Vesicoenteric fistula is a rare complication of bladder squamous cell carcinoma. We report the case of a 70-year-old male who complained of painless, total gross hematuria. Abdominopelvic computed tomography (CT) revealed an approximately 2.7-cm lobulated and contoured enhancing mass in the bladder dome. We performed partial cystectomy of the bladder dome after transurethral resection of the bladder. The biopsy result was bladder squamous cell carcinoma, with infiltrating serosa histopathologically, but the resection margin was free. Postoperatively, follow-up CT was done after 3 months. Follow-up CT revealed an approximately 4.7-cmx4.0-cm lobulated, contoured, and heterogeneous mass in the bladder dome. A vesicoenteric fistula was visible by cystography. Here we report this case of a vesicoenteric fistula due to bladder squamous cell carcinoma.
Aged ; Carcinoma, Squamous Cell/*complications/pathology/radiography ; Fatal Outcome ; Humans ; Intestinal Fistula/*etiology/radiography ; Male ; Sigmoid Diseases/*etiology/radiography ; Tomography, X-Ray Computed ; Urinary Bladder Fistula/*etiology/radiography ; Urinary Bladder Neoplasms/*complications/pathology/radiography

No abstract available.
Colectomy/methods ; Colonic Neoplasms/*diagnosis ; Colonoscopy ; Endometriosis/complications/*diagnosis/pathology/surgery/ultrasonography ; *Endosonography ; Female ; Humans ; Laparoscopy ; Middle Aged ; Muscle Neoplasms/*diagnosis ; Pelvic Pain/etiology ; Predictive Value of Tests ; Sigmoid Diseases/complications/*diagnosis/pathology/surgery/ultrasonography

BACKGROUNDIn the past several decades we have seen multiple advances in the reconstruction for girls born with vaginal agenesis. This study aimed to evaluate the technical feasibility, anatomical and functional outcomes of one-stage laparoscopic and gasless laparoscopic vaginoplasty with sigmoid colon for the patients of vaginal agenesis (Mayer-Rokitansky-Kuster-Hauser syndrome).

METHODSWe did a retrospective review of a total of 150 women with Mayer-Rokitansky-Kuster-Hauser syndrome treated at Beijing Anzhen Hospital, Capital Medical University from March 2006 to August 2010. The patients were divided into the CO2 pneumoperitoneum laparoscopic group and the abdominal wall lift of gasless laparoscopic group. Sigmoid colon vaginoplasty approaches were performed in all of the patients. The surgical techniques, perioperative results, complications, anatomical and functional outcomes of vaginoplasty were recorded.

RESULTSAll procedures were performed successfully. Significant differences in the operative time and intraoperative blood loss existed in the laparoscopic vaginoplasty group compared with the gasless laparoscopic vaginoplasty group. The patients who underwent sigmoid colon vaginoplasty had good cosmetic results without the problem of excessive mucus production. The postoperative complications were minimal. During a mean follow-up of 15.6 months, no stenosis or shrinkage was encountered. The subjective sexual satisfaction rate with the surgical outcomes in all patients was 83.3%.

CONCLUSIONSLaparoscopic or gasless laparoscopic vaginoplasty with sigmoid colon are effective and feasible approaches for women with congenital vaginal agenesis. The procedures have satisfactory anatomical and functional results.

46, XX Disorders of Sex Development ; surgery ; Abnormalities, Multiple ; surgery ; Adult ; Colon, Sigmoid ; surgery ; Congenital Abnormalities ; Female ; Humans ; Kidney ; abnormalities ; Laparoscopy ; methods ; Mullerian Ducts ; abnormalities ; Pneumoperitoneum ; Postoperative Complications ; Retrospective Studies ; Somites ; abnormalities ; Spine ; abnormalities ; Uterus ; abnormalities ; surgery ; Vagina ; abnormalities ; surgery ; Vaginal Diseases ; surgery ; Young Adult

Erlotinib is accepted as a standard second-line chemotherapeutic agent in patients with non-small cell lung cancer who are refractory or resistant to first-line platinum-based chemotherapy. There has been no previous report of bowel perforation with or without gastrointestinal metastases related to erlotinib in patients with non-small cell lung cancer. The exact mechanism of bowel perforation in patients who received erlotinib remains unclear. In this report, we report the first case of enterocutaneous fistula in a female patient with metastatic non-small cell lung cancer 9 months, following medication with erlotinib as second-line chemotherapy.
Aged ; Antineoplastic Agents/*adverse effects/therapeutic use ; Carcinoma, Non-Small-Cell Lung/complications/*drug therapy ; Female ; Humans ; Intestinal Fistula/*chemically induced/complications/radiography/surgery ; Intestinal Perforation/*chemically induced/complications/radiography/surgery ; Protein Kinase Inhibitors/*adverse effects/therapeutic use ; Quinazolines/*adverse effects/therapeutic use ; Sigmoid Diseases/*chemically induced/complications/radiography/surgery

BACKGROUND/AIMS: A stercoral perforation of the colon (SPC) is a rare, life-threatening disease. The aim of this study was to represent the definition of SPC and help the diagnosis and treatment of this condition. METHODS: We reviewed 92 medical records of patients who underwent operation due to colonic perforation from January 2000 to February 2009 retrospectively. Maurer's diagnostic criteria were used for the diagnosis of SPC. RESULTS: Eight patients (8.7%) were diagnosed as SPC. The age of the patients ranged from 59 to 85 years old. All of the patients were female and had a history of long-standing constipation. Only two patients (25%) were diagnosed as SPC preoperatively. The site of perforation of all patients was sigmoid colon. The methods of operation were Hartmann's procedure (7 cases), and primary repair with sigmoid loop colostomy (1 case). There were one recurrence and two deaths (25%) due to sepsis and multiple organ failure. CONCLUSIONS: SPC should be considered in chronically constipated, and bedridden patients who present with acute abdomen. Hartmann's procedure is the treatment of choice in most situations. Mortality is high but can be minimized with early definitive surgery.
Aged ; Aged, 80 and over ; Colon, Sigmoid/pathology ; Colonic Diseases/*diagnosis/radiography/surgery ; Female ; Humans ; Intestinal Perforation/*diagnosis/radiography/surgery ; Middle Aged ; Postoperative Complications ; Respiratory Distress Syndrome, Adult/etiology ; Retrospective Studies ; Sepsis/etiology ; Tomography, X-Ray Computed

Most common cause of brisk hematochezia is diverticular bleeding in Western countries. It occurs in 15% of patients with diverticulosis and one-third of them appear to be massive. Most of diverticulosis in Western countries occur in the left colon but the right colon is more common in Korea. Especially, the reports of diverticular bleeding on left colon are rare in Korea. We report a case presenting with multiple diverticuli complicated by recurrent massive bleeding restricted to the left colon. 75-year-old female was admitted due to hematochezia and dizziness. On past history, two years and two weeks ago respectively, she was treated of diverticular bleeding with and without diverticulitis. Hemoglobin level was 9.8 g/dL. On Colonoscopy, numerous diverticuli were seen at sigmoid colon upto splenic flexure which showed fresh blood clots in the lumen. We diagnosed her as recurrent massive diverticular bleeding on the sigmoid colon. She received elective laparoscopic left hemicolectomy.
Aged ; Colonoscopy ; Diagnosis, Differential ; Diverticulosis, Colonic/complications/*diagnosis/surgery ; Female ; Gastrointestinal Hemorrhage/*diagnosis/etiology/therapy ; Humans ; Recurrence ; Sigmoid Diseases/*diagnosis/etiology/therapy ; Tomography, X-Ray Computed

INTRODUCTIONLittle was known about the association between colorectal adenomas and cardiovascular risk factors in Taiwan. The aim of this study was to assess the association between rectosigmoid adenomas and related factors.

MATERIALS AND METHODSThis was a hospital-based, cross-sectional study. We analysed subjects receiving self-referred health examinations at 1 medical centre in Taiwan between 2001 and 2004. In total, 4413 subjects were enrolled in this study. There were 2444 men (55.4%) and 1969 women (44.6%). The mean age was 49.3 +/-12.3 years (range, 20 to 87). All subjects underwent a 60-cm flexible sigmoidoscopic examination and laboratory survey. Adjusted odds ratio (OR) and 95% confidence interval (CI) were expressed using a multivariate logistic regression analysis.

RESULTSIn the fi nal model, increasing age (OR, 1.05; 95% CI, 1.03-1.06), hypertriglyceridemia (OR, 1.49; 95% CI, 1.07-2.07), and alcohol consumption (OR, 2.11; 95% CI, 1.47-3.04) were the risk factors for rectosigmoid adenomas in men. Increasing age was the only risk factor for rectosigmoid adenomas in women (OR, 1.03; 95% CI, 1.01-1.06).

CONCLUSIONAge, hypertriglyceridemia and alcohol consumption are associated with rectosigmoid adenomas in men, and only age is significantly associated with rectosigmoid adenomas in women.

Adenoma ; complications ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Alcohol Drinking ; adverse effects ; Cardiovascular Diseases ; complications ; Cross-Sectional Studies ; Female ; Hospitals, University ; Humans ; Hypertriglyceridemia ; complications ; Male ; Middle Aged ; Odds Ratio ; Rectal Neoplasms ; complications ; Risk Factors ; Sex Factors ; Sigmoid Neoplasms ; complications ; Young Adult

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

Child ; Colitis ; diagnosis ; Colon, Sigmoid ; pathology ; Diagnosis, Differential ; Diarrhea ; etiology ; Eosinophilia ; complications ; diagnosis ; Female ; Gastroenteritis ; complications ; diagnosis ; pathology ; Humans ; Sigmoid Diseases ; complications ; diagnosis ; pathology ; Sigmoidoscopy

Adenocarcinoma ; complications ; Aged ; Colonic Diseases ; etiology ; surgery ; Humans ; Intestinal Fistula ; etiology ; surgery ; Male ; Sigmoid Neoplasms ; complications ; Urinary Bladder Fistula ; etiology ; surgery