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Zhonghua Wai Ke Za Zhi [Chinese Journal... Dec 2019To examine the value of multi-slice spiral CT angiography (MSCTA) in the analysis of anatomical variation and structural classification of right colon vessels. From...
To examine the value of multi-slice spiral CT angiography (MSCTA) in the analysis of anatomical variation and structural classification of right colon vessels. From August 2015 to August 2017, 198 patients (96 of whom underwent laparoscopic radical resection of right colon cancer) at Department of General surgery of Peking University First Hospital were retrospectively collected, and the results of abdominal enhanced CT scan were collected and three-dimensional reconstruction of blood vessels was performed. There were 104 males and 94 females. The age was 64(27) years ((), range: 19 to 87 years). Right gastroepiploic vein, anterior superior pancreaticoduodenal vein, right colonic vein (RCV), superior right colonic vein, ileocolon artery or vein (ICA or ICV), middle colon artery or vein (MCA or MCV) and Henle trunk were observed and recorded respectively. The anatomical relationship between the positions of blood vessels, the length of Henle trunk and surgical trunk were measured. ICV and ICA were the most constant anatomic structures. The ICV/ICA of all patients came directly from SMV/SMA, 36.9% (73/198) ICV going in front of SMV and 63.1% (125/198) behind SMV. 72.2% (143/198) of the patients had RCV imported into Henle trunk and the rest into SMV. Middle colonic vein (MCV) could be observed in 81.3% (161/198) of the cases. 81.4% (131/161) of MCV were imported into SMV, 16.8% (27/161) into Henle trunk, 1.2% (2/161) into the first jejunal vein and 0.6% (1/161) into the splenic vein. Henle trunk was divided into 4 types, among which the occurrence probability of gastric node and pancreatic trunk was the highest. The dry length of Henle trunk was (0.82±0.39) cm (range: 0.37 to 1.68 cm). The length of surgical trunk was (2.54±0.83) cm (range: 1.57 to 3.95 cm). Accuracy of MSCTA results was 96.9%(93/96). Anatomical variation of blood vessels in the right colon is common. Abdominal CT angiography can accurately determine the anatomical structure of the blood vessels in the right colon.
Topics: Adult; Aged; Aged, 80 and over; Colectomy; Colon; Colonic Neoplasms; Computed Tomography Angiography; Female; Humans; Laparoscopy; Male; Middle Aged; Preoperative Care; Retrospective Studies; Splanchnic Circulation; Tomography, Spiral Computed; Young Adult
PubMed: 31826598
DOI: 10.3760/cma.j.issn.0529-5815.2019.12.011 -
Internal Medicine (Tokyo, Japan) 2019We herein report a case of Brachyspira pilosicoli-caused severe colitis presenting with portal venous gas. A 75-year-old man was admitted because of a fever, severe...
We herein report a case of Brachyspira pilosicoli-caused severe colitis presenting with portal venous gas. A 75-year-old man was admitted because of a fever, severe abdominal pain and bloody diarrhea. He was negative for anti-HIV antibodies. He had been in close contact with a dog earlier. Abdominal computed tomography detected severe wall-thickening and fat-stranding of the entire colon accompanied by portal venous gas. A smear examination of his stool showed many Gram-negative spiral rods, suggesting intestinal spirochetosis. A polymerase chain reaction assay using stool samples detected an amplified band specific for B. pilosicoli. He responded well to antimicrobial agents including metronidazole.
Topics: Abdominal Pain; Aged; Animals; Anti-Bacterial Agents; Brachyspira; Colitis; Diarrhea; Dog Diseases; Dogs; Feces; Gases; Gram-Negative Bacterial Infections; Humans; Male; Metronidazole; Polymerase Chain Reaction; Portal Vein
PubMed: 31787630
DOI: 10.2169/internalmedicine.3254-19 -
Veterinary Sciences Nov 2019Exposure of neonates to subsp. (MAP) via infected dams is the primary mode of transmission of Johne's disease. Little is known about the impacts of feeding colostrum...
Exposure of neonates to subsp. (MAP) via infected dams is the primary mode of transmission of Johne's disease. Little is known about the impacts of feeding colostrum and supplemental vitamins on the gut microbiome in calves exposed to MAP. In the present study, calves were assigned at birth to one of six treatment groups: (1) Colostrum deprived (CD), no vitamins; (2) colostrum replacer (CR), no vitamins; (3) CR, vitamin A; (4) CR, vitamin D; (5) CR, vitamin E; (6) CR, vitamins A, D, E, with five calves per treatment in a 14-day study. All calves were orally inoculated with MAP on days 1 and 3 of the study. Differences due to vitamin supplementation were not significant but treatment groups CR-A, CR-E, and CR-ADE had higher numbers of MAP-positive tissues overall. Shannon diversity indices demonstrated regional differences in microbial communities, primarily Proteobacteria, Bacteroidetes, and Firmicutes, between the ileum, cecum, and spiral colon of all calves. CD calves exhibited increased richness compared with CR calves in the cecum and spiral colon and harbored increased Proteobacteria and decreased Bacteroidetes in the mucosa compared with the lumen for all three tissues. Overall, supplementation with vitamins did not appear to influence gut microbiome or impact MAP infection. Feeding of colostrum influenced gut microbiome and resulted in fewer incidences of dysbiosis.
PubMed: 31756892
DOI: 10.3390/vetsci6040093 -
Clinics in Colon and Rectal Surgery May 2019Early in the 21st century, the costs of health care in the United States have spiraled out of control, where the per capita spending is $9,237 per person-the highest in... (Review)
Review
Health Care Policy and Outcomes after Colon and Rectal Surgery: What Is the Bigger Picture?-Cost Containment, Incentivizing Value, Transparency, and Centers of Excellence.
Early in the 21st century, the costs of health care in the United States have spiraled out of control, where the per capita spending is $9,237 per person-the highest in the world. By 2020, an estimated 20% of GDP will be spent on health care. The issue of cost and quality is now becoming a national crisis, with ∼50% of hospitals losing money on clinical operations, forcing closure of essential critical access hospitals, and forcing health care workers to relocate or change professions. This crisis will only worsen with the graying of America, as an estimated 17% of Americans will be over the age of 65 years by the year 2020. The policy and financial structures on which these changes are based are important factors of which practicing surgeons should be aware. This review discusses recent national health care policy reform and specific topics including cost-containment legislation, value-based incentives and penalties, transparency, and centers of excellence in colorectal surgery.
PubMed: 31061652
DOI: 10.1055/s-0038-1677028 -
Journal of Interventional Medicine May 2018The present study retrospectively analyzed thesafety and efficacy of computed tomography (CT)-guided cryoablationin the treatment ofunresectable or recurrent advanced...
The present study retrospectively analyzed thesafety and efficacy of computed tomography (CT)-guided cryoablationin the treatment ofunresectable or recurrent advanced colorectal cancer, which did not respond well to or experienced progression with radiotherapy or chemotherapy. From January 2013 to April 2015, 31 lesions in 27 patients (16 males, 11 females; mean age of 57.2 years) with pelvic unresectableadvanced or recurrent colorectal cancer were included in the study. The tumor diameter was approximately 3.37 ±1.41 cm. The primary tumor included 25 rectal cancers, 1 sigmoid colon adenocarcinoma, and 1 ileocecal mucinous adenocarcinoma. Cryoablation was performed with 17-gauge cryoprobes and monitored by 64-slice spiral CT. Follow-up was carried out by contrast-enhanced magnetic resonance imaging (MRI). The treatment efficacy was evaluated by symptom palliation, decreased carcinoembryonic antigen (CEA) serum level, and tumor response. The cryoablation procedure was well-tolerated in all patients without major complications or procedure-related mortality. Long-term complications included abscess formation (1 patient), skin frostbite and post-sacrum antrum formation (1 patient). Pain relief was satisfactory in patients with perineal pain (<0.001), and the median time of pain relief was 3.0 months. Complete ablations were obtained in 22 lesions of 18 patients, while 9 lesions in 9 patients underwent incomplete ablation. The median time to local recurrence for lesions with complete ablations was 15.0 months, and that to the progression of tumors with incomplete ablation was 4.0 months. CT-guided cryoablation is a minimally invasive, safe, and effective therapeutic option for unresectableadvanced or recurrent colorectal cancer. The treatment is well-tolerated by patients, and pain relief is achieved rapidly.
PubMed: 34805836
DOI: 10.19779/j.cnki.2096-3602.2018.02.06 -
PloS One 2019The term heterotopy of the spiral colon encompasses a dysmorphological condition in which the spiral loops of the ascending colon (SLACs) do not form an orderly...
The term heterotopy of the spiral colon encompasses a dysmorphological condition in which the spiral loops of the ascending colon (SLACs) do not form an orderly spiraling mass adjacent to the left side of the mesojejunum. As a consequence, the spiral loops are spread over a larger surface, making them more or less movable. It has been hypothesized that the abnormal position of the spiral loops of the ascending colon might constitute a predisposing factor for an intestinal obstruction or an ileus condition. The objective of the present study was to evaluate the anatomy of the spiral loops of the ascending colon in a population of healthy calves and to determine the prevalence of dysmorphism. The investigation was carried out on 1113 slaughtered veal calves. In 472 out of the 1113 calves, the spiral loops showed conformational aspects different from what has so far been described as normal in reference textbooks. In 91 calves the condition was definitely considered a pathological deviation from normality: in fact, the spiral colon had lost its typical spiral shape with random spacing between the loops, and it was nearly or completely detached from the mesojejunum. The lack of a broad attachment of the spiral loops of the ascending colon to the mesentery could provoke an alteration of the intestinal centre of gravity, enhancing the already asymmetrical distribution of weight between the jejunum and the descending colon.
Topics: Animals; Cattle; Cattle Diseases; Choristoma; Colon, Ascending; Male; Prevalence
PubMed: 30978255
DOI: 10.1371/journal.pone.0215402 -
Tierarztliche Praxis. Ausgabe G,... Feb 2019In small ruminants intestinal volvulus is a rare finding and therefore only scarcely mentioned in the literature. The case report summarizes findings and clinical...
In small ruminants intestinal volvulus is a rare finding and therefore only scarcely mentioned in the literature. The case report summarizes findings and clinical development of a pygmy goat with a volvulus of the spiral colon. The animal presented with a highly disturbed general condition and clinical signs of shock. It showed a painful abdomen and a balloon-shaped structure in the right dorsal abdomen. Diagnostic laparotomy revealed a rotation of the spiral colon of 360° to the right. Due to cardiovascular failure the animal died during surgery. The cause of the volvulus remains undetermined.
Topics: Animals; Colon; Fatal Outcome; Goats; Intestinal Volvulus; Laparotomy; Male
PubMed: 30808030
DOI: 10.1055/a-0809-4199 -
Journal of Veterinary Diagnostic... Mar 2019Enteric disease in pigs is usually of multifactorial etiology, including infectious and non-infectious factors. In many cases of endemic diarrhea in weaner-to-finisher...
Enteric disease in pigs is usually of multifactorial etiology, including infectious and non-infectious factors. In many cases of endemic diarrhea in weaner-to-finisher pigs, the combination of 2 or more microorganisms leads to aggravation of intestinal lesions and, consequently, clinical signs. We autopsied a 4-mo-old fattening pig with diarrhea and diagnosed severe fibrinonecrotizing typhlocolitis. Numerous spiral-shaped bacteria and amoeba-like PAS-positive protozoa were observed in the cecal and colonic mucosa and submucosa. Brachyspira hyodysenteriae was detected by PCR from colonic content. By in situ hybridization, large numbers of Entamoeba polecki were found within the lamina propria and submucosa; moderate numbers of Blastocystis sp. and scattered trichomonads were present in intestinal content. In addition, Entamoeba polecki, Balantidium spp., Blastocystis sp., and Trichomonas sp. were also detected by PCR.
Topics: Animals; Brachyspira hyodysenteriae; Cecum; Coinfection; Colon; Diarrhea; Entamoeba; Entamoebiasis; Gram-Negative Bacterial Infections; In Situ Hybridization; Polymerase Chain Reaction; Swine; Swine Diseases
PubMed: 30741127
DOI: 10.1177/1040638719829800 -
Journal of Postgraduate Medicine 2019
Topics: Cardiac Surgical Procedures; Colonic Pseudo-Obstruction; Erythromycin; Female; Gastrointestinal Agents; Heart Failure; Humans; Intestine, Large; Intubation, Gastrointestinal; Middle Aged; Multidetector Computed Tomography; Neostigmine; Postoperative Complications; Tomography, Spiral Computed; Treatment Outcome
PubMed: 30693875
DOI: 10.4103/jpgm.JPGM_405_18 -
Veterinary Sciences Oct 2018Shiga toxin-producing , like O157:H7, are important human and animal pathogens. Naturally-acquired O157:H7 infections occur in numerous species but, particularly,...
Shiga toxin-producing , like O157:H7, are important human and animal pathogens. Naturally-acquired O157:H7 infections occur in numerous species but, particularly, cattle have been identified as a significant reservoir for human cases. O157:H7 are isolated from a number of domestic and wild animals, including rodents that share a living space with cattle. These Shiga toxin-producing O157:H7 strains can be highly virulent in humans, but little is known about the sequelae of interspecies transfer. In a group of neonatal calves, we determined the differences in colonization patterns and lesions associated with infection using either a wildlife or bovine O157:H7 strain. In calves challenged with the wildlife O157:H7 strain, the large (descending) colon was solely colonized, which differed substantially from the calves inoculated with the bovine O157:H7 strain, where the spiral colon was the principal target of infection. This study also demonstrated that while both interspecies- and intraspecies-derived O157:H7 can infect young calves, the distribution and severity differs.
PubMed: 30326606
DOI: 10.3390/vetsci5040088