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Right Colon (right + colon)
Selected AbstractsIn vitro determination of active bile acid absorption in small biopsy specimens obtained endoscopically or surgically from the human intestineEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 2 2002K-A. Ung Abstract Background In the construction of a Kock reservoir for continent urinary diversion, 70 cm of the distal ileum are used. Impaired absorption of bile acids in these patients might cause diarrhoea. Data on the absorption of bile acids in different parts of the human intestine are limited. Methods Biopsies were taken during endoscopy from the duodenum, the terminal ileum or the right colon, and during surgery 10, 50, 100 and 150 cm proximally to the ileo-caecal valve using standard endoscopy biopsy forceps. The biopsy specimens were incubated in vitro with radio-labelled taurocholic acid at 37 °C for 22 or 45 min The radioactivity was determined using the liquid scintillation technique. Results A linear increase in the uptake was observed, with increased concentrations of taurocholic acid between 100 and 500 µm in all specimens tested, that represented passive uptake or unspecific binding. The active uptake could be calculated from the intercept of the line representing passive uptake with the ordinate. The active uptake in the terminal ileum was 3,4 times greater than 100 cm proximal to the valve. Conclusions The active absorption of bile acids in humans can be determined in small biopsy specimens taken using standard biopsy forceps during endoscopy or surgery. This method is suitable for clinical studies of bile acid absorption. Active uptake of bile acids not only takes place in the very distal part of the ileum but also to a considerable degree 100 cm proximally to the ileo-colonic valve. This should be taken into account when selecting the ileal segment for continent urinary diversion. [source] Study on functional constipation and constipation-predominant irritable bowel syndrome by using the colonic transit test and anorectal manometryJOURNAL OF DIGESTIVE DISEASES, Issue 4 2002Li Xing ZHAN OBJECTIVE: To investigate the visceral perception, anorectal pressure and colonic transit time (CTT) in patients with functional constipation and constipation-predominant irritable bowel syndrome (C-IBS), and to study the manometric abnormalities of these two conditions. METHODS: The CTT in patients with functional constipation and C-IBS was studied by using radiopaque markers. Rectal visceral perception thresholds, rectal compliance and anorectal pressure were examined by electric barostat. RESULTS: The CTT in both groups of constipated patients was abnormal. A lot of radiopaque markers remained in the right colon in C-IBS patients, whereas in patients with functional constipation, the radiopaque markers remained in each segment of the colon. The anorectal resting pressure, squeezing pressure and relaxation pressure were normal in both groups. Rectal compliance and defecation thresholds were much higher compared with controls, and the rectal visceral perception of functional constipation was also abnormal. CONCLUSIONS: The motility abnormalities of functional constipation and C-IBS occurred in different colonic segments. Results suggest that CTT measurement and anorectal manometry could be helpful in the differential diagnosis of these two conditions. [source] Clinical features of Japanese patients with colonic angiodysplasiaJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8pt2 2008Satoru Ueno Abstract Background and Aim:, With improvements in endoscopic resolution, angiodysplasia (AGD) has become an increasingly recognized disorder. The aim of this study was to describe the clinical features of Japanese patients with colonic AGD and compare them to the clinical features of Western patients. Methods:, Retrospective analyses were performed in all patients who had undergone colonoscopical examination from March 2003 to October 2005 at the Kyoto University Hospital. Four independent literature searches were performed to document the characteristics of colonic AGD in Western countries. The characteristics of 41 Japanese patients diagnosed as having colonic AGD were compared with those of Western patients. Results:, The incidence of colonic AGD increased with age, and the most prevalent underlying disease in patients with colonic AGD was cardiovascular disease (56.1%). These tendencies were similar in the Japanese and Western data. Colonic AGD in Japanese patients was predominantly located in the left colon (41.7%), whereas in Western patients, it was mainly located in the right colon (54%,81.9%). The percentage of colonic AGD with a size of more than 5 mm or elevated type detected in Japanese patients was significantly higher than that in Western patients. Conclusion:, The characteristics of Japanese patients with colonic AGD were similar to those of Western patients, except for its localization, size, and type. [source] "Spontaneous," delayed colon and rectal anastomotic complications associated with bevacizumab therapyJOURNAL OF SURGICAL ONCOLOGY, Issue 2 2008David A. August MD Abstract Bevacizumab, a humanized monoclonal antibody used to treat recurrent and metastatic colorectal cancer, targets the vascular endothelial growth factor (VEGF) molecule. It is hypothesized that bevacizumab works by both depriving tumors of the neovascularity they require to grow, and by improving local delivery of chemotherapy through alterations of tumor vasculature permeability and Starling forces. Complications of bevacizumab treatment include bowel ischemia and perforation, but to date, these complications have only rarely been described as occurring at the site of presumably healed anastomoses following surgery. We report two cases of delayed, "spontaneous" low anterior colorectal anastomotic dehiscence and one right colon anastomotic colocutaneous fistula associated with bevacizumab therapy. After seeing three patients with complications arising from apparently healed low anterior colorectal or right colon anastomoses following initiation of bevacizumab therapy for treatment of metastatic colorectal cancer, we reviewed the experience of The Cancer Institute of New Jersey (CINJ) with use of bevacizumab in approximately 50 patients between April 2004 and December 2006. The three index cases had been treated surgically at CINJ but received chemotherapy elsewhere. None of the 50 patients receiving bevacizumab at CINJ who had previous colon or rectal anastomoses were identified as having this complication. The medical records of the three index cases were reviewed and analyzed. Additionally, a Medline search was performed to identify other reports documenting similar cases. Two reports of related cases were found in the literature. In two of our index cases who underwent low anterior anastomoses, the patients had received preoperative pelvic irradiation before their initial low anterior resection. In one of the two cases, the initial resection was complicated by an anastomotic leak requiring proximal diversion and then subsequent stoma takedown. In both cases, the dehiscence occurred more than 1 year after anastomosis, and became evident 1,10 months following initiation of bevacizumab treatment. In the third index case, a colocutaneous fistula arising from the anastomotic site presented 5 months following right colon resection and 3 months after starting adjuvant systemic therapy with FOLFOX (5-fluorouracil (5-FU), leucovorin, and oxaliplatin) and bevacizumab. Delayed colorectal anastomotic complications may occur in association with bevacizumab therapy. Contributing factors may include anastomotic leak at the time of the original operation and history of anastomotic irradiation. Clinicians treating patients who receive bevacizumab following colectomy for colorectal cancer should be aware of this possible life-threatening complication. These findings may also be relevant to the design of trials of the use of bevacizumab for the postoperative adjuvant treatment of patients with colorectal cancer. J. Surg. Oncol. 2008;97:180,185. © 2007 Wiley-Liss, Inc. [source] A dynamic model of colonic concentrations of delayed-release 5-aminosalicylic acid (Asacol)ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11 2009M. P. THORPE Summary Backround, 5-ASA in a pH sensitive tablet (Asacol) is administered as three doses/day to treat ulcerative colitis. Once daily dosing may improve patient adherence. Simulation of colonic levels of 5-ASA can be used to compare dosing regimens. Aim, To create a dynamic model of colonic concentrations of delayed-release 5-aminosalicylic acid (Asacol). Methods, Using published data, we created a computer model with STELLA software to simulate amounts of colonic 5-ASA in the total colon, right, transverse, descending and sigmoid/rectum after daily and three time/day Asacol. Results, The model predicted similar total and regional amounts of 5-ASA with both regimens. Distribution of 5-ASA was 38% in the right colon, 33% in the transverse colon and 14% each in the descending and sigmoid/rectal colon. Simulated increases in colonic motility and defecation rate exaggerated this 5-ASA distribution, resulting in negligible amounts of 5-ASA in the sigmoid/rectal region. Conclusions, This computer model suggests that Asacol can be administered as a single daily dose. The model supports experimental and clinical observations that alternate dose or route of administration may be necessary to achieve adequate 5-ASA amounts in the distal colon during acute exacerbations of ulcerative colitis. This simulation cannot account for all sources of variability in the clinical setting, but provides a rationale for further investigation. [source] Giant inguinal hernia containing right colon repaired using the prolene hernia systemANZ JOURNAL OF SURGERY, Issue 1-2 2009Neil Merrett FRACS No abstract is available for this article. [source] Long term follow-up of transcatheter coil embolotherapy for major colonic haemorrhageCOLORECTAL DISEASE, Issue 10 2010T. M. Ahmed Abstract Aim, Therapeutic angiography with embolization is fast becoming the preferred treatment modality for major bleeding in the lower gastrointestinal (LGI) tract. The aim of this study was to determine the long term outcome and complications of percutaneous coil embolization (PCE) and its efficacy as definitive therapy in patients with major LGI bleeding. Methods, All patients presenting to our institution with a haemodynamically significant LGI tract bleed between 1995 and 2001 that were unresponsive to conservative measures were considered for emergency angiography and coil embolization where appropriate. The outcome of these individuals was determined by case note review and telephone interview. Results, There were 20 patients (11 females) with a mean follow-up period 72 months, mean age was 67 years. All underwent PCE following positive angiogram. The most common site of bleeding was the right colon (40%); haemostasis was successfully achieved in 16 (80%) patients. Five of the 20 patients died within 30 days of the intervention, three following PCE and two following surgery. None of the mortality following PCE was considered procedure related. On long term follow-up four patients required readmission to hospital for further LGI bleeds at 1, 2, 12 and 16 months respectively. Ischaemic complications occurred in 23%. Conclusion, Superselective embolization as the primary technique for the treatment of haemodynamically significant LGI bleeding is an effective, feasible and safe technique. Long term follow-up in our series up to 72 months has shown that it should be considered as both a primary and potentially definitive treatment for life threatening LGI bleeds. [source] Segmental colonic transit studies: comparison of a radiological and a scintigraphic methodCOLORECTAL DISEASE, Issue 4 2007E. Lundin Abstract Objective, Colonic transit studies are used to diagnose slow transit constipation (STC) and to evaluate segmental colonic transit before segmental or subtotal colectomy. The aim of the study was to compare a single X-ray radio-opaque marker method with a scintigraphic technique to assess total and segmental colonic transit in patients with STC. Method, Thirty-one female patients (median age 46 years) with severe constipation and a prolonged or borderline prolonged colonic transit time on radio-opaque marker study were included in the study. They were subsequently investigated with 111Indium-DTPA colonic transit scintigraphy, with a median time between the investigations of 4(range 1,27) months. Normal values of healthy female controls were used for comparison. Results, There was no difference between the two methods in terms of prolonged or normal total colonic transit time. Twenty-nine of 31 female patients had a prolonged transit time only in one or two segments on the marker study. On scintigraphy, the transit time was prolonged for patients in the left (P < 0.05 to P < 0.001), but not in the right colon. With respect to prolonged or normal segmental transit time, there was a significant difference between the two methods only in the descending colon (P = 0.02). However, the results varied considerably for individual patients. Conclusion, Segmental colonic delay was a common finding. The two methods gave similar results for groups of patients, except in the descending colon. The variation of the results for individuals suggests that a repeated transit test may improve the assessment of total and segmental transit. [source] Enterocolic lymphocytic phlebitis of the right colon as a cause of massive gastrointestinal bleedingCOLORECTAL DISEASE, Issue 4 2003D. Parés First page of article [source] | ||||||||||||||||||||||