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Radiological features and clinical implications of persistent congenital mesocolon: Pictorial essay.Journal of Medical Imaging and... Apr 2022In human foetus, the mesenteries that carry vascular and neural supply to the alimentary tube play an important role in its development and anatomical location within... (Review)
Review
In human foetus, the mesenteries that carry vascular and neural supply to the alimentary tube play an important role in its development and anatomical location within the abdominal cavity. The mesenteric attachments of the small bowel, transverse colon and sigmoid allow them to be intraperitoneally mobile structures. In contrast, the ascending and descending colon lose their mesenteries by fusion with the parietal peritoneum and become fixed in retroperitoneal position along the posterolateral walls of the abdomen. In about 2%-4% of individuals, this process is disrupted, causing a complete or partial retention of their congenital mesocolon. The ascending or descending colon will then remain intraperitoneally mobile, affecting the normal visceral anatomy and causing potential complications. This article reviews the spectrum of radiological manifestations and clinical consequences of these anomalies.
Topics: Colon, Sigmoid; Humans; Laparoscopy; Mesocolon; Peritoneum; Radiography
PubMed: 34747133
DOI: 10.1111/1754-9485.13347 -
Veterinary Radiology & Ultrasound : the... May 2023Endoscopic ultrasound (EUS) is a medical procedure in which endoscopy is combined with ultrasonography (US) to compensate for problems associated with the transabdominal...
Endoscopic ultrasound (EUS) is a medical procedure in which endoscopy is combined with ultrasonography (US) to compensate for problems associated with the transabdominal US such as large penetration depths, presence of intestinal gas, and acoustic shadowing. This prospective, method comparison, pilot study was performed to assess the feasibility of applying EUS in the colorectal region and to describe the typical EUS features of the descending colon and rectum in healthy dogs. Transabdominal US and EUS with or without the hydrosonography were applied to the descending colon and rectum in 10 clinically healthy Beagle dogs and wall thickness, visibility of the wall layers, and conspicuity of the mucosal and serosal surfaces of the intestinal wall were assessed. Endoscopic ultrasound enabled circumferential evaluation of the colorectal wall and provided better visibility of the wall layers and conspicuity of the mucosal and serosal surfaces without degradation of the image, even in the far-field portion of the colorectal wall, compared to US. Moreover, EUS provided the adequate image quality of the rectum, which was difficult to evaluate with US due to deep scan depth and acoustic shadowing by the pelvis. Meanwhile, the application of hydrosonography to EUS deteriorated the visibility of the wall layers and conspicuity of the intestinal wall. The results of this study demonstrate the feasibility of EUS to assess the colorectal region and its potential application for the evaluation of rectal masses or intrapelvic lesions that are inaccessible by the transabdominal US in dogs.
Topics: Dogs; Animals; Rectum; Prospective Studies; Colon, Descending; Pilot Projects; Pelvis; Colorectal Neoplasms; Dog Diseases
PubMed: 36876648
DOI: 10.1111/vru.13226 -
European Journal of Pharmacology Sep 2023Capsaicin and allyl isothiocyanate (AITC) activate transient receptor potential (TRP) vanilloid-1 (TRPV1) and TRP ankyrin-1 (TRPA1), respectively. TRPV1 and TRPA1...
Capsaicin and allyl isothiocyanate (AITC) activate transient receptor potential (TRP) vanilloid-1 (TRPV1) and TRP ankyrin-1 (TRPA1), respectively. TRPV1 and TRPA1 expression have been identified in the gastrointestinal (GI) tract. GI mucosal functions remain largely undefined for TRPV1 and TRPA1 with side-dependence and regional differences in signalling unclear. Here we investigated TRPV1- and TRPA1-induced vectorial ion transport as changes in short-circuit current (ΔI), in defined segments of mouse colon mucosa (ascending, transverse and descending) under voltage-clamp conditions in Ussing chambers. Drugs were applied basolaterally (bl) or apically (ap). Capsaicin responses were biphasic, with primary secretory and secondary anti-secretory phases, observed with bl application only, which predominated in descending colon. AITC responses were monophasic and secretory, with ΔI dependent on colonic region (ascending vs. descending) and sidedness (bl vs. ap). Aprepitant (neurokinin-1 (NK1) antagonist, bl) and tetrodotoxin (Na channel blocker, bl) significantly inhibited capsaicin primary responses in descending colon, while GW627368 (EP4 receptor antagonist, bl) and piroxicam (cyclooxygenase inhibitor, bl) inhibited AITC responses in ascending and descending colonic mucosae. Antagonism of the calcitonin gene-related peptide (CGRP) receptor had no effect on mucosal TRPV1 signalling, while tetrodotoxin and antagonists of the 5-hydroxytryptamine-3 and 4 receptors, CGRP receptor, and EP1/2/3 receptors had no effect on mucosal TRPA1 signalling. Our data demonstrates the regional-specificity and side-dependence of colonic TRPV1 and TRPA1 signalling, with involvement of submucosal neurons and mediation by epithelial NK1 receptor activation for TRPV1, and endogenous prostaglandins and EP4 receptor activation for TRPA1 mucosal responses.
Topics: Mice; Animals; Transient Receptor Potential Channels; TRPA1 Cation Channel; Capsaicin; Tetrodotoxin; Colon; Mucous Membrane; TRPV Cation Channels
PubMed: 37394028
DOI: 10.1016/j.ejphar.2023.175897 -
World Journal of Gastroenterology Jan 2020Obesity is a risk factor for colorectal cancer, yet metabolic distinctions between healthy right and left colon tissue, before cancer is diagnosed, remains largely...
BACKGROUND
Obesity is a risk factor for colorectal cancer, yet metabolic distinctions between healthy right and left colon tissue, before cancer is diagnosed, remains largely unknown. This study compared right-ascending and left-descending colon tissue metabolomes to identify differences from the stool metabolome in normal weight, overweight, and obese adults.
AIM
To examine right and left colon tissue metabolites according to body mass index that may serve as mechanistic targets for interventions and biomarkers for colon cancer risk.
METHODS
Global, non-targeted metabolomics was applied to assess right-ascending and left-descending colon tissue collected from healthy adults undergoing screening colonoscopies to test the hypothesis that BMI differentially impacts colon tissue metabolite profiles. The colon tissue and stool metabolome of healthy adults ( 24) was analyzed for metabolite signatures and metabolic pathway networks implicated in progression of colorectal cancer.
RESULTS
Ascending and descending colon contained 504 host, food, and microbiota-derived metabolites from normal weight, overweight and obese adults grouped according to body mass index. Amino acids, lipids, and nucleotides were among the chemical types that further differentiated from the stool metabolite profiles. Normal weight adults had 46 significantly different metabolites between ascending and descending colon tissue locations, whereas there were 37 metabolite differences in overweight and 28 metabolite differences for obese adults ( < 0.05). Obese adults had trimethylamine N-oxide, endocannabinoids and monoacylglycerols with different relative abundances identified between ascending and descending colon. Primary and secondary bile acids, vitamins, and fatty acids also showed marked relative abundance differences in colon tissue from overweight/obese adults.
CONCLUSION
There were metabolite profile differences between right-ascending and left-descending colon tissue in healthy adults. Colon lipids and other metabolites in obese and overweight adults were distinguished from normal weight participants and associated with gut inflammation, nutrient absorption, and products of microbiota metabolism.
Topics: Adult; Biomarkers, Tumor; Body Mass Index; Colon, Ascending; Colon, Descending; Colorectal Neoplasms; Feces; Female; Gastrointestinal Microbiome; Healthy Volunteers; Humans; Ideal Body Weight; Intestinal Absorption; Lipid Metabolism; Lipids; Male; Metabolome; Middle Aged; Obesity; Overweight; Risk Factors
PubMed: 31988593
DOI: 10.3748/wjg.v26.i3.335 -
Clinical Gastroenterology and... Aug 2020Lymphocytic and collagenous colitis are types of microscopic colitis (MC) that commonly cause chronic watery diarrhea, but there are no macroscopic features of MC that...
BACKGROUND & AIMS
Lymphocytic and collagenous colitis are types of microscopic colitis (MC) that commonly cause chronic watery diarrhea, but there are no macroscopic features of MC that can be detected during colonoscopy. Endoscopists therefore often collect multiple random colonic biopsies, potentially oversampling, increasing times of colonoscopy and slide review. We sought to identify sites from which biopsies could be taken and analyzed to identify patients with MC with a high level of sensitivity and determine the appropriate number of biopsies to take at these sites.
METHODS
We performed a retrospective study using biopsies from 101 consecutive patients with MC (52 cases of collagenous colitis, 42 cases of lymphocytic colitis, 7 combined cases), without comorbidities, from 2017 through 2018. Slides were reviewed, and the proportion of biopsies that were diagnostic of MC were calculated at each biopsy site.
RESULTS
The proportions of biopsy fragments from each site of the colon found to be positive for MC were as follows: cecum, 90.0%; ascending colon, 96.9%; hepatic flexure, 77.8%; transverse colon, 95.7%; splenic flexure, 75.0%; descending colon, 85.0%; sigmoid colon, 90.9%; and rectum, 82.2%. For biopsies labeled random, 95.7% were positive for MC. When findings from ascending and descending colon biopsies were combined, 100% of MC cases were detected.
CONCLUSIONS
MC can be detected with certainty by analyzing biopsies from the ascending and descending colon. Fewer biopsies than were collected from our cases are sufficient for diagnosis. We propose a Western protocol (taking 2 biopsies from each of the ascending and descending colon) in evaluation of patients for MC.
Topics: Biopsy; Colitis, Microscopic; Colon; Colon, Descending; Colonoscopy; Diarrhea; Humans; Retrospective Studies
PubMed: 32109628
DOI: 10.1016/j.cgh.2020.02.036 -
Cureus May 2023Segmental colitis associated with diverticulosis (SCAD) is a rare entity characterized by segmental circumferential colonic wall thickening involving the sigmoid and/or...
Segmental colitis associated with diverticulosis (SCAD) is a rare entity characterized by segmental circumferential colonic wall thickening involving the sigmoid and/or left colon in the presence of colonic diverticulosis. We present the case of a 57-year-old female with a past medical history of colonic diverticulosis who presented with chronic intermittent abdominal pain, non-bloody diarrhea, and hematochezia. Imaging revealed long-segment circumferential colonic wall thickening involving the sigmoid and distal descending colon with engorged vasa recta without significant inflammation around the colon or diverticula, consistent with SCAD. Colonoscopy showed diffuse mucosal edema and hyperemia of the descending and sigmoid colon with easy friability and erosions primarily affecting the inter-diverticular colonic mucosa. Pathology showed changes of chronic colitis including inflammation in the lamina propria, crypt distortion, and granuloma formation. Treatment with antibiotics and mesalamine was initiated with improvement in symptoms. This case highlights the importance of considering segmental colitis associated with diverticulosis in patients with chronic lower abdominal pain and diarrhea in the setting of colonic diverticulosis, and the need for a thorough workup including imaging, colonoscopy, and histopathology to differentiate it from other types of colitis.
PubMed: 37292528
DOI: 10.7759/cureus.38724 -
Case Reports in Gastroenterology 2021Constipation is one of the most common functional gastrointestinal disorders and affects 20% of the general population. Irritable bowel syndrome (IBS) is a functional...
Constipation is one of the most common functional gastrointestinal disorders and affects 20% of the general population. Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract that affects the large intestine and is characterized by chronic abdominal pain and altered bowel habits. We report a case of a 35-year-old African American man with a past medical history of IBS who presented to the clinic with a chief complaint of abdominal pain and bloody diarrhea for 1 week. The patient stated that he used a colon-cleansing agent because of persistent constipation. Computed tomography scan of the patient's abdomen and pelvis with contrast was performed which showed diffuse contiguous segmental mural thickening and nodularity seen along the distal transverse, descending, and sigmoid colon. Colonoscopy showed moderate diffuse inflammation characterized by altered vascularity, erythema, and granularity from the rectum to the descending colon, and localized mild inflammation characterized by erythema was found at the ileocecal valve. The patient's clinical condition improved with symptomatic management over 10 days. Patients with IBS should be advised to restrain from using a colon-cleansing agent without advice from their primary doctor as it can lead to various complications.
PubMed: 34616266
DOI: 10.1159/000514440 -
Endoscopic Ultrasound 2017The peritoneal cavity is subdivided into supracolic and infracolic compartments by transverse colon and its mesocolon. The supracolic compartment contains the liver,...
The peritoneal cavity is subdivided into supracolic and infracolic compartments by transverse colon and its mesocolon. The supracolic compartment contains the liver, spleen, stomach, and lesser omentum. The infracolic compartment contains the coils of small bowel surrounded by ascending, transverse, and descending colon and the paracolic gutters. The imaging of different compartments is possible by various methods such as ultrasound (US) and computerized tomography. The treating physicians should be familiar with the relevant radiological anatomy of different compartments and spaces as accurate localization of fluid collection/lymph node in peritoneal cavity greatly aids in selection of a treatment strategy. The role of endoscopic US (EUS) is emerging for detail evaluation of all parts of peritoneal cavity as it provides an easy access for fine-needle aspiration from different compartments of peritoneal cavity. In this review, we describe the techniques of evaluation of different parts of supracolic compartments of peritoneum by EUS.
PubMed: 28440234
DOI: 10.4103/2303-9027.204816 -
Journal of Pediatric Gastroenterology... Nov 2022Mast cells (MCs) have been proposed to be involved in the pathophysiology of irritable bowel syndrome (IBS). Nonetheless, the quantity and distribution of MCs in the...
OBJECTIVES
Mast cells (MCs) have been proposed to be involved in the pathophysiology of irritable bowel syndrome (IBS). Nonetheless, the quantity and distribution of MCs in the gastrointestinal tract of pediatric patients with IBS are not well defined. This study aimed to compare the number of MCs in children with and without IBS and to establish histopathological reference values in pediatrics.
METHODS
Forty-nine participants with IBS were prospectively enrolled and classified into IBS with atopy (n = 29) and IBS without atopy (n = 20). As our retrospective control group, we selected 42 individuals with a history of polyposis syndrome or gastroesophageal reflux disease with normal histopathology. Retrospective selection of the control cohort was performed in a manner similar to previously published adult and pediatric studies. MCs were prospectively stained immunohistochemically on specimens from the stomach, duodenum, terminal ileum, and descending colon of both groups.
RESULTS
The IBS group showed significantly more MCs per high-power field (MCs/HPF) in the stomach, duodenum, terminal ileum, and descending colon ( P < 0.001), irrespective of their atopic status. Optimal MC cutoff values for IBS are ≥20.5 MCs/HPF in the stomach (area under the curve [AUC] = 0.84); ≥23.0 MCs/HPF in the duodenum (AUC = 0.79); ≥33.5 MCs/HPF in the terminal ileum (AUC = 0.82); and ≥22.5 MCs/HPF in the descending colon (AUC = 0.86).
CONCLUSIONS
Pediatric patients with IBS showed increased numbers of MCs in the stomach, duodenum, terminal ileum, and descending colon when compared with controls. Further trials are needed to explain the role of MCs in pediatric IBS, which might facilitate the development of targeted therapeutic interventions.
Topics: Adult; Humans; Child; Irritable Bowel Syndrome; Mast Cells; Retrospective Studies; Intestinal Mucosa; Biopsy
PubMed: 35976360
DOI: 10.1097/MPG.0000000000003588