancer is feasible by experienced laparoscopic colorectal surgeons based on careful evaluation and selection of patients. This operation fulfills both oncological principles and cosmetic demand.
Colon, Sigmoid ; Colonic Neoplasms ; Cosmetics ; Humans ; Laparoscopy ; Postoperative Complications ; Sigmoid Neoplasms ; Surgical Instruments ; Surgical Procedures, Operative

Distant metastasis of a colon carcinoma in situ has not yet been reported. We experienced a case of a sigmoid colon carcinoma in situ with common hepatic lymph node metastasis. After the first operation, we diagnosed dual intramucosal adenocarcinomas of the sigmoid colon without any regional lymph node metastasis. After the second operation, a metastatic adenocarcinoma was found in the common hepatic lymph nodes. We suggest that metastasis in cases of a colonic carcinoma in situ is rare, but possible. The parallel progression model of tumors can explain this early metastasis.
Adenocarcinoma ; Carcinoma in Situ ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Lymph Nodes ; Lymphatic Metastasis ; Neoplasm Metastasis ; Sigmoid Neoplasms*

Familial adenomatous polyposis(FAP) is a rare hereditary disorder characterized by the development of hundreds to thounds polyps throughout the colon and rectum. Moreover, several extracolonic manifestations are seen. Recently, this disease is recognized as a adenomatous polyposis syndrome which can involve the entire astrointestinal tract. Several reports have demonstrated a high incidence of gastroduodenal polyps in patients with familial adenomatous polyposis. These colon polyps can be eventually developed as colon cancer, if not be treated. So early diagnosis is needed and prophylactic surgery should be erformed. We experienced a case of familial adenomatous polyposis with a large sentinel polyp on the sigmoid colon, presenting hematochezia and mucoid diarrhea. He was early treated before progression to carcinoma by total colectomy, rectal mucosectomy and J pouch ileoanal anastomosis.
Adenomatous Polyposis Coli* ; Colectomy ; Colon ; Colon, Sigmoid ; Colonic Neoplasms ; Colonic Pouches ; Diarrhea ; Early Diagnosis ; Gastrointestinal Hemorrhage ; Humans ; Incidence ; Polyps* ; Rectum

BACKGROUND AND AIMS: Colonic polyps are premalignant lesion, whose removal is important for the prevention of colon cancer. METHODS: A series of 116 patients (195 polyps) who undergone colonoscopic polypectomy at Chung Nam National University Hospital from March 1994 to Feb.1997 were analyzed. RESULTS: 1) The ratio of males and females was 81:35, with the average age being in the 60's. 2) Colorectal polyps were found at the rectum (39.5%), sigmoid colon (35.9%). The size of the polyps was less than 0.6 cm in diameter (44.6%), between 0.6 and 1.0 cm (27.7%), between 1.1 and 2.0 cm (22.6%). The number of polyp was single polyp (59.5%). According to the Yamada classification, type III was the most common (43.1%). 3) Histopathologic findings were as follows. Tubular adenomas (58.6%), LSPs was in 3 cases, and malignant changed polyps in 14 case. 4) The malignantly changed polyps peaked in those in their 70's, had sizes ranging between 1.1 and 2.0 cm. Histopathologic finding were villous adenomas (50.0%), tubular adenomas (13.2%), LSPs (33.3%) in orders. CONCLUSION: Although the prevalence of cancer of villous adenomas and LSP was higher than other polyps, the size of the adenomas, their numbers do not seem to influence the malignancy rate in this report.
Adenoma ; Adenoma, Villous ; Classification ; Colon* ; Colon, Sigmoid ; Colonic Neoplasms ; Colonic Polyps* ; Female ; Humans ; Male ; Polyps ; Prevalence ; Rectum

Self-expandable metallic stents are widely used to relieve acute colorectal obstruction that's secondary to malignancy. They are utilized for both palliation and preoperative decompression prior to colorectal surgery. Although stents have been documented as a relatively safe therapeutic modality, procedure-related complications such as perforation, bleeding, stent reobstruction and migration can occur during or after colonic stent placement. Therefore, clinicians must be aware of the various complications associated with colonic stent placement. We present here a very rare case of sigmoidorectal intussusception that developed after fluoroscopic placement of a self-expandable metallic stent for preoperative decompression of sigmoid colon cancer. We misdiagnosed the intussusception as a distal stent migration on the plain radiography. On the sigmoidoscopic examination to evaluate the unrelieved colonic obstruction, we diagnosed a sigmoidorectal intussusception of the stent-implanted malignant tumor. The patient was successfully treated by laparoscopic partial reduction, followed by a curative anterior resection. This case demonstrates that careful examination must be done in cases of unrelieved colonic obstruction with suspicious stent migration, and intussusception must be considered as a rare complication of self-expandable metallic stent placement in the colon.
Colon ; Colonic Neoplasms ; Colorectal Surgery ; Decompression ; Hemorrhage ; Humans ; Intussusception ; Sigmoid Neoplasms ; Stents