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Cureus Feb 2024We present a rare case of schwannoma in the ascending colon of a 60-year-old female with dyslipidemia. A series of diagnostic procedures, including colonoscopy and CT...
We present a rare case of schwannoma in the ascending colon of a 60-year-old female with dyslipidemia. A series of diagnostic procedures, including colonoscopy and CT colonography, led to the successful robotic-assisted right hemicolectomy. Histological and immunohistochemical analyses confirmed the diagnosis of schwannoma, and the patient achieved a complete recovery post-surgery.
PubMed: 38544664
DOI: 10.7759/cureus.54902 -
Cureus Nov 2022Schwannoma of the ascending colon is an extremely rare neoplasm that is often discovered incidentally in the asymptomatic older population on surveillance colonoscopy....
Schwannoma of the ascending colon is an extremely rare neoplasm that is often discovered incidentally in the asymptomatic older population on surveillance colonoscopy. We present the case of a symptomatic 22-year-old male presenting with one month of discomfort in the right lower abdominal quadrant, abdominal bloating, and hematochezia. A sessile polyp measuring 0.5 cm was identified in the ascending colon on the colonoscopy. The polyp was completely resected using cold snare polypectomy. Histological examination of the resected polyp with hematoxylin-eosin staining revealed small nodules of bland spindle cells with focal nuclear condensation. The lesional cells tested positive for S-100 and SOX-10 on immunohistochemical analysis, establishing the diagnosis of benign schwannoma. Since this lesion was submucosal, its diagnosis required an endoscopic biopsy that could only be performed on the mucosa. It was difficult to distinguish it from other mesenchymal tumors (gastrointestinal stromal tumor or leiomyoma), and this makes the differential diagnosis exceedingly challenging. If the immunohistochemistry is positive for S-100 and negative for C-KIT, CD-34, actin, and desmin, it aids in diagnosis. These tumors have non-specific radiological features and are asymptomatic.
PubMed: 36582566
DOI: 10.7759/cureus.31946 -
Journal of Gastrointestinal and Liver... Jun 2020The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called...
BACKGROUND AND AIMS
The importance of sessile serrated lesions (SSLs) in the pathogenesis of colorectal carcinoma has been recently established. These are supposed to cause the so-called "interval cancer", having a rapidly progressive growth and being difficult to detect and to obtain an endoscopic complete resection. We aimed to establish the most important metabolic risk factors for sessile serrated lesions.
METHODS
We performed a retrospective case-control study, on a series of 2918 consecutive patients who underwent colonoscopy in Gastroenterology and Endoscopy Unit, County Clinical Emergency Hospital, Târgu-Mureș, Romania between 1 st of January 2015-31 th of December 2017. In order to evaluate the metabolic risk factors for polyps' development, enrolled participants were stratified in two groups, a study group, 33 patients with SSLs lesions, and a control group, 138 patients with adenomatous polyps, selected by systematic sampling for age and anatomical site. Independent variables investigated were: gender, smoking, alcohol consumption, obesity, arterial hypertension, diabetes, hypercholesterolemia, hypertriglyceridemia, hyperuricemia, nonalcoholic liver disease.
RESULTS
For SSLs the most common encountered localization was the right colon in 30.55% of cases. By comparative bivariate analysis between SSLs group and control group, it was observed that hypertension (p=0.03, OR 2.33, 95 %CI 1.03-5.24), obesity (p=0.03, OR 2.61, 95 %CI 1.08-6.30), hyperuricemia (p=0.04, OR 2.72, 95 %CI 1.28-7.55), high cholesterol (p=0.002, OR 3.42; 95 %CI 1.48-7.87), and high triglycerides level (p=0.0006, OR 5.75; 95 %CI 1.92-17.2) were statistically associated with SSLs development. By multivariate analysis hypertension and hypertriglyceridemia retained statistical significance.
CONCLUSIONS
Our study showed that the highest prevalence of SSLs was in the right colon and hypertension and increased triglycerides levels were associated with the risk of SSLs development. These risk factors are easy to detect in clinical practice and may help identifying groups with high risk for colorectal cancer, where screening is recommended.
Topics: Adenomatous Polyps; Carcinogenesis; Case-Control Studies; Colon, Ascending; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Correlation of Data; Female; Humans; Hypertension; Hypertriglyceridemia; Male; Middle Aged; Prevalence; Prognosis; Risk Factors; Romania
PubMed: 32530984
DOI: 10.15403/jgld-507 -
Current Microbiology Aug 2018Recently, several studies have indicated that the intestinal microbiota can be regulated by the individual attributes, and even the alternation of circadian rhythm....
Recently, several studies have indicated that the intestinal microbiota can be regulated by the individual attributes, and even the alternation of circadian rhythm. Inspired by this, we speculated that seasonal variation might also have some effect on the intestinal microbiota. A total of 11 Sprague-Dawley male rats, weighing 250-280 g, were divided into summer group (n = 5) and winter group (n = 6). Cages were individually ventilated at 20 ± 2 °C and 45-65% relative humidity with a circadian rhythm of 12/12 h. After 1 week of adaptively feeding, mucosal contents of jejunum, terminal ileum, and ascending colon were collected and analyzed by 16S rRNA Gene Amplicon Pyrosequencing. The results showed that intestinal microbiota of rats for the same strain were affected by season change under the same feeding condition and living environment. We should take seasonal factor into account in the future experimental design based on intestinal microbiome.
Topics: Animals; Bacteria; Base Sequence; Colon, Ascending; DNA, Bacterial; Gastrointestinal Microbiome; Ileum; Intestinal Mucosa; Jejunum; Male; RNA, Ribosomal, 16S; Rats; Rats, Sprague-Dawley; Seasons; Sequence Analysis, DNA
PubMed: 29546587
DOI: 10.1007/s00284-018-1480-6 -
European Review For Medical and... Oct 2017We studied the clinical effects of ascending colon patching ileorectal heart-shaped anastomosis in treating total colonic aganglionosis.
OBJECTIVE
We studied the clinical effects of ascending colon patching ileorectal heart-shaped anastomosis in treating total colonic aganglionosis.
PATIENTS AND METHODS
From June 2006 to June 2013, 15 children with severe abdominal distension, low small intestine obstruction and intestinal perforation in the neonatal period, were enrolled in this study. In phase I, patients received emergency terminal ileum stoma plus multi-site colonic biopsy and 6 to 12 months later, ascending colon patching ileorectal heart-shaped anastomosis was conducted in phase II. The occurrence of postoperative complications was recorded. Patients' defecation and anal manometry during the follow-up period were monitored and recorded. All operations were successful, and the average hospitalization time was 10.5 days, and the average amount of bleeding was 30 mL.
RESULTS
There were 2 cases of enterocolitis, but no intestinal anastomotic leakage, no incision infection, no anal stenosis and no mortality. Postoperative follow-up lasted for 1 to 2 years with an average of 1.2 years. Perianal redness and erosion occurred in an early stage after the operation, but disappeared after 6 months. Postoperative defecation frequency was about 6 to 9 times, but after 2 years this frequency reduced to 2 to 3 times. Feces transformed from watery into soft forms. Normal results were obtained in the detection of serum K+, Na+, Cl-, HCO3-, hemoglobin, albumin and globulin levels in postoperative follow-up. Rectal rest pressure and anal canal rest pressure after a radical operation on megacolon were significantly lower than those of before operation (p < 0.05).
CONCLUSIONS
Ascending colon patching ileorectal heart-shaped anastomosis preserved right hemicolon with relatively good absorptive capability and complied with the physiology of colon. Meanwhile, the ileorectal heart-shaped anastomosis was conducted. The anastomotic stoma was in an oblique heart shape, and its aperture was wide and in different planes without stenosis, blind bag and gate syndrome. We concluded that ascending colon patching ileorectal heart-shaped anastomosis was an effective and feasible method for the radical operation on total colonic aganglionosis.
Topics: Anal Canal; Anastomosis, Surgical; Biomarkers; Child; Colon, Ascending; Female; Hirschsprung Disease; Humans; Ileum; Infant; Intestinal Obstruction; Male; Middle Aged; Postoperative Complications; Retrospective Studies
PubMed: 29165757
DOI: No ID Found -
Indian Journal of Gastroenterology :... Sep 2017Diagnosis of Trichuris trichiura infestations is usually based on identification of barrel-shaped ova in stool, but is frequently missed on stool microscopy. We describe...
Diagnosis of Trichuris trichiura infestations is usually based on identification of barrel-shaped ova in stool, but is frequently missed on stool microscopy. We describe the clinical profile of patients in whom Trichuris infection was incidentally diagnosed at colonoscopy. In a cross-sectional study, patients with colonoscopic diagnosis of trichuriasis were enrolled from the endoscopy unit in a tertiary care center. Blood and stool samples were collected from all those who were willing to participate and provide samples. Sixty-two patients participated, with mean (SD) age of 50.5 (13.6) years and male to female ratio of 40:22. Abdominal pain (61.2%) and/or altered bowel habits (32.2%) were the most common indication for colonoscopy. Most (66.6%) of the Trichuris were located in the cecum and ascending colon. Majority of the patients had live worms, either motile or adhering to the colonic mucosa. The number of worms was single or a few (<15) in 74.2% of patients. Out of 62 patients, 16 (25.8%) had relatively heavy load of parasites. Most patients had normal colonoscopic findings (80.6%). Periappendicular and/or cecal ulcerations/erosions were the most common (16.1%) abnormalities noted. Stool examination showed parasite ova only in four (6.4%) patients. In conclusion, colonoscopy was better than stool microscopy for the diagnosis of trichuriasis in our study.
Topics: Adult; Animals; Cecum; Colon, Ascending; Colonoscopy; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Trichuriasis; Trichuris
PubMed: 29058208
DOI: 10.1007/s12664-017-0795-8 -
BMC Biology Oct 2020Enterotoxigenic Escherichia coli (ETEC) substantially contributes to the burden of diarrheal illnesses in developing countries. With the use of complementary in vitro...
BACKGROUND
Enterotoxigenic Escherichia coli (ETEC) substantially contributes to the burden of diarrheal illnesses in developing countries. With the use of complementary in vitro models of the human digestive environment, TNO gastrointestinal model (TIM-1), and Mucosal Simulator of the Human Intestinal Microbial Ecosystem (M-SHIME), we provided the first detailed report on the spatial-temporal modulation of ETEC H10407 survival, virulence, and its interplay with gut microbiota. These systems integrate the main physicochemical parameters of the human upper digestion (TIM-1) and simulate the ileum vs ascending colon microbial communities and luminal vs mucosal microenvironments, captured from six fecal donors (M-SHIME).
RESULTS
A loss of ETEC viability was noticed upon gastric digestion, while a growth renewal was found at the end of jejunal and ileal digestion. The remarkable ETEC mucosal attachment helped to maintain luminal concentrations above 6 log mL in the ileum and ascending colon up to 5 days post-infection. Seven ETEC virulence genes were monitored. Most of them were switched on in the stomach and switched off in the TIM-1 ileal effluents and in a late post-infectious stage in the M-SHIME ascending colon. No heat-labile enterotoxin production was measured in the stomach in contrast to the ileum and ascending colon. Using 16S rRNA gene-based amplicon sequencing, ETEC infection modulated the microbial community structure of the ileum mucus and ascending colon lumen.
CONCLUSIONS
This study provides a better understanding of the interplay between ETEC and gastrointestinal cues and may serve to complete knowledge on ETEC pathogenesis and inspire novel prophylactic strategies for diarrheal diseases.
Topics: Colon, Ascending; Enterotoxigenic Escherichia coli; Escherichia coli Infections; Gastrointestinal Microbiome; Humans; Ileum; Microbial Viability
PubMed: 33054775
DOI: 10.1186/s12915-020-00860-x -
Diseases of the Colon and Rectum Aug 2015Lymph nodes play a critical role in the staging, treatment, and prognosis of colon cancer. However, the normal number and morphology of lymph nodes in the normal...
BACKGROUND
Lymph nodes play a critical role in the staging, treatment, and prognosis of colon cancer. However, the normal number and morphology of lymph nodes in the normal mesocolon is unknown.
OBJECTIVE
This study aimed to investigate the number and size of lymph nodes in the ascending and sigmoid mesocolons.
DESIGN
This is a descriptive anatomical cadaver study of 10 sigmoid mesocolons and 5 ascending mesocolons, resected in a standardized manner and examined systematically after serial histological sectioning. The number, maximum length, and appearance of lymph nodes were analyzed, and the 2 mesocolons were compared by using the Mann-Whitney U test, the Wilcoxon signed rank test, and the χ test.
PATIENTS
Ten cadavers (mean age, 82.9 years; 5 male) with no evidence of colorectal disease were examined.
MAIN OUTCOME MEASURE
The number, maximum length, and appearance of lymph nodes and fat-associated lymphoid clusters were the primary outcomes measured.
RESULTS
The median number of lymph nodes in the sigmoid and ascending mesocolons was 71 (range, 24-116) and 61 (range, 33-71). More than 90% of lymph nodes were less than 5 mm in maximum length. Sigmoid mesocolic nodes were significantly smaller than ascending mesocolic nodes (median maximum lymph nodes length, 1.6 mm vs 2.1 mm; p < 0.001), but there was no statistically significant difference in the density of lymph nodes between the sigmoid and ascending mesocolon. Fatty replacement was seen in almost 30% of lymph nodes. A few fat-associated lymphoid clusters were observed in both mesocolons.
LIMITATIONS
Only 15 mesocolic specimens could be examined because of the detailed labor-intensive methodology, and younger cadavers were not available for analysis.
CONCLUSIONS
In this descriptive anatomical study, the median number of lymph nodes in the sigmoid and ascending mesocolon was 71 and 61. Ascending mesocolic nodes were significantly larger than sigmoid mesocolic nodes. These anatomical findings are relevant to the interpretation of lymph node yields after the surgical resection of colon cancer.
Topics: Aged; Aged, 80 and over; Cadaver; Colon, Ascending; Colon, Sigmoid; Female; Humans; Lymph Nodes; Male; Mesocolon; Organ Size
PubMed: 26163951
DOI: 10.1097/DCR.0000000000000413 -
Case Reports in Gastroenterology 2021A metastatic cardiac tumor from colon cancer is an exceedingly rare clinical feature associated with a poor prognosis without therapeutic intervention; however, such...
A metastatic cardiac tumor from colon cancer is an exceedingly rare clinical feature associated with a poor prognosis without therapeutic intervention; however, such cases may be frequently encountered in clinical practice, especially among the elderly. We report a case of synchronous double cancer of the prostate and ascending colon with metastases to multiple organs, including a large cardiac tumor. A 71-year-old Japanese man had prostate cancer with neck and para-aortic metastasis. He visited our hospital with complaints of fatigue and a positive fecal occult blood test result. Colonoscopy findings revealed the presence of a tumor in the ascending colon, and contrast-enhanced CT revealed a tumor in the heart, which was possibly due to metastasis from the ascending colon. The patient received palliative care and declined anticancer treatment. He died due to respiratory failure 3 months after the first diagnosis but did not show critical arrhythmia until death. Autopsy revealed the presence of a large mass in the right ventricle with tumor embolism of the right coronary artery. The cardiac mass was pathologically consistent with metastasis from the colon. In case of colorectal cancer with cardiac metastasis involving poor prognosis or performance status, best supportive care without any therapeutic intervention could be the optimal treatment for the quality of the remaining time.
PubMed: 34594169
DOI: 10.1159/000518022 -
Internal Medicine (Tokyo, Japan) Oct 2021
Topics: Colon, Ascending; Humans; Hypertension, Portal; Varicose Veins
PubMed: 33867394
DOI: 10.2169/internalmedicine.7334-21