-
The Eurasian Journal of Medicine Dec 2010In sigmoid volvulus (SV), the sigmoid colon wraps around itself and its mesentery. SV accounts for 2% to 50% of all colonic obstructions and has an interesting... (Review)
Review
In sigmoid volvulus (SV), the sigmoid colon wraps around itself and its mesentery. SV accounts for 2% to 50% of all colonic obstructions and has an interesting geographic dispersion. SV generally affects adults, and it is more common in males. The etiology of SV is multifactorial and controversial; the main symptoms are abdominal pain, distention, and constipation, while the main signs are abdominal distention and tenderness. Routine laboratory findings are not pathognomonic: Plain abdominal X-ray radiographs show a dilated sigmoid colon and multiple small or large intestinal air-fluid levels, and abdominal CT and MRI demonstrate a whirled sigmoid mesentery. Flexible endoscopy shows a spiral sphincter-like twist of the mucosa. The diagnosis of SV is established by clinical, radiological, endoscopic, and sometimes operative findings. Although flexible endoscopic detorsion is advocated as the primary treatment choice, emergency surgery is required for patients who present with peritonitis, bowel gangrene, or perforation or for patients whose non-operative treatment is unsuccessful. Although emergency surgery includes various non-definitive or definitive procedures, resection with primary anastomosis is the most commonly recommended procedure. After a successful non-operative detorsion, elective sigmoid resection and anastomosis is recommended. The overall mortality is 10% to 50%, while the overall morbidity is 6% to 24%.
PubMed: 25610145
DOI: 10.5152/eajm.2010.39 -
Life (Basel, Switzerland) Apr 2021Initial enteric microbial colonisation influences animal health and disease, hence an understanding of the first microbial colonisers within the piglet is important. The...
Initial enteric microbial colonisation influences animal health and disease, hence an understanding of the first microbial colonisers within the piglet is important. The spiral colon of piglets that were stillborn ( = 20), born-alive ( = 10), and born alive and had sucked ( = 9) were collected from 28 sows to investigate whether initial microbial colonisation occurs pre- or post-partum and how it develops during the first 24 h post-partum. To examine this, DNA was extracted and 16S rRNA amplicon analysis was performed to allow analysis of microbial communities. The results indicate that microbial colonisation of the spiral colon had occurred in stillborn pigs, suggesting microbial exposure prior to birth. Alpha diversity metrics indicated that the number of taxa and community richness were higher in piglets that sucked ( < 0.001) and community evenness was lower in stillborns in comparison to born-alive ( < 0.001) but was not affected by colostrum consumption ( < 0.001). Additionally, when compared with stillborn piglets, the bacteria colonising the spiral colon during the first 24 h post-partum included the potentially pathogenic bacteria , and , and potentially beneficial bacteria and . The relative presence of Archaea was high in stillborn piglets but decreased with post-natal environmental exposure. It is evident that stillborn piglets have bacteria present within their spiral colon, however further studies are needed in order to determine the time at which colonisation is initiated and the mechanisms determining how colonisation occurs. Additionally, as expected, the immediate post-natal environment largely influences the microorganisms colonising, while colostrum consumption further contributes to the microbial community enrichment.
PubMed: 33918395
DOI: 10.3390/life11040312 -
World Journal of Clinical Cases Jul 2022Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity, although colon cancer and rectal cancer have...
BACKGROUND
Colorectal cancer is one of the most common cancers worldwide with high mortality and is classified as a single entity, although colon cancer and rectal cancer have largely different diagnoses, treatments, surgical methods, and recurrence rates. ≥ 16-slice spiral computed tomography (SCT) is mostly applied to detect the local stage of colon cancer; however, its diagnostic accuracy and whether it is conducive to distinguishing between high-risk and low-risk colon cancer are unclear.
AIM
To systematically review the diagnostic accuracy of ≥ 16-slice SCT for local staging of colon cancer.
METHODS
Based on the PubMed, EMBASE, Cochrane Library, and Web of Science databases, computers were used to search the literature from the establishment of the database to April 2021, and the results of the diagnostic tests on ≥ 16-slice SCT for local staging of colon cancer were collected according to the inclusion criteria. The data were then extracted and assessed on the basis of the Quality Assessment Checklist of the Institute of Economics of Canada, Reference Citation Analysis (https://www.referencecitationanalysis.com/). Afterward, a meta-analysis was performed using the statistical software Meta-disc 14.0 and Stata 15.0.
RESULTS
Eleven studies that provided data on 1613 subjects with computed tomography diagnostic tests were included in this study. Meta-analysis revealed that the pooled sensitivity, pooled specificity, pooled negative likelihood ratio (LR), pooled diagnostic odds ratio, and area under the fitted receiver operating characteristic (ROC) curve of ≥ 16-slice SCT for colon cancer T staging were 0.67 (95%CI: 0.65-0.70), 0.81 (95%CI: 0.80-0.83), 4.13 (95%CI: 2.66-6.41), 0.39 (95%CI: 0.31-0.49), 10.81 (95%CI: 7.33-15.94), and 0.829, respectively, while the specificity, negative LR, diagnostic odds ratio, and area under the fitted ROC curve of ≥ 16-slice SCT for N staging of colon cancer were 0.54 (95%CI: 0.49-0.59), 0.74 (95%CI: 0.70-0.77), 1.92 (95%CI: 1.36-2.70), 0.67 (95%CI: 0.51-0.87), 3.74 (95%CI: 1.76-7.94), and 0.829 respectively. The sensitivity and specificity of ≥ 16-slice SCT for colon cancer T staging were acceptable, while the sensitivity for colon cancer N staging was relatively low, though its specificity was acceptable.
CONCLUSION
≥ 16-slice SCT for local staging of colon cancer has good diagnostic value; however, the accuracy needs to be confirmed by further clinical practice.
PubMed: 35979307
DOI: 10.12998/wjcc.v10.i19.6483 -
Medicine Dec 2020Colon cancer is a common malignant tumor of the gastrointestinal tract. Therefore, a clear diagnosis is particularly important for the treatment of colon cancer....
BACKGROUND
Colon cancer is a common malignant tumor of the gastrointestinal tract. Therefore, a clear diagnosis is particularly important for the treatment of colon cancer. Ultrasound and spiral computed tomography (CT) can both be used in the diagnosis, but each has its own advantages and disadvantages, which could cause confusion in clinical choice. The purpose of this study was to systematically evaluate the practicability of spiral CT and ultrasound in the diagnosis of colon cancer.
METHODS
A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu [VIP], CBM). Besides, manually search for Google and Baidu academic of diagnostic experimental study of ultrasound and spiral CT in the diagnosis of Colon Cancer. The retrieval time limit was from the establishment of the database to October 2020. Two researchers independently extracted and evaluated the quality of the data in the included study. A meta-analysis was performed using Meta Disc1.4 and RevMan5.3 software.
RESULTS
Sensitivity, specificity, positive Likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were used to determine the diagnostic efficacy of ultrasonography and helical CT in colorectal cancer.
CONCLUSIONS
This study will compare the practicability of CT and ultrasound in the diagnosis of colon cancer and provide reliable evidence-based basis for clinicians to choose the appropriate or best evidence-based basis.
ETHICS AND DISSEMINATION
The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.
OSF REGISTRATION NUMBER
DOI 10.17605/OSF.IO/WAJHQ.
Topics: Colonic Neoplasms; Humans; Likelihood Functions; Meta-Analysis as Topic; Odds Ratio; Research Design; Sensitivity and Specificity; Systematic Reviews as Topic; Tomography, Spiral Computed; Ultrasonography
PubMed: 33327262
DOI: 10.1097/MD.0000000000023381 -
Alimentary Pharmacology & Therapeutics May 2000The aim of this article is to review selected aspects of the pathogenesis of cholesterol-rich, gall-bladder stones (GBS)--with emphasis on recent developments in biliary... (Review)
Review
The aim of this article is to review selected aspects of the pathogenesis of cholesterol-rich, gall-bladder stones (GBS)--with emphasis on recent developments in biliary cholesterol saturation, cholesterol microcrystal nucleation, statis within the gall-bladder and, particularly, on the roles of intestinal transit and altered deoxycholic acid (DCA) metabolism, in GBS development. In biliary cholesterol secretion, transport and saturation, recent developments include evidence in humans and animals, that bile lipid secretion is under genetic control. Thus in mice the md-2 gene, and in humans the MDR-3 gene, encodes for a canalicular protein that acts as a 'flippase' transporting phospholipids from the inner to the outer hemi-leaflet of the canalicular membrane. In the absence of this gene, there is virtually no phospholipid or cholesterol secretion into bile. Furthermore, when inbred strains of mice that have 'lith genes' are fed a lithogenic diet, they become susceptible to high rates of GBS formation. The precipitation/nucleation of cholesterol microcrystals from supersaturated bile remains a critical step in gallstone formation. methods of studying this phenomenon have now been refined from the original 'nucleation time' to measurement of cholesterol appearance/detection times, and crystal growth assays. Furthermore, the results of recent studies indicate that, in addition to classical Rhomboid-shape monohydrate crystals, cholesterol can also crystallize, transiently, as needle-, spiral- and tubule-shaped crystals of anhydrous cholesterol. A lengthy list of promoters, and a shorter list of inhibitors, has now been defined. There are many situations where GB stasis in humans is associated with an increased risk of gallstone formation--including iatrogenic stone formation in acromegalic patients treated chronically with octreotide (OT). As well as GB stasis, however, OT-treated patients all have 'bad' bile which is supersaturated with cholesterol, has excess cholesterol in vesicles, rapid microcrystal mulceation times and a two-fold increase in the percentage DCA in bile. This increase in the proportion of DCA seems to be due to OT-induced prolongation of large bowel transit time (LBTT). Thus LBTT is linearly related to (i) the percentage of DCA in serum; (ii) the DCA pool size; and (III) the DCA input or 'synthesis' rate. Furthermore, the intestinal prokinetic, cisapride, counters the adverse effects of OT on intestinal transit, and 'normalizes' the percentage of DCA in serum/bile. Patients with spontaneous gallstone disease also have prolonged LBTTs, more colonic gram-positive anaerobes, increased bile acid metabolizing enzymes and higher intracolonic pH values, than stone-free controls. Together, these changes lead to increased DCA formation, solubilization and absorption, Thus, in addition to the 'lithogenic liver' and 'guilty gall-bladder' one must now add the 'indolent intestine' to the list of culprits in cholesterol gallstone formation.
Topics: Acromegaly; Animals; Bile Acids and Salts; Cholelithiasis; Cholesterol; Crystallization; Deoxycholic Acid; Gallbladder; Gastrointestinal Transit; Humans; Mice
PubMed: 10903002
DOI: 10.1046/j.1365-2036.2000.014s2039.x -
Frontiers in Nutrition 2022Short bowel syndrome (SBS), secondary to any natural loss or after any extensive bowel resection for congenital malformations or acquired disease, is the most common... (Review)
Review
Short bowel syndrome (SBS), secondary to any natural loss or after any extensive bowel resection for congenital malformations or acquired disease, is the most common cause of intestinal failure in children. Extensive introduction of parenteral nutrition (PN) has dramatically changed the outcome of these patients, allowing for long-term survival. The main goal in children with SBS remains to be increasing enteral tolerance and weaning from PN support. Post resection intestinal adaptation allows for achievement of enteral autonomy in a subset of these patients, but the inability to progress in enteral tolerance exposes others to long-term complications of PN. Autologous intestinal reconstruction surgery (AIRS) can facilitate the fulfilment of enteral autonomy, maximizing the absorptive potential of the remaining gut. All the different intestinal reconstruction techniques, from simple procedures like tapering, reversed segments, and colon interposition, to more complex lengthening procedures (LILT: longitudinal intestinal lengthening and tailoring, STEP: serial transverse enteroplasty, and SILT: spiral intestinal lengthening and tailoring) and techniques designed for peculiar problems like controlled intestinal tissue expansion or duodenal lengthening are presented. AIRS indications, clinical applications, and results reported in the literature are reviewed.
PubMed: 35463997
DOI: 10.3389/fnut.2022.861093 -
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 -
Evidence-based Complementary and... 2022Colon cancer is a common digestive system malignancy with nonspecific early symptoms, which necessitates better early detection methods. The present study was conducted...
Colon cancer is a common digestive system malignancy with nonspecific early symptoms, which necessitates better early detection methods. The present study was conducted to assess the accuracy and clinical value of multislice spiral CT (MSCT) plus magnetic resonance imaging (MRI) for colon cancer. Between January 2019 and July 2020, 100 patients with pathologically confirmed colon cancer treated in Wuxi People's Hospital were assessed for eligibility and recruited. All eligible patients received MRI and MSCT without any treatment prior to scanning. The accuracy of preoperative diagnosis and staging of colon cancer by MRI, MSCT, and MRI plus MSCT were analyzed using postoperative pathological results as the gold standard, and consistency analysis was performed. The receiver operating characteristic curve (ROC) was plotted, and the area under the curve (AUC) was obtained to analyze the preoperative diagnostic value. The accuracy of MRI, MSCT, and MRI plus MSCT was 98.00%, 96.00%, and 100% with good consistency (Kappa = 0.732, 0.703, and 0.756). The AUC of MRI, MSCT, and MRI plus MSCT was 0.889, 0.861, and 0.903, respectively. The preoperative diagnostic accuracy of MRI for colon cancer at T1, T2, T3, and T4 stages was 76.92%, 82.61%, 73.47%, and 86.67%, respectively, those of MSCT was 53.85%, 69.57%, 63.27%, and 40.00%, respectively, and those of MRI plus MSCT was 100.00%, 95.65%, 95.92%, and 86.67%, respectively. Consistency analysis yielded good consistency for the diagnosis of the T-staging of colon cancer (Kappa = 0.754, 0.731, 0.776). MSCT plus MRI yielded higher accuracy, specificity, and sensitivity in the detection of colon cancer versus the standalone MRI or MSCT, which demonstrated great potential in the early detection of colon cancer with a high clinical value.
PubMed: 35685721
DOI: 10.1155/2022/6507865 -
The Quarterly Journal of Nuclear... Mar 2006Thi study is based on medical health check-up and cancer screening on of a medical health club using PET, MRI, spiral CT and other conventional examinations. (Clinical Trial)
Clinical Trial
AIM
Thi study is based on medical health check-up and cancer screening on of a medical health club using PET, MRI, spiral CT and other conventional examinations.
METHODS
Between October 1994 and June 2005, 9,357 asymptomatic members of the health club participated in 24,772 screening session (5,693 men and 3,664 women, mean age was 52.2+/-10.4 years).
RESULTS
Malignant tumors were discovered in 296 of the 9,357 participants (3.16%) and 24,772 screening sessions (1.19%). The detection rate of our program is much higher than that of mass screening in Japan. The thyroid, lung, colon and breast cancers were PET positive, but the prostate, renal and bladder cancers were generally PET negative.
CONCLUSIONS
FDG-PET has the potential to detect a wide variety of cancers at curable stages in asymptomatic individuals. To reduce false-positive and false-negative results of PET examination, there is a need for experienced radiologist and/or oncologists who had training in the wide aspect of FDG-PET. FDG-PET has limitations in the detection of urological cancers, cancers of low cell density, small cancers and hypometabolic or FDG non-avid cancers. Therefore, conventional examinations and/or PET/CT are also needed for cancer screening in association with FDG-PET.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Fluorodeoxyglucose F18; Humans; Incidence; Japan; Male; Middle Aged; Neoplasms; Positron-Emission Tomography; Radiopharmaceuticals; Reproducibility of Results; Risk Assessment; Risk Factors; Sensitivity and Specificity; Whole Body Imaging
PubMed: 16557201
DOI: No ID Found