Cases reported "Colonic Diseases"

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1/274. Tension pneumoperitoneum: a report of 4 cases.

    Four cases of tension pneumoperitoneum are described. In 3 patients this condition followed a perforation of a grossly distended caecum. In 2 of these patients there was an associated malignant neoplasm of the pelvic colon with obstruction. The third patient had a pseudo-obstruction of the transverse colon. The fourth patient had a tension penumoperitoneum with associated surgical emphysema in the neck and subcutaneous tissues of the abdomen and chest walls, following perforation of a duodenal ulcer. The aetiology, presentation and management, together with the mechanism of tension pneumoperitoneum, are discussed.
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keywords = obstruction
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2/274. The uptake of gallium 67 in colonic macrophages.

    A case is presented in which a patient with a well-differentiated adenocarcinoma showed high gallium concentration in the segment with melanosis coli proximal to the obstruction. Although in this case the gallium was associated with an increased number of faecal pigment containing macrophages it is unlikely that macrophages are the main factor in tumour uptake of gallium compounds.
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keywords = obstruction
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3/274. Changing diagnostic and therapeutic approaches to the 'Ogilvie syndrome'.

    The only thing that has remained unchanged about the genuinely described 'Ogilvie syndrome' is its name. Recently it was considered to be an acute colonic pseudoobstruction, a clinical entity mimicking the mechanic ileus of the distal large intestine, without organic obstruction. It is almost always secondary to other diseases. Not all details of the pathogenesis are known, but it has become clear that the direct factor leading to the disturbance of the motility is a vegetative imbalance. X-ray findings are highly characteristic and critical in the planning of treatment. The danger for the patients is the progression of the state or the long duration of the process. Conservative treatment is suitable only for early cases, without complications. In case of failure non-invasive endoscopic or endoscopically assisted minimally invasive procedures may be mandatory. These methods have seen rapid advance in recent years. Uncertain diagnoses or complications call for open surgery. cecostomy is the solution of choice anyway. The mortality is high in this group of elderly polymorbid patients. Authors compare six of their cases with data collected from the literature.
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keywords = obstruction
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4/274. Colonic lithobezoar.

    We report a four-year-old girl with large number of stones in the colon presenting with subacute intestinal obstruction.
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ranking = 0.5
keywords = obstruction
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5/274. Simultaneous pyloric and colonic obstruction associated with hiatus hernia in a weightlifter: a case report.

    Hiatus hernia is usually attributed to conditions that cause a chronic increase in intra-abdominal pressure such as multiple pregnancies and obesity. A 30-year-old man, a weightlifter, had a massive hiatus hernia causing both high and low gastrointestinal obstruction but no involvement of the gastroesophageal junction or fundus. The onset of the obstruction is attributed to an extreme increase in intra-abdominal pressure caused by the action of lifting weights.
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ranking = 3
keywords = obstruction
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6/274. Autoimmune pancreatitis, pancreatic mass, and lower gastrointestinal bleed.

    Autoimmune pancreatitis (AIMP) is a recently described clinical entity causing chronic pancreatitis. It often presents with diffuse enlargement of the pancreas and/or a focal mass at the head of the pancreas causing common bile duct obstruction and jaundice. In most instances, AIMP is mistaken for pancreatic cancer. A number of laboratory abnormalities such as positive antinuclear antibody, hypergammaglobulinemia, and antibody to carbonic anhydrase are often present in these patients. Currently, pancreatic biopsy demonstrating characteristic histopathologic changes is essential to establish the diagnosis. We report the first case of AIMP presenting as a pancreatic tail mass and lower gastrointestinal bleed.
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ranking = 0.5
keywords = obstruction
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7/274. Lymphatic cyst of the colon: a case report.

    A rare case of a lymphatic cyst of the ascending colon is reported. The lobulated and fluctuant lesion, located in the hepatic flexure, was diagnosed by barium enema and colonoscopy, incidentally. Surgical treatment with segmental resection of the ascending colon was done because of the risk of obstruction and the question of an underlying malignancy. The clinical features, appropriate treatment, preoperative diagnosis and histopathology are discussed. We emphasize that lymphatic cysts are very rare and are difficult to identify by radiology or colonoscopy before surgery. They must be included in the differential diagnosis of submucosal tumors such as lipomas, leiomyomas and hemangiomas.
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ranking = 0.5
keywords = obstruction
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8/274. Splenic flexure volvulus in association with chilaiditi syndrome: report of a case.

    Hepatodiaphragmatic interposition of the intestine, or chilaiditi syndrome, is uncommon and typically asymptomatic, but it can be associated with symptoms ranging from intermittent, mild abdominal pain to acute intestinal obstruction. Factors such as the interruption or absence of peritoneal attachments and redundant colon with a long mesentery predispose to both chilaiditi syndrome and colonic volvulus. The presence of hepatodiaphragmatic interposition of the intestine requires no specific treatment in the absence of symptoms. Colonic volvulus in association with chilaiditi syndrome is treated based on the location of the volvulus. Volvulus of the splenic flexure is typically treated with resection and primary anastomosis. We report only the third case of colonic volvulus in association with chilaiditi syndrome and the first with volvulus of the splenic flexure.
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ranking = 0.5
keywords = obstruction
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9/274. Localized AL amyloidosis of the colon and clinical features of intestinal obstruction. A case report.

    The term amyloidosis refers to a group of disorders characterized by the extracellular accumulation of insoluble, fibrillar proteins (i.e. amyloid) in various organs and apparatuses. Local deposition of amyloid without systemic involvement is a rather uncommon form that gives rise to an amyloid pseudo-tumor or "amyloidoma". This paper describes the clinical features of an intestinal subocclusion observed in an elderly patient with localized primary amyloidosis of the transverse colon. The endoscopic picture indicated a stenosing neoplasm. Segmentary colectomy, however, followed by histological examination (characteristic green color in polarized light after staining with congo red) and immunohistochemical analysis of the resected tissue, revealed massive deposits of amyloid composed of lambda light chains in the interstitial connective, and perivascular tissue and muscular tunic, and resulted in a diagnosis of AL amyloidosis. This was successfully treated with a combination of melphalan and prednisone.
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ranking = 2
keywords = obstruction
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10/274. Colonic spasm and pseudo-obstruction in an elongated colon secondary to physical exertion: diagnosis by stress barium enema.

    Anatomic and functional abnormalities of the colon are known to cause a variety of abdominal complaints, including constipation, diarrhea, and pain. We describe a patient with dolichocolon (elongated colon) with transient spasm (pseudo-obstruction) associated with exertion. The diagnosis in this case rested with a novel approach and less invasive evaluation of the colon.
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ranking = 2.5
keywords = obstruction
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