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Gastroenterology Jan 1997
Topics: Barium Sulfate; Colonic Polyps; Colonoscopy; Colorectal Neoplasms; Enema; Humans; Radiography; Sensitivity and Specificity
PubMed: 8978373
DOI: 10.1016/s0016-5085(97)70248-8 -
World Journal of Gastrointestinal... Mar 2016Colorectal cancer (CRC) is the 2(nd) most common cancer in women and 3(rd) most common cancer in men worldwide. Most CRCs develop from adenomatous polyps arising from... (Review)
Review
Colorectal cancer (CRC) is the 2(nd) most common cancer in women and 3(rd) most common cancer in men worldwide. Most CRCs develop from adenomatous polyps arising from glandular epithelium. Tumor growth is initiated by mutation of the tumor suppressor gene APC and involves other genetic mutations in a stepwise process over years. Both hereditary and environmental factors contribute to the development of CRC. Screening has been proven to reduce the incidence of CRC. Screening has also contributed to the decrease in CRC mortality in the United States. However, CRC incidence and/or mortality remain on the rise in some parts of the world (Eastern Europe, Asia, and South America), likely due to factors including westernized diet, lifestyle, and lack of healthcare infrastructure. Multiple screening options are available, ranging from direct radiologic or endoscopic visualization tests that primarily detect premalignant or malignant lesions such as flexible sigmoidoscopy, optical colonoscopy, colon capsule endoscopy, computed tomographic colonography, and double contrast barium enema - to stool based tests which primarily detect cancers, including fecal DNA, fecal immunochemical test, and fecal occult blood test. The availability of some of these tests is limited to areas with high economic resources. This article will discuss CRC epidemiology, pathogenesis, risk factors, and screening modalities with a particular focus on new technologies.
PubMed: 26981176
DOI: 10.4253/wjge.v8.i5.252 -
Acta Medica Academica 2012This article discusses the possibilities of diagnosing abdominal imaging in patients with rectal cancer, detecting lesions and assessing the stage of the lesions, in... (Review)
Review
This article discusses the possibilities of diagnosing abdominal imaging in patients with rectal cancer, detecting lesions and assessing the stage of the lesions, in order to select the appropriate therapy. Before the introduction of imaging technologies, the diagnosis of colorectal pathology was based on conventional methods of inspecting intestines with a barium enema, with either a single or double contrast barium enema. Following the development of endoscopic methods and the wide use of colonoscopy, colonoscopy became the method of choice for diagnosing colorectal diseases. The improvement of Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI), gave us new possibilities for diagnosing colorectal cancer. For rectal cancer, trans-rectal US (TRUS) or endo-anal US (EAUS) have a significant role. For staging rectal cancer, the Multi Slice Computed Tomography (MSCT) is not the method of choice, but Magnetic Resonance Imaging (MRI) is preferred when it comes to monitoring the rectum. The role of the MRI in the T staging of rectal cancer is crucial in preoperative assessment of: thickness - the width of the tumor, the extramural invasion, the circumference of resection margin (CRM), and the assessment of the inclusion of mesorectal fascia. For successful execution of surgical techniques, good diagnostic imaging of the cancer is necessary in order to have a low level of recurrence. According to medical studies, the sensitivity of FDG-PET in diagnosing metastatic nodals is low, but for now it is not recommended in routine diagnosis of metastatic colorectal carcinoma.
Topics: Humans; Magnetic Resonance Imaging; Positron-Emission Tomography; Preoperative Care; Radiography; Rectal Neoplasms; Rectum
PubMed: 23331394
DOI: 10.5644/ama2006-124.52 -
Cureus May 2022Colorectal carcinoma is the third most malignant and second leading cause of death from cancer. The cruelty of this entity is that it takes decades to be symptomatic and... (Review)
Review
Colorectal carcinoma is the third most malignant and second leading cause of death from cancer. The cruelty of this entity is that it takes decades to be symptomatic and is known to be detected late in its timeline by a screening technique. The fatality of this carcinoma only means heightened importance of screening guidelines to be laid down and strict follow-ups by the healthcare providers. A novel method, a potential competitor that could now replace the present screening techniques for colorectal carcinoma, is computed tomographic colonography (CTC) or virtual colonoscopy. Though it first came into existence in 1994, this method is yet to be deeply studied and scrutinized for it to be the next benchmark modality. This review has mainly focused on the various features of CTC. It is contrasted against the gold standard colonoscopy for its superiority, efficacy, cost-effectiveness, patient logistics, and role in detecting extra-colonic lesions. The main focus would be laid on CTC being a screening modality. The review also emphasized why there is a need for the current healthcare providers to incorporate this modality into their practice widely. Although much has been said about CTC and its various aspects of cost-effectiveness, about it being replaced or supplemented for cancer screening, a collaborative effort has to be made by both the fields of radiology and gastroenterology to investigate the outcomes of this not so new technique in daily practice and to avoid misinterpretation of the results due to lack of skill and proficiency.
PubMed: 35719832
DOI: 10.7759/cureus.24916 -
The Medical Journal of Malaysia May 2020Hirschsprung's Disease (HD) also called congenital aganglionic megacolon is a disorder caused by undeveloped distal to proximal intestinal nerve ganglion cells.... (Comparative Study)
Comparative Study
INTRODUCTION
Hirschsprung's Disease (HD) also called congenital aganglionic megacolon is a disorder caused by undeveloped distal to proximal intestinal nerve ganglion cells. Diagnosis includes determining the aganglionic segment through barium enema radiology examination and histopathology of frozen section with permanent section as gold standard. Determining the diagnostic value of this modality is important for operative management decision.
MATERIALS AND METHODS
The study was a retrospective, cross-sectional study with diagnostic test design. Patient data were obtained in the form of clinical symptoms, barium enema, and frozen section expertise were assessed for the suitability of the diagnostic value by referring to the permanent section as the gold standard.
RESULT
Thirty-four patient data were obtained. The sensitivity, specificity, and accuracy of barium enemas were 95%, 69.2%, and 82%, respectively. The values of sensitivity, specificity, and accuracy of frozen section were 95%, 92.8%, and 88%, respectively. The Cohen-Kappa statistic value was 0.62 (good agreement).
CONCLUSION
Accuracy of FS is better than barium enema in diagnosing HD. In health care center with limitation of histopathological facility, BE could be used as the alternative procedure as interrater comparisons showed good agreement. Therefore, either frozen section or barium enema can be carried out in common or in separate term.
Topics: Barium Enema; Cross-Sectional Studies; Female; Frozen Sections; Hirschsprung Disease; Humans; Indonesia; Infant; Male; Tertiary Care Centers
PubMed: 32471967
DOI: No ID Found -
International Journal of Women's Health 2020Endometriosis is a chronic condition primarily affecting young women of reproductive age. Although some women with bowel endometriosis may be asymptomatic patients... (Review)
Review
Endometriosis is a chronic condition primarily affecting young women of reproductive age. Although some women with bowel endometriosis may be asymptomatic patients typically report a myriad of symptoms such as alteration in bowel habits (constipation/diarrhoea) dyschezia, dysmenorrhoea and dyspareunia in addition to infertility. To date, there are no clear guidelines on the evaluation of patients with suspected bowel endometriosis. Several techniques have been proposed including transvaginal and/or transrectal ultrasonography, magnetic resonance imaging, and double-contrast barium enema. These different imaging modalities provide greater information regarding presence, location and extent of endometriosis ensuring patients are adequately informed whilst also optimizing preoperative planning. In cases where surgical management is indicated, surgery should be performed by experienced surgeons, in centres with access to multidisciplinary care. Treatment should be tailored according to patient symptoms and wishes with a view to excising as much disease as possible, whilst at the same time preserving organ function. In this review article current perspectives on diagnosis and management of bowel endometriosis are discussed.
PubMed: 32099483
DOI: 10.2147/IJWH.S190326 -
International Journal of Surgery... 2012Gastrocolic Fistula is, in the majority of cases the pathological communication between stomach and transverse colon, because cases involved with the small intestine,... (Review)
Review
Gastrocolic Fistula is, in the majority of cases the pathological communication between stomach and transverse colon, because cases involved with the small intestine, pancreas and skin have been also documented, even though are rare. It occurs mostly in adults, but they can be present to infants, as well, as a result of congenital abnormalities or iatrogenic procedures (i.e. migration of PEG tube that placed before). In the Western Countries, the most common cause is the adenocarcinoma of the colon, while in Japan, adenocarcinoma of the stomach is the most frequent cause. It seldom appears, as a complication of a benign peptic ulcer, in Crohn's disease and as a result of significant intake of steroids or NSAIDs. The typical symptoms of a gastrocolic fistula are abdominal pain, nausea-vomiting, diarrhea and weight loss. Radiology has been used for the detection of the fistulae all these years but the golden standard remained the barium enema. Barium meal and CT findings play a smaller role in the diagnosis. Although the management of gastrocolic fistulae has historically been surgical, medical treatment has recently been recommended as the first line when a malignancy can be excluded.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Colon, Transverse; Colonic Diseases; Colonic Neoplasms; Crohn Disease; Diagnosis, Differential; Diagnostic Imaging; Digestive System Surgical Procedures; Gastric Fistula; Humans; Intestinal Fistula
PubMed: 22361308
DOI: 10.1016/j.ijsu.2012.02.011 -
Therapeutic Advances in Gastroenterology 2023Benign and malignant pelvic masses with or without intestinal invasion are common in women of childbearing age. Patients may have nonspecific symptoms and signs or... (Review)
Review
Benign and malignant pelvic masses with or without intestinal invasion are common in women of childbearing age. Patients may have nonspecific symptoms and signs or experience no symptoms. Laparoscopic resection of pelvic masses is currently the mainstream treatment; therefore, accurate preoperative evaluation is not only essential for patients suspected of having intestinal invasion, but also extremely important for the selection of follow-up treatment. Procedures, including endoscopic ultrasonography (EUS), pelvic magnetic resonance imaging, abdominal computed tomography, vaginal ultrasonography, barium enema, and colonoscopy, aid in determining the presence, depth, and histology of the disease. In particular, the wide application and continuous developments in EUS techniques have improved the diagnostic accuracy for intestinal subepithelial and peripheral organ lesions. This article reviewed the clinical value of EUS in the diagnosis of benign and malignant pelvic masses with bowel involvement.
PubMed: 37153498
DOI: 10.1177/17562848231163414 -
BMC Pediatrics Oct 2020Preoperative diagnosis of total colonic aganglionosis is important for the rational choice of treatment. The present study aimed to evaluate the diagnostic performance...
BACKGROUND
Preoperative diagnosis of total colonic aganglionosis is important for the rational choice of treatment. The present study aimed to evaluate the diagnostic performance of radiographic signs on preoperative barium enema in patients with total colonic aganglionosis.
METHODS
Forty-four patients [41 (3-659) days] with total colonic aganglionosis, including 17 neonatal patients, who received preoperative barium enema at Beijing Children's Hospital, from January 2007 to December 2019 were included. All radiographs were retrospectively restudied by 2 pediatric radiologists to ascertain radiographic signs including rectosigmoid index, transition zone, irregular contraction, gas-filled small bowel, microcolon, question-mark-shaped colon and ileocecal valve reflux. Kappa test was performed to assess the accuracy and consistency of the radiographic signs.
RESULTS
The 2 radiologists showed slight agreement for gas-filled small bowel, microcolon and rectosigmoid index, fair agreement for transition zone and irregular contraction, and moderate agreement for question-mark-shaped colon and ileocecal valve reflux (Kappa values, 0.043, 0.075, 0.103, 0.244, 0.397, 0.458 and 0.545, respectively). In neonatal patients, the 2 radiologists showed moderate agreement for ileocecal valve reflux and substantial agreement for question-mark-shaped colon (Kappa values, 0.469 and 0.667, respectively). In non-neonatal patients, the 2 radiologists showed substantial agreement for ileocecal valve reflux (Kappa value, 0.628). In 36 patients with total colonic aganglionosis extending to the ileum, the accuracies of question-mark-shaped colon, ileocecal valve reflux and the combination of both were 47%, 53%, and 75%, respectively, in one radiologist and 53%, 50% and 72%, respectively, in the other radiologist.
CONCLUSIONS
Ileocecal valve reflux is a relatively reliable radiographic sign for diagnosing total colonic aganglionosis and could improve the diagnostic accuracy upon combination with question-mark-shaped colon.
Topics: Barium Enema; Child; Enema; Hirschsprung Disease; Humans; Infant, Newborn; Retrospective Studies
PubMed: 33126876
DOI: 10.1186/s12887-020-02403-3 -
Cureus Feb 2024Chilaiditi's sign (colonic interposition) is a rare anomaly due to an abnormally located portion of the colon that is interposed in between the liver and the diaphragm....
Chilaiditi's sign (colonic interposition) is a rare anomaly due to an abnormally located portion of the colon that is interposed in between the liver and the diaphragm. This rare anomaly is often incidentally seen on chest or abdominal radiographs. Chilaiditi's radiographic sign is usually asymptomatic, whereas the medical condition accompanied by clinical symptoms is termed Chilaiditi's syndrome. Possible causes of the syndrome include a long and mobile colon, scarring of the liver (cirrhosis), ascites, long-standing lung disease, as well as laxity of the falciform ligament. The most common clinical signs of Chilaiditi's syndrome include gastrointestinal symptoms; however, clinical presentation can vary. This report describes a case of a 21-year-old male patient who presented with a longstanding history of left upper quadrant epigastric abdominal pain with diarrhea (six to eight loose watery stools). The patient was diagnosed with Crohn's colitis and had tried a myriad of medical therapies with no adequate response. He chose to seek a second opinion and was subsequently discovered to have Chilaiditi's syndrome via computed tomography (CT) and confirmed by barium enema. The patient then elected to undergo a right laparoscopic colectomy to resolve the symptoms. By postoperative day five, all symptoms had resolved including abdominal pain and diarrhea. Therefore, it is important to consider Chilaiditi's syndrome as a differential diagnosis in persons presenting with left upper quadrant pain and symptoms of Crohn's colitis, especially those treated with adequate medical therapy without alleviation of symptoms.
PubMed: 38524032
DOI: 10.7759/cureus.54655