1/210. Metastasis of hepatocellular carcinoma to the right colon manifested by gastrointestinal bleeding.An 82-year-old black woman with a history of hepatocellular carcinoma presented with gastrointestinal bleeding. barium enema and fibrocolonoscopy revealed a 4-cm polypoid mass at the level of the ascending colon with evidence of active bleeding. Biopsies of the lesion proved it to be metastatic hepatocellular carcinoma. Exploratory laparotomy revealed no further dissemination of the tumor, and the patient underwent an ileocolectomy. The serosal side of the colonic lesion was free from tumor, and there was no peritoneal implantation, direct extension, or lymph node involvement. This case represents an extremely rare presentation of metastatic hepatocellular carcinoma.- - - - - - - - - - ranking = 1keywords = colonic (Clic here for more details about this article) |
2/210. Massive rectal bleeding due to jejunal and colonic tuberculosis.A case of massive rectal bleeding due to colonic tuberculosis in advanced pregnancy with intrauterine foetal death is reported. Patient was treated with resection of the left colon and left transverse end colostomy with closure of the rectal stump. hysterotomy for the removal of the dead foetus was performed. The patient improved in health with antitubercular treatment. The colorectal anastomosis was performed after 4 months. Massive rectal bleeding in intestinal tuberculosis, though rare should be kept in mind.- - - - - - - - - - ranking = 5keywords = colonic (Clic here for more details about this article) |
3/210. Colonic ulceration caused by administration of loxoprofen sodium.A 54-year-old female with chronic headache was admitted to our hospital because of hematochezia. She had routinely taken loxoprofen sodium because of severe headache. Emergent colonoscopic examination revealed ulceration of the cecum. After administration of loxoprofen sodium was discontinued and administration of sulfasalazine was initiated, her intestinal bleeding subsided. Two months after discontinuation of loxoprofen sodium, the colonoscopic examination revealed scar formation at the site of cecal ulceration. In this case, it was conceivable that the administration of loxoprofen sodium might have induced colonic ulceration.- - - - - - - - - - ranking = 1keywords = colonic (Clic here for more details about this article) |
4/210. Enteroscopic identification of an adenocarcinoma of the small bowel in a patient with previously unrecognized hereditary nonpolyposis colorectal cancer syndrome.Tumors of the small bowel are uncommon and seldom suspected on a clinical basis. Together with the relative inaccessibility of the small bowel to endoscopic investigation, the rarity of these tumors undoubtedly delays their diagnosis. The case reported is of a patient with an adenocarcinoma of the jejunum presenting as gastrointestinal bleeding of obscure origin. diagnosis was by push enteroscopy, after several years of unsuccessful radiological and upper and lower endoscopic evaluation. The patient's family fulfilled the Amsterdam criteria for hereditary nonpolyposis colorectal cancer syndrome, which was previously unrecognized. This report emphasizes the value of push enteroscopy and the limits of radiography of the small bowel when investigating patients with obscure GI bleeding. It also underlines the importance of a careful evaluation of the pedigree (concerning history of colorectal and extracolonic cancer) of all patients, including those who present with adenocarcinoma of the small bowel; it is similarly important to consider the possibility of small bowel cancer in members of families with hereditary nonpolyposis colorectal cancer (HNPCC) syndrome.- - - - - - - - - - ranking = 1keywords = colonic (Clic here for more details about this article) |
5/210. Ruptured primary splenic angiosarcoma into the colon. Presentation as anal bleeding.A 71-year-old woman presented with a six month history of constipation and abdominal discomfort, with anal bleeding during the last days. ultrasonography and CT-scan of the abdomen showed a large heterogeneous mass that was located in the splenic region, but the nature and origin of the tumour could not be clearly established preoperatively. The clinical diagnosis was of abdominal tumour with colonic and splenic involvement, and a left hemicolectomy and splenectomy were performed. Pathologic examination revealed a primary angiosarcoma of the spleen with penetration and fistulization of the tumour into the large bowel. The patient received adjuvant radiation therapy, but she died of extensive metastastic disease from her primary angiosarcoma of the spleen nine months after surgery. In summary, splenic angiosarcoma is very difficult to diagnose preoperatively. This highly aggressive neoplasm has an overall poor prognosis, specially if it is associated with rupture and haemoperitoneum. As this case highlights, unusual forms of rupture may lead to atypical clinical presentations, increasing even more the difficulty in the diagnosis.- - - - - - - - - - ranking = 1keywords = colonic (Clic here for more details about this article) |
6/210. hemostasis of colonic diverticular bleeding with hemoclips under endoscopic control: report of a case.This paper reports a case in which endoscopic hemostasis of a bleeding colonic diverticula was successful with endoscopic hemoclip. The patient, a 53 year-old man with painless hematochezia, was urgently admitted to our institute. After colonic cleaning preparation, colonoscopic examination was performed. At the bottom of the diverticulum of the ascending colon, a vessel with oozing blood was endoscopically noted. Hemoclips were placed on and around the visible vessel and immediate hemostasis was completed. Endoscopic clipping method for management of bleeding diverticular vessel is an effective, simple, and safe procedure.- - - - - - - - - - ranking = 6keywords = colonic (Clic here for more details about this article) |
7/210. Cow's milk enteropathy: surgical pitfalls.BACKGROUND: Cow's milk-induced intestinal bleeding is a well-recognized cause of rectal bleeding in infancy. The authors report on 5 older children who presented with either visible rectal bleeding or profound anemia associated with occult intestinal bleeding secondary to cow's milk enteropathy. methods: Five children (3 boys and 2 girls) aged between 20 months and 9 years were referred for further investigation of gastrointestinal bleeding. Two had been investigated previously on multiple occasions, and both had undergone laparotomies with negative results. Further investigations showed evidence of allergic colitis in 3 detected only on proximal colonic biopsy findings. RESULTS: In all cases, bleeding resolved completely after instituting a cow's milk-free diet. Two of the patients subsequently have undergone a cow's milk challenge leading to prompt recurrence of symptoms, which again resolved after simple dietary manipulation. CONCLUSIONS: Cow's milk enteropathy may cause overt rectal bleeding or profound anemia from occult intestinal bleeding even in older children. Histological abnormalities in such cases may be confined to the proximal colon. After appropriate investigation, a trial of cow's milk exclusion should always be considered before laparotomy for obscure, chronic gastrointestinal bleeding in children.- - - - - - - - - - ranking = 1keywords = colonic (Clic here for more details about this article) |
8/210. An endoscopic injection with N-butyl-2-cyanoacrylate used for colonic variceal bleeding: a case report and review of the literature.We report a 64-yr-old patient with liver cirrhosis and bleeding esophageal varices that were obliterated by repeated endoscopic sclerotherapy. Eleven years later, he developed a massive, life-threatening rectosigmoid variceal hemorrhage. An endoscopic injection with N-butyl-2-cyanoacrylate (Histoacryl), performed over the rectosigmoid varices, achieved temporary hemostasis. The etiology, prevalence, relationship with portal hypertension, diagnosis, and treatment of colorectal varices are discussed.- - - - - - - - - - ranking = 4keywords = colonic (Clic here for more details about this article) |
9/210. Acute hemorrhage from right-colonic hemangiomas: report of a case.A rare case of severe rectal bleeding beginning in adult life is reported. A diffuse, cavernous hemangioma of the right transverse colon was visualized by superior mesenteric arteriography and the diagnosis was confirmed by peroperative colonoscopy carried out through a colotomy. The patient was treated by right hemicolectomy. The diagnostic value of selective abdominal arteriography in patients who have severe rectal bleeding is demonstrated.- - - - - - - - - - ranking = 4keywords = colonic (Clic here for more details about this article) |
10/210. Massive colonic bleeding and oral contraceptive "pills".Two patients on oral contraceptives who developed massive colonic bleeding have been presented. The clinical course and various studies suggest the mesenteric insufficiency syndrome as being a possible result of oral contraceptive effect on mesenteric vasculature. Although no definite histologic confirmation is available, the onset, course, and follow-up of these patients suggest contraceptive-induced massive colonic bleeding. The spectrum of oral contraceptive-induced colonic bleeding may vary from mucosal injury with massive colonic bleeding to transmural infarction. Only the clinical follow-up would determine the severity of the involvement and that would determine whether surgical intervention will be necessary.- - - - - - - - - - ranking = 8keywords = colonic (Clic here for more details about this article) |
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