Globally white-light endoscopy with biopsy sampling is the gold standard diagnostic modality for esophageal, gastric, and colonic pathologies. However, there is overwhelming evidence to highlight the deficiencies of an approach based predominantly on eyeball visualization. Biopsy sampling is also problematic due in part to excessive sampling and hence attendant cost. Various innovations are currently taking place in the endoscopic domain to aid operators in diagnosis forming. These include narrow band imaging which aims to enhance the surface anatomy and vasculature, and confocal laser endomicroscopy which provides real time histological information. However, both of these tools are limited by the skill of the operator and the extensive learning curve associated with their use. There is a gap therefore for a new form of technology that relies solely on an objective measure of disease and reduces the need for biopsy sampling. Raman spectroscopy (RS) is a potential platform that aims to satisfy these criteria. It enables a fingerprint capture of tissue in relation to the protein, DNA, and lipid content. This focused review highlights the strong potential for the use of RS during endoscopic gastroenterological examination.
Biopsy ; Colon* ; Colonic Diseases* ; Dermatoglyphics ; Diagnosis* ; DNA ; Endoscopy ; Learning Curve ; Narrow Band Imaging ; Pathology ; Spectrum Analysis, Raman*

Lower gastrointestinal complications often develop in end stage renal disease patients, and among the more problematic is recurrent colon ulcer. The exact pathogenesis of this condition is not known and there were no specific therapeutic modalities concerning this type of disease entity. We report, with a literature review, a case of recurrent colon ulcer with intermittent hematochezia in an end stage renal disease patient on long term hemodialysis that improved after conversion to peritoneal dialysis.
Aspirin/therapeutic use ; Colon/pathology ; Colonic Diseases/complications/*diagnosis/drug therapy ; Colonoscopy ; Drug Therapy, Combination ; Gastrointestinal Hemorrhage ; Humans ; Kidney Failure, Chronic/*complications ; Male ; Middle Aged ; Peritoneal Dialysis ; Recurrence ; Ticlopidine/therapeutic use ; Ulcer/complications/*diagnosis/drug therapy

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

We report one such case which was diagnosed intraoperatively as left dorsal colon volvulus due to multiple mesenteric abnormalities. A 17-year-old castrated male horse was taken to the Tehran University Veterinary Hospital for treatment of metacarpal wound accompanied by severe abdominal distension and acute colic. The treatment and measurement were taken for a month, and the prepared biopsy indicated that the healing trend was obvious. Unfortunately, prior to discharge, the clinical colic manifestations emerged and the animal suddenly died. Dilated large intestine was palpated per rectum and a ventral midline exploratory laparotomy was performed, a complete volvulus of the ascending colon was identified with multiple mesenteric anomalies of unknown aetiology. The pathologic changes observed in this study accurately reflect those changes reported in horse with naturally occurring colonic volvulus and can serve as a reference for subsequent studies on attenuating bowel injury. The present study results can be used to make a scientific assessment of prognosis in the pre-operative, operative, and post-operative management of horses with large colon volvulus.
Animals ; Colon ; pathology ; Colonic Diseases ; veterinary ; Fatal Outcome ; Horse Diseases ; diagnosis ; pathology ; Horses ; Male

Malakoplakia is a rare granulomatous disease that occurs commonly in the urinary tract and secondarily in the gastrointestinal tract. Most reported cases of malakoplakia are associated with immunosuppressive diseases or chronic prolonged illness. Here, we report a rare case of malakoplakia in a young healthy adolescent without any underlying disease. A 19-year-old female was referred to our hospital following the discovery of multiple rectal polyps with sigmoidoscopy. She had no specific past medical history but complained of recurrent abdominal pain and diarrhea for 3 months. A colonoscopy revealed diverse mucosal lesions including plaques, polyps, nodules, and mass-like lesions. Histological examination revealed a sheet of histiocytes with pathognomonic Michaelis-Gutmann bodies. We treated the patient with ciprofloxacin, the cholinergic agonist bethanechol, and a multivitamin for 6 months. A follow-up colonoscopy revealed that her condition was resolved with this course of treatment.
Anti-Bacterial Agents/therapeutic use ; Bethanechol/therapeutic use ; Biopsy ; Ciprofloxacin/therapeutic use ; *Colon/drug effects/pathology ; *Colonic Diseases/diagnosis/therapy ; Colonoscopy ; Drug Therapy, Combination ; Female ; Humans ; *Intestinal Mucosa/drug effects/pathology ; *Malacoplakia/diagnosis/therapy ; Muscarinic Agonists/therapeutic use ; Treatment Outcome ; Vitamins/therapeutic use ; Young Adult

BACKGROUND/AIMS: Colonoscopic polypectomy is a valuable procedure for preventing colorectal cancer, but is not without complications. Delayed bleeding after colonoscopic polypectomy is a rare, but serious complication. The aim of this study was to identify risk factors of delayed bleeding after colonoscopic polypectomy. METHODS: A retrospective case-control study was conducted in a single university hospital. Forty cases and 120 controls were included. Data collected included comorbidity, use of antiplatelet agents, size and number of resected polyps, histology and gross morphology of resected polyps, endoscopist's experience, resection method, use of sedation, and use of prophylactic hemostasis. RESULTS: In univariate analysis, size, histology and number of resected polyps, endoscopist's experience, resection method and use of prophylactic hemostasis were significant risk factors for delayed bleeding after colonoscopic polypectomy. In multivariate analysis, risk of delayed bleeding increased by 11.6% for every 1 mm increase in resected polyp diameter (OR, 1.116; 95% CI 1.041-1.198; p=0.002). Number of resected polyps (OR, 1.364; 95% CI, 1.113-1.671; p=0.003) and endoscopist's experience (OR, 6.301; 95% CI, 2.022-19.637; p=0.002) were significant risk factors for delayed bleeding after colonoscopic polypectomy. CONCLUSIONS: Size and numbers of resected polyps, and endoscopist's experience were independent risk factors for delayed bleeding after colonoscopic polypectomy. More caution would be necessary when removing polyps with these factors.
Adult ; Aged ; Case-Control Studies ; Colonic Diseases/*diagnosis/pathology ; Colonic Polyps/*surgery ; Colonoscopy/adverse effects ; Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage/etiology ; Retrospective Studies ; Risk Factors

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

No abstract available.
Adult ; Colonic Diseases/*diagnosis/etiology/surgery ; Colonoscopy ; Humans ; Intussusception/*diagnosis/etiology/surgery ; Lipoma/complications/*diagnosis/pathology ; Male ; Tomography, X-Ray Computed

OBJECTIVETo evaluate the value of dynamic enhanced-CT in differential diagnosis of solitary pulmonary nodules.

METHODSSixty-three solitary pulmonary nodules were evaluated by dynamic enhanced multi-slice CT. Images were obtained before and at 20 s, 30 s, 45 s, 60 s, 75 s, 90 s, 120 s, 180 s, 300 s, 540 s, 720 s, 900 s and 1200 s after the injection of contrast media. All lesion enhanced parameters and morphological features were recorded. The differences between benign and malignant nodules were analyzed. The diagnostic sensitivity and specificity of solitary pulmonary nodules were evaluated by receiver operator characteristic analysis.

RESULTSCT enhancement value at 120 s [(29.5 ± 30.2) HU vs. (32.5 ± 14.7) HU, P = 0.023], washout at 20 min [(36.5 ± 24.6) HU vs. (15.6 ± 16.6) HU, P = 0.044], washout ratio at 20 min [(36.5 ± 24.6)% vs. (17.8 ± 14.5)%, P = 0.006], slope of washout at 20 min [(0.006 ± 0.005)%/s vs. (0.002 ± 0.0016)%/s, P = 0.001], type II (24/42 vs. 4/21, P = 0.004) and III (5/42 vs. 9/21, P = 0.005) curves were significantly different between benign and malignant nodules. Using the above mentioned parameters, the results of receiver operator characteristic analysis had a sensitivity of 64.3% and specificity of 84.2% for identification of malignant tumors. The morphological features including round-like, triangle-like, multi-angle, spiculation, light lobulation, the degree of edge (sharp, clear, blur), vessel convergence sign, vacuole sign, airing of bronchi, cut-off of the bronchi and depression of pleura were significantly different between benign and malignant nodules. The results of ROC analysis showed that the above mentioned morphological features had a sensitivity of 92.9% and specificity of 100% for differentiating malignant tumors from benign nodules. The results of ROC analysis showed that combination of morphological features and dynamic enhancement parameters had a sensitivity of 95.2% and specificity of 100% for identification of malignant tumors.

CONCLUSIONSDynamic enhanced CT images can evaluate morphological and enhancement features of solitary pulmonary nodules. Combination of morphological features and enhancement characteristics can improve the accuracy of diagnosis.

Adenocarcinoma ; diagnostic imaging ; Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; Colonic Neoplasms ; pathology ; Contrast Media ; Diagnosis, Differential ; Female ; Hamartoma ; diagnostic imaging ; Humans ; Lung Diseases ; diagnostic imaging ; Lung Neoplasms ; diagnostic imaging ; secondary ; Male ; Middle Aged ; ROC Curve ; Radiographic Image Enhancement ; Sensitivity and Specificity ; Solitary Pulmonary Nodule ; diagnostic imaging ; Tomography, Spiral Computed ; methods ; Tuberculoma ; diagnostic imaging ; Tuberculosis, Pulmonary ; diagnostic imaging

Antigens, CD20 ; metabolism ; CD5 Antigens ; metabolism ; Colonic Neoplasms ; complications ; metabolism ; pathology ; surgery ; Cyclin D1 ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Ileal Diseases ; complications ; pathology ; surgery ; Ileocecal Valve ; Intestinal Neoplasms ; complications ; metabolism ; pathology ; surgery ; Intestinal Polyps ; complications ; metabolism ; pathology ; surgery ; Intussusception ; complications ; pathology ; surgery ; Leukemia, Lymphocytic, Chronic, B-Cell ; metabolism ; pathology ; Lymphoma, Mantle-Cell ; complications ; metabolism ; pathology ; surgery ; Middle Aged