Showing 7 results for Colon
Ahmad Khaleghnejad Tabari, Alireza Mirshemirani, Nasibeh Khaleghnejad Tabari,
Volume 3, Issue 2 (1-2012)
Abstract
Background: Complete colonic duplication is a very rare congenital anomaly that may have different presentations according to its location and size. Complete colonic duplication can occur in 15% of gastrointestinal duplication. We report two cases of complete colonic duplications, and their characteristics.
Case Presentation: We present two patients with complete colonic duplication with different types and presentations. Case 1: A 2- year old boy presented to the clinic with abdominal protrusion, difficulty to defecate, chronic constipation and mucosal prolaps covered bulging (rectocele) since he was 6 months old. The patient had palpable pelvic mass with doughy consistency. Rectal exam confirmed perirectal mass with soft consistency. The patient underwent a surgical operation that had total tubular colorectal duplication with one blind end and was treated with simple fenestration of distal end, and was discharged without complication. After two years follow up, he had normal defecation and good weight gain. Case 2: A 2 –day old infant was referred with imperforate anus and complete duplication of recto-sigmoid colon, diphallus, double bladder, and hypospadiasis. After clinical and paraclinical investigations, he underwent operations in several stages in different periods, and was discharged without complications. After four years follow up, he led a normal life.
Conclusion: The patients with complete duplication have to be examined carefully because of the high incidence of other systemic anomalies. Treatment includes simple resection of distal common wall, fenestration, and repair other associated anomalies.
Mohsen Vakili-Sadeghi, Mohammadhasan Omranpour,
Volume 4, Issue 3 (1-2013)
Abstract
Background: Solid tumors may occur in 3% of the patients with chronic myeloid leukemia (CML). In this paper, we presented a case of CML following treatment of colon cancer.
Case Presentation: A 25 year old man was diagnosed of adenocarcinoma of rectosigmoid treated with fluorouracil-based chemotherapy. Following relapse, he received florouracil, oxaliplatin and irinotecan during the next year. Then he developed BCR-ABL positive CML. With Imatinib 400 mg/day, he achieved hematologic response but died because of progressive colon cancer.
Conclusion: This article emphasizes that there is a possibility for etiologic correlation between CML and chemotherapeutic agents in solid cancers.
Kobra Baghbani, Javad Shokry-Shirvani , Hassan Taheri,
Volume 5, Issue 3 (5-2014)
Abstract
Background: The appropriate colon cleansing is a major determinant of quality of colonoscopy. The aim of this study was to compare the efficacy and tolerability of the morning (AM) PEG (polyethylene glycol) solution to previous-evening (PM) PEG solution for the afternoon colonoscopy.
Methods: This comparative study compared the AM to PM prep for afternoon outpatient colonoscopy. The subjects randomly received PEG PM dose 4 liters of water plus 4 pack PEG powder at 6 pm before colonoscopy (250 ml every 15 min) or AM ( the same dose solution at 6 am on the day of colonoscopy). The preparation and colonoscopy quality, PEG side effects, sleep quality, lesion detection, flush need and suction fluid were compared in these two groups.
Results: One hundred seven cases received AM prep and 102 received PM prep. The colon prep was adequate in 94.4% in AM group and in 90.2% cases in PM group (P=0.2). The incidence of adverse events in these two groups was similar. Sleep quality and the need for flush was lower in the AM group (P=0.004 and P=0.03). The mean volume of suction fluid was higher in the AM group (P=0.01). The detected lesions were similar between the two groups. Adequate prep was associated with lower flush need in AM group (P=0.001).
Conclusion: AM and PM PEG solutions were clinically equivalent with cleansing efficacy and side effect and lesion detection. AM group was associated with a better sleep quality and less flush need, but more suction fluid.
Nadia Banihashem, Ebrahim Alijanpour, Majid Basirat, Javad Shokri, Mehrdad Kashifard, Seyed Hasan Taheri, Shahryar Savadkohi, Vahid Hosseini, Seyed Sedigheh Solimanian,
Volume 6, Issue 1 (1-2015)
Abstract
Abstract
Background: The combination of propofol-fentanyl for sedation during colonoscopy is characterized by the frequent incidence of side effects. Etomidate-fentanyl provides fewer hemodynamic and respiratory complications. The aim of our study was to compare the safety and efficacy of propofol-fentanyl and etomidate-fentanyl for conscious sedation in elective colonoscopy.
Methods: This double-blind clinical trial was conducted on 90 patients aged between 18 and 55 years old who were candidates for elective colonoscopy. Patients were randomized to receive sedation with fentanyl plus propofol or etomidate. Two minutes after injecting 1 micro/kg of fentanyl, the patients received propofol (0.5 mg/kg followed 25 micro/kg/min) or etomidate (0.1 mg/kg followed 15 micro/kg/min). Pulse rate, mean arterial blood pressure, respiratory rate, and saturation of peripheral oxygen (SPO2) were monitored. Indeed, the patient and colonoscopist satisfaction, the recovery time, sedation and pain score in both groups were assessed.
Results: Sedation score in propofol group was higher. Pain score as well as the physician and patient satisfaction showed no significant difference in two study groups. Hemodynamic changes and arterial saturation were the same in both groups. The duration of recovery was 1.27±0.82 minutes in the etomidate group whereas, it was 2.57±2.46 minutes in the propofol group (P=0.001). Hospital discharge in the propofol group was 5.53±4.67 minutes and in the etomidate group was 2.68±3.14 minutes (p=0.001).
Conclusion: The combination of fentanyl and etomidate provides an acceptable alternative to sedation with fentanyl and propofol with the advantage of significantly faster recovery time, which are of relevance in the outpatient setting.
Abbasali Ahmadi, Parviz Amri, Javad Shokri-Shirvani, Karimollah Hajian,
Volume 6, Issue 2 (4-2015)
Abstract
Background: Although some patients can tolerate
colonoscopy procedure using fentanyl/ midazolam without any sedation and
analgesic requirements but some patients may require additional sedation with
benzodiazepines. We performed the present study to compare the effect of
paracetamol/midazolam with fentanyl/ midazolam.
Methods: In a clinical trial, 96 patients aged 18
to 75 years old, who were candidate for elective colonoscopy assigned
consecutively into two groups as paracetamol/midazolam and fentanyl/midazolam.
The first group received 1 gr paracetamol 45 minutes before colonoscopy and 0.5
mg/kg midazolam 5 minutes before colonoscopy whereas the second group received 04-
0.5-1 mcg/kg fentanyl 3 minutes before colonoscopy and similar dose of
midazolam. The two groups were compared in regard to patient intensity,
discomfort, a colonoscopist and, patient satisfaction and rescue dose
of propofol during colonoscopy and vital signs.
Results: There was no significant difference
between the two groups for patient pain score, colonoscopist satisfaction,
patient satisfaction and rescue dose of propofol (P=0.817, 0.978, 0.460, and 0.104, respectively). The incidence
of apnea was greater in fentanyl group (P=0.045). After adjusting for age and
education, there was also no significant difference between the two groups.
Conclusion: This study indicates that paracetamol can
be considered as an alternative drug regimen in preparation of colonoscopy.
Muhammad Shoaib Khan , Muhammad Ishaq, Mark Hinson, Bindu Potugari, Ateeq U Rehman,
Volume 10, Issue 4 (9-2019)
Abstract
Background: Parvimonas micra is a gram-positive anaerobe and a part of the normal commensal flora of the gastrointestinal tract. Factors predisposing to anaerobic bacteremia include malignant neoplasms, periodontal disease, immune deficiencies, chronic renal insufficiency, decubitus ulcers and perforated abdominal viscus. Cases of Parvimonas bacteremia in a patient with esophageal carcinoma and in a patient following ERCP procedure have been reported but to our best knowledge no case has been reported yet in which a patient had colonic carcinoma.
Case presentation: We present a rare case of a 94-year-old male who presented with chief complaint of fever and constipation. Complete blood count revealed normal white blood cell count anemia. Urinalysis came out to be unremarkable for any evidence of infection. Two blood cultures grew Parvimonas micra and Gamella morbillorum and patient was later switched to ampicillin-sulbactam as per blood culture susceptibility results. Echocardiogram came negative for any evidence of infective endocarditis. CT abdomen/pelvis showed soft tissue mass in the ascending colon just superior to the ileocecal valve (fig.1, 2). Colonoscopy showed non-obstructing eccentric mass (fig. 3). Biopsy of the mass revealed moderately differentiated adenocarcinoma. Because of lack of distant metastasis, surgical resection of the mass as definitive curative treatment was done.
Conclusion: Immune deficiency is a risk factor for anaerobic bacteremia. Apart from immediately starting the patient on antibiotics, a thorough search for malignancy may be considered when a patient presents with anaerobic bacteremia, especially, when the source of infection is not known. Identifying malignancy in earliest stages may improve treatment outcome.
Feridon Sabzi, Mohammad Rozbahani, Aghighe Heidar, Reza Faraji,
Volume 12, Issue 0 (7-2021)
Abstract
Background: Volvulus of colon is a very rare phenomenon in post cardiac surgery course, and their predicting factor in most patients is unknown. Between colonic volvulus, splenic flexure is the rarest site for torsion in general population. The main symptoms are vague abdominal pain, vomiting and distension. The primary diagnostic images include plain chest x-ray, CT scan and colonoscopy.
Case Presentation: We report the case of a 57-year -old opium male addict, who was. Admitted for abdominal pain, nausea, and vomiting five days after off-pump coronary artery bypass surgery (OPCAB). An abdominal x-ray reported a colonic volvulus. Exploratory laparotomy showed acute abdomen resulting from a gangrene of long segment of splenic flexure caused by volvulus.
Conclusion: Gastrointestinal complication such as volvulus is an exceedingly rare complication of OPCAB, despite the absence of anatomic abnormalities only complete colonic malrotation as the result of mega colon and constipation, the main pathogenetic causes. This patient was unique because of careful literature search revealed that this case was the first reported volvulus that has been described so far.
