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Re: Perforated descending colon adenocarcinoma manifesting as necrotizing fasciitis

Muhamad A, Hayati F, Azizan N, Sahid Nik Lah NA, Andee DZ

ANZ J Surg, 2021 04;91(4):763-764.
PMID: 33847052 DOI: 10.1111/ans.16536
Matched MeSH terms: Colon, Descending
Diverticular disease of the colon among West Malaysians

Mow TK, Kwi NK

Australas Radiol, 1975 Mar;19(1):47-51.
PMID: 1147863
Matched MeSH terms: Diverticulum, Colon/complications; Diverticulum, Colon/radiography*
Fulltext Anomalous peritoneal band connecting greater omentum to the ascending colon: a possible cause for dilation of ascending colon

Nayak SB, Soumya KV

Anat Cell Biol, 2020 Sep 30;53(3):372-375.
PMID: 32647076 DOI: 10.5115/acb.20.082

Anomalies of the peritoneum and the colon are quite common. Some of these anomalies can disturb the normal digestive and absorptive functions of the intestine and the others might result in formation of volvulus or impede the blood supply of the intestine. We report a rare, combined variation of peritoneum and ascending colon. In a 70-year-old male cadaver, the greater omentum was very small and extended only for about an inch below the transverse colon. From its lower end, a fibrous band extended to the right wall of the upper part of ascending colon. There was a deep constriction on the right wall of the ascending colon at the site of attachment of the fibrous band. The ascending colon was grossly dilated. Further, the ascending colon was mobile and presented a small ascending mesocolon along its left edge. We discuss the possible embryological basis and clinical and surgical relevance of the case.

Matched MeSH terms: Colon; Mesocolon; Colon, Ascending; Colon, Transverse
An unusual endoscopic appearance of rectosigmoid endometriosis

Lim JY, Yang WL, Huang WF

Gastrointest Endosc, 2024 Apr;99(4):656-657.
PMID: 37806405 DOI: 10.1016/j.gie.2023.10.015
Matched MeSH terms: Colon
Case of spontaneous hernia through the transverse mesocolon

BALASEGARAM M

Med J Malaya, 1963 Mar;17:187-90.
PMID: 13969251
Matched MeSH terms: Colon, Transverse*
Fulltext Intramural gas: would it be life-threatening

Azna Aishath Ali, Syamim Johan, Chiak, Yot Ng, Firdaus Hayati

Borneo Journal of Medical Sciences, 2020;14(3):63-64.
MyJurnal

The CECT scan of the abdomen at axial and coronal views show gas bubbles tracking along the inner wall of the ascending colon and hepatic flexure, which is separated from the intraluminal gas within the bowel. These intramural gas bubbles appear to be outlining the bowel wall circumferentially. The bowel wall appears to be thickened however the inner mucosa is not enhanced. There are no ascites in the images provided. The colon of the hepatic flexure and transverse colon appears dilated. No significant atherosclerotic plaque in the visualised arteries. Based on the clinical presentations and CECT features in Figure 1 and Figure 2, the best diagnosis for him is benign pneumatosis intestinalis (PI) secondary to obstructed low rectal cancer. He was subjected for a trephine transverse colostomy to relieve the obstruction with simultaneous transanal rectal mass biopsy. Once the histology is available, he subsequently will be referred for concurrent chemo-radiotherapy as neoadjuvant treatment and later for a low anterior resection, provided that it is a localized disease.

Matched MeSH terms: Colon; Colon, Ascending; Colon, Transverse
Actual and estimated adenoma detection rates: a 2-year monocentric colonoscopic screening outcome in Shenzhen, China

Zeng L, Chua EG, Xiong Y, Ding S, Ai H, Hou Z, et al.

JGH Open, 2020 Aug;4(4):707-712.
PMID: 32782960 DOI: 10.1002/jgh3.12322

Background and Aim: While adenoma detection rate (ADR) is an important quality metric for screening colonoscopy, it remains difficult to be accessed due to the lack of integrated endoscopy and pathology databases. Hence, the use of an adenoma-to-polyp detection rate quotient and polyp detection rate (PDR) has been proposed to predict ADR. This study aimed to examine the usefulness of estimated ADR across different colonic segments in two age groups for Shenzhen people in China.
Methods: We retrospectively analyzed 7329 colonoscopy procedures performed by 12 endoscopists between January 2012 and February 2014. The PDR, actual ADR, and estimated ADR of the entire, proximal, and distal colon, and within each colonic segment, in two patient age groups: <50 and ≥50 years, were calculated for each endoscopist.
Results: The overall polyp and adenoma prevalence rates were 19.1 and 9.3%, respectively. The average age of adenoma-positive patients was significantly higher than that of adenoma-negative patients (54 ± 12.6 years vs 42.9 ± 13.2 years, respectively). A total of 1739 polyps were removed, among which 826 were adenomas. More adenomatous polyps were found in the proximal colon (60.4%, 341/565) than in the distal colon (40.9%, 472/1154). Overall, both actual and estimated ADR correlated strongly at the entire colon level and within most colonic segments, except for the cecum and rectum. In both age groups, these parameters correlated strongly within the traverse colon and descending colon.
Conclusion: Caution should be exercised when predicting ADR within the sigmoid colon and rectum.

Matched MeSH terms: Colon; Colonoscopy; Colon, Sigmoid; Colon, Descending
Epiploic Appendagitis: An uncommon surgical diagnosis

Michael A, Zakry Y, Hanif H

Med J Malaysia, 2017 04;72(2):128-129.
PMID: 28473679 MyJurnal

Epiploic appendagitis or appendices epiploicae, is a rare cause of abdominal pain in patients with mild signs of abdominal pathology. It mimics diverticulitis or appendicitis clinically as there are no pathognomonic features. It is a surgical diagnosis presenting with localised, sharp, acute abdominal pain, not associated with symptoms like nausea, vomiting, fever or suggestive laboratory values. With the availability of abdominal CT scans and ultrasound, it will frequently be a differential diagnosis preventing unnecessary surgery for patients. However, it may be erroneous and therefore clinical judgement is of paramount importance. This report highlights this rare presentation and identifies management guidelines.

Matched MeSH terms: Colon/pathology; Colon/surgery
An Additional 30-s Observation of the Right-Sided Colon with Narrow Band Imaging Decreases Missed Polyps: A Pilot Study

Yoshida N, Inoue K, Yasuda R, Hirose R, Dohi O, Naito Y, et al.

Dig Dis Sci, 2018 12;63(12):3457-3464.
PMID: 30232637 DOI: 10.1007/s10620-018-5275-1

INTRODUCTION: Previous narrow-band imaging (NBI) was dark and reported not to be useful for polyp detection. In this study, we analyzed the efficacy of an additional 30-s observation of the right-sided colon with the recent bright high-resolution NBI.
METHODS: We enrolled patients undergoing colonoscopy from February 2015 to May 2017 in two institutions. All procedures were performed with the latest system (EVIS LUCERA ELITE, Olympus). The cecum and ascending colon were first observed with white light imaging (WLI) in both the NBI and WLI group. Then, the colonoscope was re-inserted, and the cecum and ascending colon were observed for an additional 30 s. In this second observation, NBI was performed for the first 130 patients in the NBI group and WLI for the next 130 in the WLI group. The number of adenoma and sessile serrated polyps (ASPs) in the second observation were examined in both groups. According to our initial pilot study, the sample size was estimated at 126.
RESULTS: In the first observation, the number of ASPs was 72 in the NBI group and 72 in the WLI group (p = 1.0). In the second observation, the number of ASPs was 23 in the NBI group and 10 in the WLI group (p = 0.02). The polyp and adenoma detection rates in the second observation were 16.2% and 12.3% in the NBI group and 7.7% (p = 0.03) and 6.2% (p = 0.09) in the WLI group.
CONCLUSIONS: The additional 30-s observation with recent NBI decreased missed polyps in the right-sided colon.

Matched MeSH terms: Colon; Colonoscopy; Colonoscopes; Colon, Ascending
Complete sigmoid colon erosion by an intrauterine contraception device in an ectopic pregnancy: a case report

Sen CJ, Samad NHA, Huei TJ, Peng LE

J Prim Health Care, 2021 Sep;13(3):283-286.
PMID: 34588112 DOI: 10.1071/HC21084

INTRODUCTION An intrauterine contraceptive device (IUCD) is a common contraception method used for family planning. IUCD erosion into adjacent organs is a rare but serious complication of IUCD use. CASE PRESENTATION A 41-year-old female presented to us with a leaking left ectopic pregnancy. Emergency laparotomy and left salpingectomy were performed. A copper ICUD was found intraperitoneally and part of it had completely eroded into the sigmoid colon. Sigmoid colotomy was performed and the IUCD was removed successfully. Further history revealed that the patient had her IUCD inserted 12 years previously but was forgotten. The patient was discharged well after 4 days of admission. DISCUSSION Erosion of an IUCD into the colon is uncommon and may be asymptomatic or present with bowel perforation and obstruction. There should be a high index of suspicion for pregnancy occurring among women post-IUCD insertion. A misplaced IUCD can cause chronic inflammation of the fallopian tube, which may alter tubal functionality and increase the risk of ectopic pregnancy. Family planning is commonly done in primary health care. Primary care education and counselling are essential to improve awareness of fertile women to prevent similar complications. Periodic examination of IUCD string either by users or primary health-care practitioners is crucial. Ultrasound can be advocated if there are difficulties with the insertion. An abdominal radiograph is useful and should be performed in the case of missing IUCDs.

Matched MeSH terms: Colon, Sigmoid/surgery
Fulltext Effect of Tualang honey on the anastomotic wound healing in large bowel anastomosis in rats-A randomized controlled trial

Aznan MI, Khan OH, Unar AO, Tuan Sharif SE, Khan AH, Syed Abd Aziz SH, et al.

BMC Complement Altern Med, 2016 Jan 23;16:28.
PMID: 26803744 DOI: 10.1186/s12906-016-1003-6

BACKGROUND: Honey has long been used for the treatment of number of ailments and diseases including surgical wounds. Current study evaluates the effectiveness of Tualang honey (TH) for large bowel anastomotic healing in Wistar rats.
METHODS: Thirty male Wistar rats were given a 3 centimeter infra-umbilical laparotomy wound, in`flicted on their abdomen. The colonic transection was performed at 5 cm distal to caecum, with end to end anastomosis of colon segment. They were divided into two groups. Group I was fed with standard rat chow and water. Meanwhile, Group II apart from standard feed, was also given TH 1.0 g/kg every morning until day seven post operatively. Afterwards, anastomotic bursting pressures were measured and histopathological examination on the anastomosis line was performed with light microscopes. The data from two groups were analyzed by Independent paired t test for continuous variables.
RESULTS: It was found that the tensile strength of colon anastomosis (95 % CI; p = <0.001) and the histopathological study including fibroblast count (p = <0.001) and inflammatory cells (p = 0.002) showed statistically significant difference in the favor of TH-treated group. Meanwhile, neovascularization formation was not statistically significant (p = 0.807); however, the overall count in the TH group was high.
CONCLUSION: Oral treatment with TH enhances anastomotic wound healing by increasing the number of fibroblasts and by decreasing inflammatory cells leading towards increased wound strength.

Matched MeSH terms: Colon/drug effects; Colon/physiopathology; Colon/surgery*
Fulltext Colonic metastasis from an invasive lobular carcinoma of the breast

Norfaidhi Akram, M.N., Samuel, T., Norly, S., Ros’aini, P.

Journal of Surgical Academia, 2017;7(2):37-38.
MyJurnal

Breast carcinoma to the colon and rectum is rare type of metastatic spread. We report a case of colonic metastasis
from a lobular carcinoma of the breast twelve years after the initial diagnosis. Accurate diagnosis and early treatment
of systemic therapy can be done if awareness is increased.

Matched MeSH terms: Colon
Fulltext Performance of SVM with multiple kernel learning for classification tasks of imbalanced datasets

Saeed, Sana, Ong, Hong Choon

Pertanika Journal of Science & Technology, 2019;27(1):527-545.
MyJurnal

Support vector machine (SVM) is one of the most popular algorithms in machine learning
and data mining. However, its reduced efficiency is usually observed for imbalanced
datasets. To improve the performance of SVM for binary imbalanced datasets, a new scheme
based on oversampling and the hybrid algorithm were introduced. Besides the use of a
single kernel function, SVM was applied with multiple kernel learning (MKL). A weighted
linear combination was defined based on the linear kernel function, radial basis function
(RBF kernel), and sigmoid kernel function for MKL. By generating the synthetic samples
in the minority class, searching the best choices of the SVM parameters and identifying
the weights of MKL by minimizing the objective function, the improved performance of
SVM was observed. To prove the strength of the proposed scheme, an experimental study,
including noisy borderline and real imbalanced datasets was conducted. SVM was applied
with linear kernel function, RBF kernel, sigmoid kernel function and MKL on all datasets.
The performance of SVM with all kernel functions was evaluated by using sensitivity,
G Mean, and F measure. A significantly improved performance of SVM with MKL was
observed by applying the proposed scheme.

Matched MeSH terms: Colon, Sigmoid
A new algorithm for improving the low contrast of computed tomography images using tuned brightness controlled single-scale Retinex

Al-Ameen Z, Sulong G

Scanning, 2015 Mar-Apr;37(2):116-25.
PMID: 25663630 DOI: 10.1002/sca.21187

Contrast is a distinctive visual attribute that indicates the quality of an image. Computed Tomography (CT) images are often characterized as poor quality due to their low-contrast nature. Although many innovative ideas have been proposed to overcome this problem, the outcomes, especially in terms of accuracy, visual quality and speed, are falling short and there remains considerable room for improvement. Therefore, an improved version of the single-scale Retinex algorithm is proposed to enhance the contrast while preserving the standard brightness and natural appearance, with low implementation time and without accentuating the noise for CT images. The novelties of the proposed algorithm consist of tuning the standard single-scale Retinex, adding a normalized-ameliorated Sigmoid function and adapting some parameters to improve its enhancement ability. The proposed algorithm is tested with synthetically and naturally degraded low-contrast CT images, and its performance is also verified with contemporary enhancement techniques using two prevalent quality evaluation metrics-SSIM and UIQI. The results obtained from intensive experiments exhibited significant improvement not only in enhancing the contrast but also in increasing the visual quality of the processed images. Finally, the proposed low-complexity algorithm provided satisfactory results with no apparent errors and outperformed all the comparative methods.

Matched MeSH terms: Colon, Sigmoid
Fulltext How to perform and assess colonic manometry and barostat study in chronic constipation

Lee YY, Erdogan A, Rao SS

J Neurogastroenterol Motil, 2014 Oct 30;20(4):547-52.
PMID: 25230902 DOI: 10.5056/jnm14056

Management of chronic constipation with refractory symptoms can be challenging. Although new drugs and behavioral treat-ments have improved outcome, when they fail, there is little guidance on what to do next. At this juncture, typically most doc-tors may refer for surgical intervention although total colectomy is associated with morbidity including complications such as recurrent bacterial overgrowth. Recently, colonic manometry with sensory/tone/compliance assessment with a barostat study has been shown to be useful. Technical challenges aside, adequate preparation, and appropriate equipment and knowledge of co-lonic physiology are keys for a successful procedure. The test itself appears to be safe with little complications. Currently, colon-ic manometry is usually performed with a 6-8 solid state or water-perfused sensor probe, although high-resolution fiber-optic colonic manometry with better spatiotemporal resolutions may become available in the near future. For a test that has evolved over 3 decades, normal physiology and abnormal findings for common phenotypes of chronic constipation, especially slow transit constipation, have been well characterized only recently largely through the advent of prolonged 24-hour ambulatory colonic manometry studies. Even though the test has been largely restricted to specialized laboratories at the moment, emerg-ing new technologies and indications may facilitate its wider use in the near future.(J Neurogastroenterol Motil 2014;20:547-552).

Matched MeSH terms: Colon
Leptospirosis complicating with acute large bowel gangrene: a case report

Zamri Z, Shaker AH, Razman J

Clin Ter, 2012;163(5):399-400.
PMID: 23099969

Leptospirosis is a zoonosis with worldwide distribution. It is often referred to as swineherd's disease, swamp fever or mud fever. In recent years there is increase incidence in leptospirosis in human. The incidence varies from sporadic in temperate zones to endemic in the tropical countries. Leptospirosis generally present with features of bacterial infection in acute phase following with multi organs complications. Acute bowel ischaemia with perforation following leptospirosis is a rare presentation . To the best of our knowledge, this is the first case report of such condition. The surgical management of this rare incidence will be discussed.

Matched MeSH terms: Colon/pathology*; Colonic Diseases/microbiology*; Colonic Diseases/pathology*
Fulltext Large tubular colonic duplication in an adult treated with a small midline incision

Yong YG, Jung KU, Cho YB, Yun SH, Kim HC, Lee WY, et al.

J Korean Surg Soc, 2012 Mar;82(3):190-4.
PMID: 22403754 DOI: 10.4174/jkss.2012.82.3.190

Tubular colonic duplication presenting in adults is rare and difficult to diagnose preoperatively. Only a few cases have been reported in the literature. We report a case of a 29-year-old lady presenting with a long history of chronic constipation, abdominal mass and repeated episodes of abdominal pain. The abdominal-pelvic computed tomography scan showed segmental bowel wall thickening thought to be small bowel, and dilatation with stasis of intraluminal content. The provisional diagnosis was small bowel duplication. She was scheduled for single port laparoscopic resection. However, a T-shaped tubular colonic duplication at sigmoid colon was found intraoperatively. Resection of the large T-shaped tubular colonic duplication containing multiple impacted large fecaloma and primary anastomosis was performed. There was no perioperative complication. We report, herein, the case of a T-shaped tubular colonic duplication at sigmoid colon in an adult who was successfully treated through mini-laparotomy assisted by single port laparoscopic surgery.

Matched MeSH terms: Colon; Colon, Sigmoid
Trichuriasis: localized inflammatory responses in the colon

Kaur G, Raj SM, Naing NN

Southeast Asian J. Trop. Med. Public Health, 2002 Jun;33(2):224-8.
PMID: 12236416

Most patients with trichuriasis have light worm burdens. Data regarding the inflammatory response to Trichuris worms in the colon of lightly infected persons are scant. Nine patients whose Trichuris infection was found by colonoscopy had biopsies taken from a site adjacent to visible worms and from a second site some 20 cm distally. The biopsies were studied by routine and immunohistochemical methods. None of the biopsies showed mucosal ulceration, significant congestion, fibrosis, gland distortion or goblet cell mucin depletion. There was no difference between worm and worm-free sites in terms of edema, lymphoid follicles or epithelial slough. Worm sites had higher numbers of eosinophils, neutrophils and total inflammatory cells and lower numbers of plasma cells. However there was no difference in lymphocyte, mast cell, and B- and T-cell counts between the two sites. This suggests that the T. trichiura worm incites a local inflammatory response involving eosinophils and neutrophils, even when the colon has only a light burden of worms.

Matched MeSH terms: Colon/pathology*; Colonoscopy
Oesophageal replacement with colon in corrosive stricture

Wai NC

Med J Malaya, 1969 Sep;24(1):49-57.
PMID: 4243844
Matched MeSH terms: Colon/surgery
An unexpected cause of transient diarrhea

Chuah YY, Lee YY, Tsai TJ

Postgrad Med, 2017 May;129(4):488-490.
PMID: 28335674 DOI: 10.1080/00325481.2017.1311198

Migration of percutaneous endoscopic gastrostomy (PEG) tube to colon with gastro-colonic-cutaneous fistula formation is a rare complication of the procedure. Transient episodic diarrhea following each PEG tube feeding is typical of this complication. We present a 72-year-old man with cerebrovascular disease and scoliosis who encountered episodes of transient diarrhea after each PEG tube feeding. His diarrhea was refractory to medications. Colonoscopy demonstrated a mal-positioned PEG in the transverse colon. Computed tomogram (CT) of abdomen further confirmed the finding. After removal of the migrated PEG, his diarrhea had ceased completely. The gastro-colonic-cutaneous fistula was further managed with endoscopic clipping method with no complications encountered during follow up.

Matched MeSH terms: Colon*; Colonoscopy

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