摘要:

&NA;From 1968 to 1979, 18 patients underwent emergency abdominal colectomy with ileorectal anastomosis. Indications for operation included massive colonic bleeding (11), obstructing carcinoma (5), toxic megacolon (1), and enterocolitis (1). Five patients died postoperatively (27.8 per cent). Causes of death included sepsis, upper gastrointestinal bleeding, and respiratory failure. All had peritonitis, and five had documented anastomotic leaks. Seven of the surviving patients had significant morbidity from the procedure which included anastomotic leak, small bowel obstruction, wound infection, sepsis, and pulmonary emboli. Only six patients survived without complications. Although others have written about the safety of emergency subtotal colectomy with ileorectal anastomosis, our experience suggests this procedure is associated with excessive morbidity and mortality.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Various sigmoid lesions, seen on barium enema of 39 patients, were investigated with angiography of the inferior mesenteric artery using three series. The first was performed with contrast medium only, the second after use of epinephrine, and the third after a beta‐blocking agent (propranolol) combined with epinephrine. The patients were followed for more than three years. Eleven carcinomas were detected, all diagnosed angiographically. Carcinoma, radiation fibrosis, and diverticulitis with fibrosis may appear similar on pharmacoangiography, but the inflammatory reaction seen, for example in diverticulitis, is different. These findings are important because they can have an influence on the indications and selection of the most suitable operation to be performed.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Through experience with 1,464 examinations using the short flexible fiberoptic colonscope, the author concludes it to be the preferred instrument for endoscopy of the distal bowel. He finds it superior to the rigid instrument in detection of polyps and early malignant disease of the distal descending and sigmoid colons. The flexible instrument is generally less uncomfortable for the patient and is readily accepted as a routine part of a thorough colonic and rectal examination.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Successful use of a rectal sump drain in two patients with severe secretory diarrhea is briefly described

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Anal fissures, fistulas, and abscesses occurred as complications in 22 per cent of our population of 1,098 patients with Crohn's disease. Crohn's colitis was much more frequently associated with an anal lesion than Crohn's disease of the small bowel (52 per cent vs. 14 per cent). When an anal lesion is the manifesting sign, Crohn's disease will soon develop elsewhere in the intestine. Since these lesions frequently herald the onset of intestinal Crohn's disease, the physician must always be aware of the possibility of inflammatory bowel disease when dealing with suspicions anal lesions.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Between 1960 and 1979, 37 patients, ranging in age from 18 to 40 years, were treated for colorectal cancer. Symptoms typical of colorectal malignancy had been present for an average of 10.4 months; a positive family history, previous colonic disease, or immunosuppression was present in 22 patients (59 per cent). Distribution of lesions was unusual in that only 40 per cent were within reach of the sigmoidoscope, and only 7.5 per cent could be palpated on rectal examination.Dukes' staging at diagnosis was improved in distribution to that reported in the adult population (51 per cent localized vs. 40.1 per cent). Histologic characteristics of the tumors were not unusual; however, incidence of poorly differentiated (18.9 per cent) and mucin‐producing (10.8 per cent) cancers was increased. Perineural invasion was associated with disseminated disease. Vascular invasion was associated with disseminated disease and poor prognosis. Overall fiver‐year survival was 56.8 per cent. Five‐year survival in 24 patients undergoing potentially curative resection increased to 70.8 per cent.Colorectal carcinoma in patients under 40 years of age is unusual, and delay in diagnosis is common. The distribution of lesions is more homogeneous than that seen in older patients, and high‐grade malignancies are more frequent. Survival data in this series are more favorable than those generally reported. Improved five‐year survival following potentially curative resection (70.8 per cent) stresses the need for early diagnosis and treatment

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Colonic polyps were systematically searched for in 508 specimens collected from unselected autopsies in individuals more than 10 years of age from Medillin, Colombia, a low‐indicidence geographic region for colorectal cancer. Adenomatous polyps have a low prevalence rate in both sexes, comparable to that found in Cali, Colombia, and other populations with low risk for cancer. They were found more frequently in the right side of the colon and are rare in the sigmoid colon. They begin to appear in the third decade of life in both sexes. Prevalence rates for single and multiple polyps increase with age in both sexes, males showing higher rates than females at every age group. Adenomatous polyps in this population are usually less than 3 mm in diameter and do not show villous changes or epithelial atypia. Hyperplastic polyps were more frequently observed than adenomatous polyps and rates show a progressive increase with age in both sexes. Multiplicity also increases with age. Most polyps are located in the low rectum and sigmoid followed by the cecum and ascending colon. Usually hyperplastic polyps are smaller than 3 mm in diameter and do not show epithelial atypia. Juvenile polyps were infrequently found in this series because children less than 10 years old were excluded. Diverticular disease was also rare and, when found, was not associated with adenomatous polyps. The association between adenomatous polyps and colonic cancer is discussed based on findings in this report.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Mucosal enteritis, a nonspecific inflammation of both the mucosa and submucosa, is a complication seen in 13 per cent to 43 per cent of patients with a continent ileostomy. Six cases are presented with emphasis on history, diagnosis, and treatment. Because the inflammation is secondary to an overgrowth of anaerobic bacteria in a functional blind loop, treatment consists of drainage and antibiotics. Metronidazole may be the drug of choice. Refractor cases will benefit only by resection and conversion to a Brooke ileostomy.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID