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European Journal of Radiology Open 2019To evaluate the effectiveness of a therapeutic barium enema as a treatment for colonic diverticulum bleeding, by using a standard concentration as a diagnostic...
PURPOSE
To evaluate the effectiveness of a therapeutic barium enema as a treatment for colonic diverticulum bleeding, by using a standard concentration as a diagnostic examination.
METHODS
We retrospectively analyzed 68 cases of the patients admitted to our hospital with colonic diverticular bleeding between October 2012 and September 2017. We evaluated the following items: (1) the presence/absence of a previous history of diverticular bleeding, (2) the use of medications (anticoagulants, nonsteroidal anti-inflammatory drugs, and antiplatelet drugs), (3) the location of bleeding, (4) the presence/absence of previous treatment and the result, (5) the time between bleeding and the beginning of the barium enema, (6) procedural success, (7) the clinical success of the initial hemostasis, (8) the clinical success of preventing recurrence, and (9) complications such as perforation and diverticulitis associated with this procedure.
RESULTS
Four patients (three men and one woman; age range 60-85 years; median age 76 years) who underwent therapeutic barium enema with a concentration equivalent for diagnostic purpose (78 w/v%) were included. The follow-up period ranged from 11 to 12 months (median 12 months). All three patients who received a barium enema for initial hemostasis were successfully treated. All four patients remained free from recurrence during the follow-up period. There was no complication due to barium in this series.
CONCLUSION
Although we had no statistical evidence, a therapeutic barium enema with a standard concentration as a diagnostic examination may be effective for both the initial hemostasis and preventing the recurrence of colonic diverticular bleeding without complications.
PubMed: 31016208
DOI: 10.1016/j.ejro.2019.03.005 -
Radiology May 2012To estimate the prevalence of underlying adenocarcinoma of the colon in patients in whom acute diverticulitis was diagnosed at computed tomography (CT) and to compare... (Review)
Review
PURPOSE
To estimate the prevalence of underlying adenocarcinoma of the colon in patients in whom acute diverticulitis was diagnosed at computed tomography (CT) and to compare that to the prevalence of colon cancer in the general population.
MATERIALS AND METHODS
A comprehensive literature review was performed to find articles in which patients with CT diagnosis of acute diverticulitis underwent surgery, colonoscopy, or barium enema study within 24 weeks. Patients meeting these criteria were included for analysis. A pooled prevalence of cancer was calculated on the basis of a random effects model and compared qualitatively with the prevalence of cancer in the general population. The 95% confidence intervals around the prevalence of cancer in the study populations were determined.
RESULTS
Ten articles met the inclusion criteria. Data from these articles included only 771 patients who underwent surgery, colonoscopy, or barium enema study within 24 weeks of diagnosis. Fourteen patients were found to have colon cancer, for a prevalence of 2.1% (95% confidence interval: 1.2%, 3.2%). This compares to a calculated estimated prevalence of 0.68% among U.S. adults older than 55 years.
CONCLUSION
There are limited data to support the recommendation to perform colonoscopy after a diagnosis of acute diverticulitis.
Topics: Adenocarcinoma; Barium Sulfate; Colonic Neoplasms; Colonoscopy; Confidence Intervals; Contrast Media; Diagnosis, Differential; Diverticulitis, Colonic; Humans; Predictive Value of Tests; Prevalence; Tomography, X-Ray Computed
PubMed: 22517956
DOI: 10.1148/radiol.12111869 -
California Medicine Oct 1964Patients requiring emergency operation for severe acute colonic hemorrhage usually arrive in the operating room inadequately studied and the point of bleeding not known....
Patients requiring emergency operation for severe acute colonic hemorrhage usually arrive in the operating room inadequately studied and the point of bleeding not known. A well planned procedure for making an operative diagnosis is lacking. The fact that diverticular disease is the most common cause of massive colonic bleeding, dominates the surgical management of this problem. A critical interpretation of the color and the consistency of the stools must be made by the surgeon. Since the bleeding lesion is usually otherwise clinically silent, the character of the stools may be the only indication of the level of bleeding and the rate and the amount of the blood loss. A proctoscopic examination, followed by an emergency barium enema study if possible, is always done before subjecting a patient to laparotomy. The indications for emergency operation include acute exsanguinating hemorrhage, less severe but persistent colonic bleeding and recurrent colonic bleeding. The steps for the operative diagnosis and the surgical procedure utilized for a specific situation are discussed.
Topics: Colonic Diseases; Diagnosis, Differential; Diverticulum; Emergencies; Enema; Exsanguination; Feces; Gastrointestinal Hemorrhage; Humans; Melena; Proctoscopy; Surgical Procedures, Operative
PubMed: 14201233
DOI: No ID Found -
Radiology Case Reports Jul 2019Unrecognized vaginal intubation during the barium enema procedure with subsequent balloon inflation and contrast instillation is a potentially fatal complication of an...
Unrecognized vaginal intubation during the barium enema procedure with subsequent balloon inflation and contrast instillation is a potentially fatal complication of an otherwise common and routine procedure. We describe a patient who, while undergoing a routine barium enema, had misplacement of the enema catheter into the vagina, subsequent rupture of the superior/lateral vagina upon inflation of the catheter retention balloon, and injection of barium contrast into the retroperitoneum. The patient was admitted for surgical repair of the vaginal laceration and monitoring for chemical peritonitis; and was managed without exploratory laparotomy. We review the existing literature, summarize 18 reported cases from worldwide literature, detail potential complications and propose management and prevention strategies based on the mechanism of injury.
PubMed: 31193046
DOI: 10.1016/j.radcr.2019.04.017 -
BMC Surgery Nov 2022Immaturity of ganglia (IG) is an extremely rare disease and always requires surgical intervention in the neonatal period, but without guidelines to choose the ideal...
BACKGROUND
Immaturity of ganglia (IG) is an extremely rare disease and always requires surgical intervention in the neonatal period, but without guidelines to choose the ideal enterostomy procedure, the timing of stoma closure remains controversial. The aim of this study was to report our experience using Santulli enterostomy for the treatment of nine infants diagnosed with IG.
METHODS
Patients who underwent Santulli enterostomy and were diagnosed with IG in our center between 2016 and 2021 were retrospectively studied. Temporary stoma occlusion and a 24-h delayed film of barium enema (BE) were performed to evaluate intestinal peristalsis function to determine the timing of stoma closure. The demographic data, clinical and radiological findings, stoma occlusion and stoma closure results were explored.
RESULTS
A total of 9 infants underwent Santulli enterostomy and were diagnosed with IG postoperatively. Their median gestational age at birth was 36 weeks (range 31-42), and their median birth weight was 2765 g (range 1300-3400). All patients had symptom onset in the neonatal period, including abdominal distension and biliary vomiting. Eight patients showed obvious small bowel dilatation in the plain films, except for one patient's films that suggested gastrointestinal perforation with free gas downstream of the diaphragm. BE was performed in 6 patients, all of which had microcolons. The median age at operation was 3 days (range 1-23). Seven patients had an obvious transitional zone (TZ) during laparotomy, and the position of the TZ was 25-100 cm proximal above the ileocecal (IC) valve. Immature ganglion cells were present in the colon in 7 patients and the terminal ileum in 6 patients. The median age of successful stoma occlusion was 5 M (range 2-17) and 8 M (range 4-22) at ostomy closure. There was little or no barium residue in the 24-h delayed film of BE before stoma closure, and all patients were free of constipation symptoms during the follow-up.
CONCLUSION
Santulli enterostomy appears to be a suitable and efficient procedure for IG, combined with temporary stoma occlusion and 24-h delayed film of BE to evaluate the recovery of intestinal peristalsis function.
Topics: Humans; Infant; Infant, Newborn; Retrospective Studies; Ileostomy; Enterostomy; Anastomosis, Surgical; Ganglia
PubMed: 36401255
DOI: 10.1186/s12893-022-01849-9 -
World Journal of Gastroenterology Mar 2008Microscopic forms of colitis have been described, including collagenous colitis. This disorder generally has an apparently benign clinical course. However, a number of...
Microscopic forms of colitis have been described, including collagenous colitis. This disorder generally has an apparently benign clinical course. However, a number of gastric and intestinal complications, possibly coincidental, may develop with collagenous colitis. Distinctive inflammatory disorders of the gastric mucosa have been described, including lymphocytic gastritis and collagenous gastritis. Celiac disease and collagenous sprue (or collagenous enteritis) may occur. Colonic ulceration has been associated with use of nonsteroidal anti-inflammatory drugs, while other forms of inflammatory bowel disease, including ulcerative colitis and Crohn's disease, may evolve from collagenous colitis. Submucosal "dissection", colonic fractures or mucosal tears and perforation from air insufflation during colonoscopy may occur and has been hypothesized to be due to compromise of the colonic wall from submucosal collagen deposition. Similar changes may result from increased intraluminal pressure during barium enema contrast studies. Finally, malignant disorders have also been reported, including carcinoma and lymphoproliferative disease.
Topics: Celiac Disease; Colitis, Collagenous; Colitis, Ulcerative; Colon; Colonic Neoplasms; Crohn Disease; Gastritis; Humans; Intestinal Mucosa; Ulcer
PubMed: 18350593
DOI: 10.3748/wjg.14.1643 -
World Journal of Gastrointestinal... Feb 2018The objective of this review is to examine whether a redundant colon gives rise to symptoms like constipation and volvulus. In 1820, Monterossi made drawings of colons... (Review)
Review
The objective of this review is to examine whether a redundant colon gives rise to symptoms like constipation and volvulus. In 1820, Monterossi made drawings of colons with displacements and elongation of the colon found during autopsy. In 1912, Kienböeck first visualized a redundant colon using bismuth, and Lardennois and Auborg named the anatomic variant dolichocolon in 1914. The criteria were later: A sigmoid loop rising over the line between the iliac crests, a transverse colon below the same line and extra loops at the flexures. The incidence of dolichocolon is 1.9%-28.5%. Dolichocolon seems to be congenital, as fetuses, newborns, and infants exhibit colonic redundancies. Studies have identified a triade of constipation, abdominal pain, and distension. Colon transit time was recently shown to increase significantly with increased number of redundancies, which increases abdominal pain, bloating and infrequent defecation. The diagnosis of dolichocolon is established by barium enema or CT-colonography. Treatment is conservative, or surgical in case of volvulus or refractory constipation.
PubMed: 29492185
DOI: 10.4240/wjgs.v10.i2.6 -
Gut Dec 1975The effect of glucagon on human colonic myoelectrical activity is described. By means of intraluminal, serosal, and surface electrodes, recordings from all areas of the... (Clinical Trial)
Clinical Trial Comparative Study
The effect of glucagon on human colonic myoelectrical activity is described. By means of intraluminal, serosal, and surface electrodes, recordings from all areas of the large bowel have been obtained. Glucagon inhibited both electrical and pressure rhythms in all subjects tested. Evidence is produced to suggest a direct action on colonic smooth muscle. A controlled trial using glucagon during routine barium enema examinations suggests that it may prove to be useful for hypotonic examinations of the colon where painful spasm is present.
Topics: Barium Sulfate; Cecum; Clinical Trials as Topic; Colon, Sigmoid; Electrodes; Electromyography; Enema; Female; Gastrointestinal Motility; Glucagon; Humans; Infusions, Parenteral; Male; Muscle, Smooth; Rectum; Tachyphylaxis
PubMed: 767229
DOI: 10.1136/gut.16.12.973 -
The Netherlands Journal of Medicine Mar 2011Colorectal cancer is the second most common cancer in Europe and meets the criteria for population screening. Population screening should lead to a reduction in... (Review)
Review
Colorectal cancer is the second most common cancer in Europe and meets the criteria for population screening. Population screening should lead to a reduction in CRC-related mortality and incidence. Several options are available for CRC screening, which can be itemised as stool-based tests and structural exams. Stool-based tests include guaiac and immunochemical faecal occult blood tests and DNA -marker tests. Structural exams comprise endoscopic techniques (flexible sigmoidoscopy, colonoscopy and capsule endoscopy) and radiological exams (double contrast barium enema, CT colonography and MR colonography). Each test has its own test performance characteristics and acceptability profile, which affect the participation and effectiveness of the associated screening programmes. Faecal occult blood tests (FOBT ) and flexible sigmoidoscopy (FS) are the only methods with a demonstrated mortality reduction during a ten-year period (FOBT 16% and FS 31%) while flexible sigmoidoscopy is the only screening test with a demonstrated reduction in CRC incidence (23%). It is likely that other screening techniques such as colonoscopy and CT colonography will also be effective in the reduction of CRC-related mortality. DNA -marker tests, capsule endoscopy and MR colonography are possible options for the future.
Topics: Carcinoma; Colorectal Neoplasms; Early Detection of Cancer; Humans
PubMed: 21444935
DOI: No ID Found