OBJECTIVE: To determine the effect of reduced abdominal compression in prone position on ascending colonic movement during supine-to-prone positional change during CT colonography (CTC). MATERIALS AND METHODS: Eighteen consecutive patients who had undergone prone CTC scanning with cushion blocks placed under the chest and hip/thigh to reduce abdominal compression and had confirmed sessile polyps > or = 6 mm in the well-distended, straight, mid-ascending colon, were included. Radial location along the ascending colonic luminal circumference (degrees) was measured for 24 polyps and 54 colonic teniae on supine and prone CTC images. The supine-to-prone change ranging between -180degrees and +180degrees (- and + for internal and external colonic rotations, respectively), was determined. In addition, possible causes of any ascending colonic rotations were explored. RESULTS: Abdominal compression during prone CTC scanning completely disappeared with the use of cushion blocks in 17 of 18 patients. However, some degrees of ascending colonic rotation were still observed, with the radial location changes of -22degrees to 61degrees (median, 13.9degrees) for the polyps and similar degrees for teniae. Fifty-four percent and 56% of polyps and teniae, respectively, showed changes > 10degrees. The radial location change of the polyps was significantly associated with the degree of anterior shift of the small bowel and mesentery (r = 0.722, p < 0.001) and the degree of posterior displacement of the ascending colon (r = 0.566, p = 0.004) during supine-to-prone positional change. CONCLUSION: Ascending colonic rotation upon supine-to-prone positional change during CTC, mostly in the form of external rotation, is not eliminated by removing abdominal compression in prone position.
Aged ; Colon/*pathology/*radiography ; Colonic Polyps/*radiography ; Colonography, Computed Tomographic/*methods ; Female ; Humans ; Male ; Middle Aged ; Movement ; Prone Position/*physiology ; Retrospective Studies ; Rotation

OBJECTIVETo investigated the involvement of pulmonary function impairment in ulcerative colitis (UC), to explore a scientific basis for the Chinese medicine (CM) theory of exterior-interior correlation between Lung (Fei) and Large intestine (Dachang).

METHODSTotally 120 patients with a diagnosis of UC were recruited and the demographics, clinical data, and blood samples were collected. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) concentrations were measured. Every patient accepted pulmonary function test and took chest radiograph (CXR).> RESULTS: Pulmonary function abnormalities were present in 72 of 120 patients. The median (interquartile range) vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 s (FEV), carbon monoxide diffusion capacity (DL) of lung, total lung capacity (TLC) and functional residual volume (FRV) were decreased in distal UC and pancolitis compared with ulcerative prochitis (P <0.0005). Male patients had increased VC, FEV/FVC, and residual volume (RV)/TLC compared with female (P <0.0005), but decreased DLand carbon monoxide iffusion capacity (K) of lung/alveolar ventilation (P <0.0005). Age was strongly correlated with RV (Spearman rank correlation coefficient (rs)=-0.57,P <0.0001), and RV/TLC (rs=0.48,P<0.0001). Age was also correlated with FEV/FVC (rs=-0.29, P=0.001), forced expiratory flow in 75% vital capacity (FEF75%, rs=-0.20, P=0.03), DL(rs=-0.21, P=0.02), TLC (rs=-0.25, P=0.006), and FRV (rs=-0.28, P=0.002). The course of disease was correlated with FEF75% (rs=-0.18, P=0.049) and K(rs=-0.19, P=0.036). Chest radiograph abnormalities were presented in 38 of 120. Pulmonary symptoms were presented in 10 of 120. Other extraintestinal complications were presented in 21 of 120.

CONCLUSIONSPulmonary function impairment was more frequently than other extraintestinal complications in UC patients, which may be affected by sex, age, extent and course of disease. These results may be a scientific basis for the theory of exterior-interior correlation between Lung and Large intestine.

Adolescent ; Adult ; Age of Onset ; Aged ; Colitis, Ulcerative ; complications ; pathology ; physiopathology ; Colon ; pathology ; Demography ; Female ; Humans ; Inflammation ; complications ; pathology ; Lung ; diagnostic imaging ; physiopathology ; Male ; Middle Aged ; Radiography, Thoracic ; Respiratory Function Tests ; Young Adult

Contrast-enhanced computed tomography colonography (CE-CTC) is a useful guide for the laparoscopic surgeon to avoid incorrectly removing the colonic segment and the failure to diagnose of synchronous colonic and extra-colonic lesions. Lymph node dissection and vessel ligation under a laparoscopic approach can be time-consuming and can damage vessels and organs. Moreover, mesenteric vessels have extreme variations in terms of their courses and numbers. We describe the benefit of using an abdominal vascular map created by CE-CTC in laparoscopic colorectal surgery candidates. We describe patients with different diseases (colorectal cancer, diverticular disease, and inflammatory bowel disease) who underwent CE-CTC just prior to laparoscopic surgery.
Adult ; Aged ; Colectomy/*methods ; Colon/blood supply/pathology/radiography ; Colonography, Computed Tomographic/*methods ; Colorectal Neoplasms/pathology/*radiography/*surgery ; Contrast Media ; Female ; Humans ; Laparoscopy/*methods ; Lymph Node Excision/methods ; Male ; Middle Aged ; Neoplasm Staging/methods

No abstract available.
Adult ; Colon, Transverse/radiography ; Colonoscopy ; Fibrosis/pathology ; Gastrointestinal Hemorrhage ; Humans ; Intestinal Mucosa/pathology/*surgery ; Male ; Pneumatosis Cystoides Intestinalis/*diagnosis/surgery ; Tomography, X-Ray Computed

Churg-Strauss syndrome (CSS) is a rare disease characterized by asthma, peripheral eosinophilia and vasculitis. A quarter of CSS patients with clinical remission have experienced a relapse. We report here a case of lung abscess in a patient with relapsed CSS. A 46-year-old man who achieved clinical remission of CSS was confirmed for relapse by the presence of peripheral eosinophillia, pulmonary lesions and perivascular infiltrate of eosinophils in colon pathology. After administration of systemic glucocorticoid and one cycle of cyclophosphamide pulse therapy, he complained of dyspnea, sputum and chest pain. There were necrotic masses containing internal air-fluid levels in the right upper and the left lower lobes of the lung on chest radiography. Percutaneous needle aspiration culture specimens revealed the presence of K. pneumoniae. The patient was successfully treated with a 5-week course of antibiotics.
Anti-Bacterial Agents ; Asthma ; Chest Pain ; Churg-Strauss Syndrome* ; Colon ; Cyclophosphamide ; Dyspnea ; Eosinophilia ; Eosinophils ; Humans ; Lung Abscess* ; Lung* ; Middle Aged ; Needles ; Pathology ; Pneumonia ; Radiography ; Rare Diseases ; Recurrence ; Sputum ; Thorax ; Vasculitis

Congenital infantile fibrosarcoma (CIF) is a rare soft-tissue tumor in the pediatric age group and seldom involves the gastrointestinal tract. A 2-day-old boy was transferred to our hospital with a pneumpoperitoneum. After emergency operation, we could find a solid mass wrapping around a sigmoid colon and performed a segmental resection of sigmoid colon including a mass. Histopathologic examination showed an infantile fibrosarcoma origining from the muscular layer of colon. The baby was discharged on the 17th hospital day and followed for 1 yr without recurrence.
Colon, Sigmoid/pathology ; Fibrosarcoma/congenital/*diagnosis/pathology ; Humans ; Infant, Newborn ; Male ; Peritoneum/radiography ; Positron-Emission Tomography and Computed Tomography ; Soft Tissue Neoplasms/congenital/*diagnosis/pathology

Self-expandable stents are widely available for the treatment of perforation of the gastrointestinal tract. Because of the risk of migration, there has been no report of the use of self-expandable stents for the treatment of perforation of the colon or rectum. This is a report of successful treatment of iatrogenic colonic perforation during balloon dilatation of anastomotic stricture with a fully covered stent. Fully covered, self-expandable metallic stents can be considered useful tools for management of this condition.
Aged, 80 and over ; Colon/*injuries/pathology/radiography ; Colonic Diseases/diagnosis/*therapy ; Constriction, Pathologic ; Dilatation/*adverse effects ; Humans ; *Iatrogenic Disease ; Intestinal Obstruction/diagnosis/*therapy ; Intestinal Perforation/diagnosis/etiology/*therapy ; Male ; *Metals ; Prosthesis Design ; Sigmoidoscopy ; *Stents ; Treatment Outcome ; Wound Healing

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

The gastrointestinal (GI) tract is the most frequently involved site of mucosa-associated lymphoid tissue (MALT) lymphoma. Stomach is the most common site of involvement among the GI tract. However, MALT lymphoma of the large intestine is rare. A diagnosis is established by pathological examination of the surgical or endoscopic specimens. A 72-year-old man with low abdominal pain was diagnosed as a sigmoid MALT lymphoma, which was noted as an obstructing mass in a colonoscopic examination. A left hemicolectomy was performed, and the patient has had no recurrence postoperatively without any chemotherapy.
Aged ; Colon, Sigmoid/*pathology ; Colonoscopy ; Diagnosis, Differential ; Humans ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/radiography ; Male

Intestinal neuronal dysplasia (IND) type B is a disease of the submucosal plexus of intestine manifesting chronic intestinal obstruction or severe chronic constipation. IND is one of intestinal dysganglionoses and clinically closely associated with Hirschsprung's disease. Until recently, it is not fully clear whether IND is a congenital malformation or an acquired secondary condition related to some gastrointestinal problems. However, recently published data and consensus reports have enhanced our understanding of the pathogenesis and management of IND. The aim of this paper was to review the current state of knowledge regarding the controversial issues of IND including the etiology, classification, diagnostic criteria, and available therapeutic intervention.
Child ; Colon/*innervation/radiography ; Constipation/etiology ; Enteric Nervous System/*abnormalities ; Ganglia/pathology ; Gastrointestinal Motility ; Hirschsprung Disease/pathology ; Humans ; Immunohistochemistry ; Intestinal Diseases/*diagnosis/pathology ; Intestinal Mucosa/pathology