WorldWideScience

Sample records for mesocolon

  1. Cellular schwannoma arising from sigmoid mesocolon presenting ...

    African Journals Online (AJOL)

    We present a case of a 58‑year‑old female with a massive twisted tumor arising from sigmoid mesocolon. The tumor was diagnosed to be a case of cellular schwannoma, an exceedingly rare tumor in this location with rare presentation. Keywords: Pelvis, Retroperitoneum, Schwannoma, Sigmoid mesocolon, Torsion, Tumor ...

  2. Haematoma in the transverse mesocolon secondary to acute ...

    African Journals Online (AJOL)

    A case of acute haematoma of the transverse mesocolon secondary to acute necrotizing pancreatitis is presented. with a brief discussion of the pathogenesis and computed tomographic findings. The value of computed tomography in acute complicated pancreatitis is emphasized.

  3. Ectopic Human Fasciola hepatica Infection by an Adult Worm in the Mesocolon.

    Science.gov (United States)

    Kim, Ah Jin; Choi, Chang Hwan; Choi, Sun Keun; Shin, Yong Woon; Park, Yun-Kyu; Kim, Lucia; Choi, Suk Jin; Han, Jee Young; Kim, Joon Mee; Chu, Young Chae; Park, In Suh

    2015-12-01

    We report here an ectopic case of Fasciola hepatica infection confirmed by recovery of an adult worm in the mesocolon. A 56-year-old female was admitted to our hospital with discomfort and pain in the left lower quadrant of the abdomen. Abdominal CT showed 3 abscesses in the left upper quadrant, mesentery, and pelvic cavity. On surgical exploration, abscess pockets were found in the mesocolon of the sigmoid colon and transverse colon. A leaf-like worm found in the abscess pocket of the mesocolon of the left colon was diagnosed as an adult fluke of F. hepatica. Histologically, numerous eggs of F. hepatica were noted with acute and chronic granulomatous inflammations in the subserosa and pericolic adipose tissues. Conclusively, a rare case of ectopic fascioliasis has been confirmed in this study by the adult worm recovery of F. hepatica in the mesocolon.

  4. Anatomy of the Transverse Mesocolon Based on Embryology for Laparoscopic Complete Mesocolic Excision of Right-Sided Colon Cancer.

    Science.gov (United States)

    Matsuda, Takeru; Sumi, Yasuo; Yamashita, Kimihiro; Hasegawa, Hiroshi; Yamamoto, Masashi; Matsuda, Yoshiko; Kanaji, Shingo; Oshikiri, Taro; Nakamura, Tetsu; Suzuki, Satoshi; Kakeji, Yoshihiro

    2017-11-01

    To treat colon cancer via complete mesocolic excision (CME) with central vascular ligation (CVL), dissection along the embryologic fusion planes is required. However, this surgery is difficult, especially for right-sided colon cancer, because the anatomy and embryology of the transverse mesocolon are not familiar to gastrointestinal surgeons. In this video article, the anatomic details of the transverse mesocolon based on embryology are illustrated with a focus on the venous anatomy. Dissection of the transverse mesocolon along the embryologic planes using a cranial approach during laparoscopic right hemicolectomy also is presented. During the development of the primitive gastrointestinal tract, the transverse mesocolon locates between the terminal portion of the midgut and the beginning of the hindgut. After 270° counterclockwise rotation of the primary intestinal loop, the transverse mesocolon fuses with the frontal surface of the duodenum and pancreas. Simultaneously, the greater omentum hangs down from the greater curvature of the stomach in front of the transverse colon and fuses with the transverse mesocolon. Moreover, the drainage vein of the right colon sometimes joins the right gastroepiploic vein, and the gastrocolic trunk is formed. Anatomic complexity of the transverse mesocolon is caused by rotation and fusion of the gastrointestinal tract during embryologic development. Knowledge concerning these embryologic peculiarities of the transverse mesocolon should be useful in the performance of laparoscopic CME with CVL for right-sided colon cancer.

  5. Giant urothelial carcinoma of unknown origin invading the sigmoid mesocolon - a case report

    International Nuclear Information System (INIS)

    Kolacinska, A.; Howaniec, J.; Stanczyk, M.; Pawlak, M.; Morawiec, Z.; Rykala, J.

    2007-01-01

    Background: Transitional cell carcinoma, also called urothelial carcinoma, is the most common malignancy of the urinary bladder. Additionally, it can develop in the lining of the renal pelvis, ureter, prostate and urethra. Exceptionally, cancer can arise from the urachus. Also primary transitional cell carcinoma of the endometrium or ovary is a rare entity. Aim: The aim of this article was to present a case of giant urothelial carcinoma of unknown origin invading the sigmoid mesocolon. We report a rare case of urothelial carcinoma invading the sigmoid mesocolon in a 60-year-old female admitted to our department. The patient presented with a 25-cm intra-abdominal mass and 6-cm ulcerated lesion at the top of the umbilicus. Laparotomy was performed which demonstrated a huge polycystic and solid tumour of the sigmoid mesentery infiltrating the sigmoid colon and appendix. Appendectomy and resection of the tumour with an infiltrated sigmoid loop were performed. A right ovarian cyst - not contiguous to the aforementioned tumour - was found at the time of the operation and excised. We also removed the 6-cm skin lesion in the umbilical area. Histopathological examination revealed urothelial carcinoma with squamous cell metaplasia of the sigmoid mesocolon with bowel and umbilical invasion. Concurrent desmoid cyst (mature teratoma) of the right ovary was found. In conclusion, this patient with a sigmoid mesocolon invasion from urothelial carcinoma of unknown origin posed a diagnostic dilemma. (authors)

  6. [Cystic lymphangioma of the transverse mesocolon simulating neoplasm of the pancreatic tail].

    Science.gov (United States)

    Zago, A; Tosi, D; Portuese, D; Rosa, G

    1997-01-01

    Mesenteric cysts are uncommon lesions interesting surgeons above all for frequently difficulties in the preoperatory diagnosis. The role of radiology is to demonstrate the nature of these abdominal masses, but only with surgery we can establish a definitive histologic diagnosis. The authors report a case of a lynphangioma of the transverso mesocolon, miming a pancreatic neoplasm.

  7. Cellular Schwannoma Arising from Sigmoid Mesocolon Presenting ...

    African Journals Online (AJOL)

    Immunostaining showed diffuse S‑100 positivity [Figure 2, inset] and no reactivity for CD117, CD34,. SMA, CD31, HMB‑45, and desmin. A diagnosis of cellular schwannoma with torsion was conferred. Discussion. The schwannomas are typically found as solitary tumors. Presentation associated with schwannomatosis or.

  8. Haematoma in the secondary to acute transverse mesocolon ...

    African Journals Online (AJOL)

    1983-04-09

    Apr 9, 1983 ... extension of the inflammatory process into the anterior pararenal spaces and small-bowel mesentery; there was some penetration of Gerota's fascia of the right kidney (Figs I and 2). There was. Departments of 'Diagnostic Radiology and Surgery,. Baragwanath Hospital and University of the Witwatersrand,.

  9. Extra gonadal sclerosing stromal tumour in the transverse mesocolon

    African Journals Online (AJOL)

    2016-03-01

    Mar 1, 2016 ... munoreactivity for only Vimentin (Figure 3). Figure 3 Tumour cells immunoreactive to vimentin. Other markers such as CD 45(lymphocyte common An- tigen), AE1/AE2 (pan cytokeratin), CD 117, Calretinin,. AFP, Inhibin, S 100, SMA, myogenin were negative. CA 125 assay was within normal limits - 23.1U/ ...

  10. Ectopic paragonimiasis on colon wall and mesocolon of the descending colon

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hae Jeong; Hong, Kyung Chun; Chung, Hye Kyung; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1983-06-15

    Paragonimiasis is prevalent in Far East and a kind of endemic Korean diseases. The primary site of human paragonimiasis is the lung, but the ectopic infection of lung fluke has been reported by many authors. We experienced one case of abdominal paragonimiasis in a 44 year old male with a complaint of left lower quadrant pain. Physical examination, barium enema, and other data suggested the possibility of tumor originating from the wall of descending colon. (intramural tumor). Postoperative specimen taken from the solid tumorous lesion showed parasitic granuloma, characteristic of Paragonimus Westermani. Here, we report a cases of very peculiar ectopic paragonimiasis involved descending colon wall simulating neoplastic tumor, and also review the literatures briefly.

  11. Case report

    African Journals Online (AJOL)

    abp

    2015-12-02

    Dec 2, 2015 ... A primitive pelvic tumor was suspected. At laparotomy exploration, the surgeons noted a pink multiloblar tumor of the transverse mesocolon of 15 cm is his greatest axis, without any ascites or peritoneal carcinoid. The surgeons performed a resection of the tumor and the adjacent part of the mesocolon.

  12. Complete pancreas traumatic transsection

    Directory of Open Access Journals (Sweden)

    H. Hodžić

    2005-02-01

    Full Text Available This report presents a case of a twenty-year old male with complete pancreas breakdown in the middle of its corpus, which was caused by a strong abdomen compression, with injuries of the spleen, the firstjejunumcurve,mesocolon transversum, left kidney, and appereance of retroperitoneal haemathoma. Surgical treatment started 70 minutes after the injury. The treatment consisted of left pancreatectomy with previous spleenectomy, haemostasis of ruptured mesocolon transversum blood vessels, left kidney exploration, suturing of the firstjejunumcurvelession and double abdomen drainage. Posttraumatic pancreatitis which appeared on the second postoperative day and prolonged drain secretion were successfully solved by conservative treatment.

  13. South African Medical Journal - Vol 68, No 15 (1983)

    African Journals Online (AJOL)

    Trichomonas infection in pregnancy does it affect perinatal outcome? EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT ... Haematoma in the transverse mesocolon secondary to acute pancreatitis - A case report · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  14. Retrograde Jejuno‑gastric Intussusception

    African Journals Online (AJOL)

    Bowel sounds were normal. Abdominal X‑ray showed dilated stomach with dilated small bowel loops ... This was reduced and fixed to the abdominal wall and transverse mesocolon. It should be ... reduction of intussusception, but it is contraindicated when signs of peritoneal irritation are present.[9] Due to a limited view on ...

  15. Primary Closure versus Gastric Resection for Perforated Gastric

    African Journals Online (AJOL)

    2017 Nigerian Journal of Surgery | Published by Wolters Kluwer - Medknow. Perforated gastric ulcer is one of the most ... Review Article. Abstract. Access this article online. Quick Response Code: ... Figure 1: Destructive defect in the mesocolon. Figure 2: Giant perforated gastric ulcer of the posterior wall of the antrum.

  16. Enterocutaneous Fistulas in the Setting of Trauma and Critical Illness

    Science.gov (United States)

    2010-01-01

    an extension of the lesser sac inflammation through the leaves of the transverse mesocolon leading to direct involvement of the colon or thrombosis of...adjacent mesenteric vessels and infarction Figure 1 Enteroatmospheric fistula: forceps point to prox- imal small bowel fistula in the upper abdomen

  17. Retroperitoneal Liposarcoma

    African Journals Online (AJOL)

    sion of the lobulated mass was performed, includ- ing a splenectomy. The ureter, which was displaced to the right of the aorta, was identified and reflected off the tumour. Vasculature to the colon was re- tained and the colon was replaced in the paracolic gutter. The mesocolon was repaired and reperitonealisation achieved.

  18. Giant gastrointestinal stromal tumor of the vermiform appendix: A case report.

    Science.gov (United States)

    Kaneko, Manabu; Kawai, Kazushige; Murono, Koji; Nishikawa, Takeshi; Sasaki, Kazuhito; Otani, Kensuke; Yasuda, Koji; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Hata, Keisuke; Nozawa, Hiroaki; Ishihara, Soichiro; Hayashi, Akimasa; Shinozaki-Ushiku, Aya; Fukayama, Masashi; Watanabe, Toshiaki

    2017-09-01

    Gastrointestinal stromal tumors (GISTs) of the vermiform appendix are rare, measuring vermiform appendix, and that the peritoneal metastasis was located in the ascending mesocolon. The patient underwent laparoscopic appendectomy and excision of the peritoneal metastasis, without tumor rupture. Therefore, in appropriately selected patients, neoadjuvant imatinib for borderline resectable or oligometastatic GISTs may be a reasonable choice.

  19. An appraisal of the computed axial tomographic appearance of the human mesentery based on mesenteric contiguity from the duodenojejunal flexure to the mesorectal level

    Energy Technology Data Exchange (ETDEWEB)

    Coffey, J.C.; Culligan, Kevin; Walsh, Leon G.; Sehgal, Rishab; Dunne, Colum; McGrath, Deirdre; Walsh, Dara [University Hospital Limerick, Centre for Interventions in Infection, Inflammation and Immunity (4i), Graduate Entry Medical School and Department of Surgery, Limerick (Ireland); Moore, Michael [Cork University Hospital, Department of Radiology, Cork (Ireland); Staunton, Marie [Mercy University Hospital, Department of Radiology, Cork (Ireland); Scanlon, Timothy; Dewhurst, Catherine; Kenny, Bryan; O' Brien, Julie M. [University Hospital Limerick, Department of Radiology, Limerick (Ireland); O' Riordan, Conor [Kilkenny General Hospital, Department of Radiology, Kilkenny (Ireland); Quondamatteo, Fabio; Dockery, Peter [National University of Ireland Galway, Anatomy, School of Medicine, Galway (Ireland)

    2016-03-15

    The human mesentery is now regarded as contiguous from the duodenojejunal (DJ) to anorectal level. This interpretation prompts re-appraisal of computed tomography (CT) images of the mesentery. A digital model and reference atlas of the mesentery were generated using the full-colour data set of the Visible Human Project (VHP). Seventy one normal abdominal CT images were examined to identify mesenteric regions. CT appearances were correlated with cadaveric and histological appearances at corresponding levels. Ascending, descending and sigmoid mesocolons were identifiable in 75 %, 86 % and 88 % of the CTs, respectively. Flexural contiguity was evident in 66 %, 68 %, 71 % and 80 % for the ileocaecal, hepatic, splenic and rectosigmoid flexures, respectively. A posterior mesocolic boundary corresponding to the anterior renal fascia was evident in 40 % and 54 % of cases on the right and left, respectively. The anterior pararenal space (in front of the boundary) corresponded to the mesocolon. Using the VHP, a mesenteric digital model and reference atlas were developed. This enabled re-appraisal of CT images of the mesentery, in which contiguous flexural and non-flexural mesenteric regions were repeatedly identifiable. The anterior pararenal space corresponded to the mesocolon. (orig.)

  20. An appraisal of the computed axial tomographic appearance of the human mesentery based on mesenteric contiguity from the duodenojejunal flexure to the mesorectal level.

    Science.gov (United States)

    Coffey, J Calvin; Culligan, Kevin; Walsh, Leon G; Sehgal, Rishab; Dunne, Colum; McGrath, Deirdre; Walsh, Dara; Moore, Michael; Staunton, Marie; Scanlon, Timothy; Dewhurst, Catherine; Kenny, Bryan; O'Riordan, Conor; O'Brien, Julie M; Quondamatteo, Fabio; Dockery, Peter

    2016-03-01

    The human mesentery is now regarded as contiguous from the duodenojejunal (DJ) to anorectal level. This interpretation prompts re-appraisal of computed tomography (CT) images of the mesentery. A digital model and reference atlas of the mesentery were generated using the full-colour data set of the Visible Human Project (VHP). Seventy one normal abdominal CT images were examined to identify mesenteric regions. CT appearances were correlated with cadaveric and histological appearances at corresponding levels. Ascending, descending and sigmoid mesocolons were identifiable in 75%, 86% and 88% of the CTs, respectively. Flexural contiguity was evident in 66%, 68%, 71% and 80% for the ileocaecal, hepatic, splenic and rectosigmoid flexures, respectively. A posterior mesocolic boundary corresponding to the anterior renal fascia was evident in 40% and 54% of cases on the right and left, respectively. The anterior pararenal space (in front of the boundary) corresponded to the mesocolon. Using the VHP, a mesenteric digital model and reference atlas were developed. This enabled re-appraisal of CT images of the mesentery, in which contiguous flexural and non-flexural mesenteric regions were repeatedly identifiable. The anterior pararenal space corresponded to the mesocolon. The Visible Human Project (VHP) allows direct identification of mesenteric structures. Correlating CT and VHP allows identification of flexural and non-flexural mesenteric components. Radiologic appearance of intraperitoneal structures is assessed, starting from a mesenteric platform.

  1. An appraisal of the computed axial tomographic appearance of the human mesentery based on mesenteric contiguity from the duodenojejunal flexure to the mesorectal level

    International Nuclear Information System (INIS)

    Coffey, J.C.; Culligan, Kevin; Walsh, Leon G.; Sehgal, Rishab; Dunne, Colum; McGrath, Deirdre; Walsh, Dara; Moore, Michael; Staunton, Marie; Scanlon, Timothy; Dewhurst, Catherine; Kenny, Bryan; O'Brien, Julie M.; O'Riordan, Conor; Quondamatteo, Fabio; Dockery, Peter

    2016-01-01

    The human mesentery is now regarded as contiguous from the duodenojejunal (DJ) to anorectal level. This interpretation prompts re-appraisal of computed tomography (CT) images of the mesentery. A digital model and reference atlas of the mesentery were generated using the full-colour data set of the Visible Human Project (VHP). Seventy one normal abdominal CT images were examined to identify mesenteric regions. CT appearances were correlated with cadaveric and histological appearances at corresponding levels. Ascending, descending and sigmoid mesocolons were identifiable in 75 %, 86 % and 88 % of the CTs, respectively. Flexural contiguity was evident in 66 %, 68 %, 71 % and 80 % for the ileocaecal, hepatic, splenic and rectosigmoid flexures, respectively. A posterior mesocolic boundary corresponding to the anterior renal fascia was evident in 40 % and 54 % of cases on the right and left, respectively. The anterior pararenal space (in front of the boundary) corresponded to the mesocolon. Using the VHP, a mesenteric digital model and reference atlas were developed. This enabled re-appraisal of CT images of the mesentery, in which contiguous flexural and non-flexural mesenteric regions were repeatedly identifiable. The anterior pararenal space corresponded to the mesocolon. (orig.)

  2. Hemorragia rectocolónica aguda masiva secundaria a colitis ulcerosa asociada a lipodistrofía mesentérica colónica

    OpenAIRE

    MANSON,ROBERTO R; AMARILLO,HUGO A; KATSINI B,ROXANA; AMARILLO,MARCELO R; FOURCANS,SEBASTIÁN; AMARILLO,HUGO R

    2009-01-01

    La lipodistrofía mesentérica es una enfermedad inflamatoria crónica inespecífica progresiva que afecta el tejido adiposo del intestino delgado (mesenterio) o del mesocolon. Su etiología es idiopática y su fisiopatología permanece incierta. La lipodistrofía mesentérica con compromiso colorrectal es una condición muy poco frecuente y su asociación a colitis ulcerosa es aún más rara. No hemos encontrado ningún reporte previo en la literatura. Se comunica un caso de lipodistrofía colorrectal asoc...

  3. Torsion and volvulus of the transverse and descending colon in a German shepherd dog.

    Science.gov (United States)

    Halfacree, Z J; Beck, A L; Lee, K C L; Lipscomb, V J

    2006-08-01

    A German shepherd dog was presented two months after surgery for correction of acute gastric dilatation volvulus. The dog had been diagnosed with exocrine pancreatic insufficiency. Radiographs revealed marked gaseous distension of one loop of intestine with a generalised increase in intestinal gas content. A 360 degrees anticlockwise rotation of the descending and transverse colon, around the longitudinal axis of the mesocolon, was diagnosed at exploratory coeliotomy. The transverse and descending colon appeared uniformly necrotic and an end-to-end colo-colic resection and anastomosis was performed. The dog initially made satisfactory postoperative progress but was euthanased on the third postoperative day after it developed an intestinal intussusception.

  4. Postoperative Complications Leading to Death after Coagulum Pyelolithotomy in a Tetraplegic Patient: Can We Prevent Prolonged Ileus, Recurrent Intestinal Obstruction due to Adhesions Requiring Laparotomies, Chest Infection Warranting Tracheostomy, and Mechanical Ventilation?

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2013-01-01

    Full Text Available A 22-year-old male sustained C-6 tetraplegia in 1992. In 1993, intravenous pyelography revealed normal kidneys. Suprapubic cystostomy was performed. He underwent open cystolithotomy in 2004 and 2008. In 2009, computed tomography revealed bilateral renal calculi. Coagulum pyelolithotomy of left kidney was performed. Pleura and peritoneum were opened. Peritoneum could not be closed. Following surgery, he developed pulmonary atelectasis; he required tracheostomy and mechanical ventilation. He did not tolerate nasogastric feeding. CT of abdomen revealed bilateral renal calculi and features of proximal small bowel obstruction. Laparotomy revealed small bowel obstruction due to dense inflammatory adhesions involving multiple small bowel loops which protruded through the defect in sigmoid mesocolon and fixed posteriorly over the area of previous intervention. All adhesions were divided. The wide defect in mesocolon was not closed. In 2010, this patient again developed vomiting and distension of abdomen. Laparotomy revealed multiple adhesions. He developed chest infection and required ventilatory support again. He developed pressure sores and depression. Later abdominal symptoms recurred. This patient’s general condition deteriorated and he expired in 2011. Conclusion. Risk of postoperative complications could have been reduced if minimally invasive surgery had been performed instead of open surgery to remove stones from left kidney. Suprapubic cystostomy predisposed to repeated occurrence of stones in urinary bladder and kidneys. Spinal cord physicians should try to establish intermittent catheterisation regime in tetraplegic patients.

  5. An Optimal Approach for Laparoscopic D3 Lymphadenectomy Plus Complete Mesocolic Excision (D3+CME) for Right-Sided Colon Cancer.

    Science.gov (United States)

    Xie, Daxing; Yu, Chaoran; Gao, Chun; Osaiweran, Hasan; Hu, Junbo; Gong, Jianping

    2017-05-01

    It is common knowledge that high ligation of blood vessels at the D3 level and complete mesocolic excision (CME) are two critical points of right hemicolectomy for right colon cancer (RCC). 1-5 To date, a safe strategy for completing these two procedures under laparoscopic surgery has not been extensively described. The authors provide a video to demonstrate laparoscopic right hemicolectomy (D3 + CME) with an optimal mesentery-defined approach. By identifying three "tri-junctions," this approach facilitates dissection of the entire mesocolon along the embryologic planes as far centrally as possible and enables the high tie of feeding vessels at bifurcation. The authors propose that this approach is safe, decreases blood loss, and is a secure method for right colon cancer intervention. Between June 2014 and June 2015, the study recruited 36 patients with informed consent, and these patients underwent laparoscopic D3+CME for right colon cancer by a single surgeon. All the participants provided informed written consent to participate in the study. This study was approved by the Tongji Hospital Ethics Committee. The patients' demographics, oncologic charac- teristics, postoperative outcomes within 30 days, and follow-up data were collected. The perioperative outcomes included blood lost, number of retrieved lymph nodes, postoperative hospital length of stay, and morbidity. The postoperative 30-day morbidity included cardiovascular, pulmonary, and urinary complications, as well as wound infection, anastomotic leakage, and postoperative ileus. The complications were diagnosed and categorized based on relevant clinical manifestations. For this procedure, all patients are placed in the Trendelenburg position, with five trocars inserted. Carbon dioxide (CO 2 ) is inflated through the intraumbilical trocar, maintaining steady intraabdominal pressure. The operating surgeon stands between the patient's legs, with the camera holder on the left and the assistant on the right

  6. Fibromatosis of the Sigmoid Colon With CTNNB1 (β-Catenin) Gene Mutation, Arising at the Site of Ileocolic Anastomosis for Resection of Gastrointestinal Stromal Tumor.

    Science.gov (United States)

    Thway, Khin; Abou Sherif, Sara; Riddell, Angela M; Mudan, Satvinder

    2016-05-01

    We describe a case of intra-abdominal fibromatosis, which occurred in a 44-year-old woman who had a previous history of gastrointestinal stromal tumor (GIST) of the sigmoid mesocolon, which was treated with imatinib and resection. A mass was detected at the site of ileocolic anastomosis of the previous small bowel resection and sigmoid colectomy, nearly 3 years later. Clinically, this was suspected to represent recurrent GIST and was excised, but histology and mutational analysis showed desmoid-type fibromatosis with a mutation in codon 41 of exon 3 of the CTNNB1 (β-catenin) gene. The occurrence of fibromatosis at the site of excision of GIST is very rare, but its recognition is important as the treatment of the two neoplasms differs significantly. As imaging cannot reliably distinguish between these 2 entities, histological diagnosis is crucial for correct clinical management. © The Author(s) 2015.

  7. Septic thrombophlebitis of the inferior mesenteric vein and associated mesenteric abscess complicating sigmoid diverticulitis: A case report

    International Nuclear Information System (INIS)

    Cha, Seong Jae; Lee, Hae Kyung; Yi, Beom Ha; Lee, Min Hee; Hong, Hyun Sook

    2013-01-01

    Thrombophlebitis occurs secondarily to inflammatory conditions of adjacent organs, and radiologic finding is essential for diagnosis. However, because of the rarity on clinical cases that involve the inferior mesenteric vein, many radiologists are unfamiliar with its location and appearance. We experience a case of septic thrombophlebitis with abscess complication sigmoid diverticulitis. CT scans reveals a low density thrombus and air in the inferior mesenteric vein, combining with perivascular fat infiltration, and focal wall defects with abscess formation. After surgical treatment, the abscess was not visible in the follow-up CT scans. Septic thrombophlebitis of the inferior mesenteric vein, although being a rare disease, should be diagnosed on CT according to the given unique location, the appearance of inflamed vein and the adjacent descending mesocolon.

  8. Septic thrombophlebitis of the inferior mesenteric vein and associated mesenteric abscess complicating sigmoid diverticulitis: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Cha, Seong Jae; Lee, Hae Kyung; Yi, Beom Ha; Lee, Min Hee; Hong, Hyun Sook [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2013-07-15

    Thrombophlebitis occurs secondarily to inflammatory conditions of adjacent organs, and radiologic finding is essential for diagnosis. However, because of the rarity on clinical cases that involve the inferior mesenteric vein, many radiologists are unfamiliar with its location and appearance. We experience a case of septic thrombophlebitis with abscess complication sigmoid diverticulitis. CT scans reveals a low density thrombus and air in the inferior mesenteric vein, combining with perivascular fat infiltration, and focal wall defects with abscess formation. After surgical treatment, the abscess was not visible in the follow-up CT scans. Septic thrombophlebitis of the inferior mesenteric vein, although being a rare disease, should be diagnosed on CT according to the given unique location, the appearance of inflamed vein and the adjacent descending mesocolon.

  9. Secondary metastasis in the lymph node of the bowel invaded by colon cancer: a report of three cases.

    Science.gov (United States)

    Takiyama, Aki; Nozawa, Hiroaki; Ishihara, Soichiro; Takiyama, Hirotoshi; Murono, Koji; Yasuda, Koji; Otani, Kensuke; Nishikawa, Takeshi; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Kawai, Kazushige; Hata, Keisuke; Watanabe, Toshiaki

    2016-10-26

    Secondary metastasis to regional lymph nodes for adjacent bowel invaded by colorectal cancers (CRCs) has not been extensively reviewed. We herein present three such cases. The first case is a cancer involving the cecum and sigmoid colon, and its primary site could not be determined even by pathological evaluation. Nodal involvement was revealed both in the mesocolon of the cecum and sigmoid. The second and third cases are a sigmoid colon cancer invading the jejunum and an ascending colon cancer invading the jejunum, respectively. These patients harbored secondary metastases to lymph nodes draining from the invaded small bowel segments. In spite of complete resection, all three patients metachronously developed liver metastases or recurrent disseminated nodules in the pelvis and subsequently died. In cases of CRC invading another bowel segment, bowel resection with regional lymphadenectomy for both involved segments should be considered to achieve complete resection. However, the radical surgery did not necessarily provide a long-term survival.

  10. Extracolic-infiltrative lesions of the sigmoid colon and recto-sigmoid junction

    Energy Technology Data Exchange (ETDEWEB)

    Krestin, G.P.; Beyer, D.; Lorenz, R.

    1983-06-01

    The problems of extracolic-infiltrative lesions of the sigmoid colon and recto-sigmoid junction are discussed, based on representative case studies. Because of the localisation of these bowel segments in the lower peritoneal cavity, they can be reached by direct infiltration of contiguous tumors - especially carcinoma of the ovary - or by seeding into the pouch of Douglas and the sigmoid mesocolon. In many cases characteristic roentgen-morphologic features indicate a secondary infiltration, but inflammatory and malignant lesions have to be differentiated. The differential-diagnosis must consider also diverticulitis, endometriosis and extracolic growth of colonic carcinoma. Additional ultrasonography and computed tomography may help to clear topographical relations and to detect direct and indirect signs of peritoneal carcinomatosis and abscess.

  11. Extracolic-infiltrative lesions of the sigmoid colon and recto-sigmoid junction

    International Nuclear Information System (INIS)

    Krestin, G.P.; Beyer, D.; Lorenz, R.

    1983-01-01

    The problems of extracolic-infiltrative lesions of the sigmoid colon and recto-sigmoid junction are discussed, based on representative case studies. Because of the localisation of these bowel segments in the lower peritoneal cavity, they can be reached by direct infiltration of contiguous tumors - especially carcinoma of the ovary - or by seading into the pouch of Douglas and the sigmoid mesocolon. In many cases characteristic roentgen-morphologic features indicate a secondary infiltration, but inflammatory and malignant lesions have to be differentiated. The differential-diagnosis must consider also diverticulitis, endometriosis and extracolic growth of colonic carcinoma. Additional ultrasonography and computed tomography may help to clear topographical relations and to detect direct and indirect signs of peritoneal carcinomatosis and abscess. (orig.)

  12. An outbreak of Clostridium difficile-associated diarrhea in piglets in Brazil

    Directory of Open Access Journals (Sweden)

    Rodrigo Otávio Silveira Silva

    2014-02-01

    Full Text Available In spite of the substantial role of Clostridium difficile in causing diarrhea in piglets, there have been few reports of the disease caused by this bacterium in Rio Grande do Sul, Brazil. In this paper, we describe an outbreak of C. difficile-associated diarrhea in a pig farm in Brazil. The diarrhea rate increased in piglets 1-to-7 days old from an average of 2% to approximately 20%. Necropsied piglets showed mesocolon edema, and in a histological evaluation, severe necrotizing neutrophilic colitis was observed. The intestinal contents were positive for the A/B toxins of C. difficile and negative for other tested enteropathogens. The association between the clinical signs, post mortem findings and laboratory exams confirmed the diagnosis of C. difficile-associated diarrhea. The present report confirms C. difficile as a pathogen in swine in Brazil and highlights the need for up to date routine laboratory protocols for the diagnosis of this disease in swine.

  13. Multiple Visceral and Peritoneal Anomalies

    Directory of Open Access Journals (Sweden)

    Gayathri Prabhu S

    2016-07-01

    Full Text Available Visceral and peritoneal anomalies are frequently encountered during cadaveric dissections and surgical procedures of abdomen. A thorough knowledge of the same is required for the success of diagnostic, surgical and radiological procedures of abdomen. We report multiple peritoneal and visceral anomalies noted during dissection classes for medical undergraduates. The anomalies were found in an adult male cadaver aged approximately 70 years. The right iliac fossa was empty due to the sub-hepatic position of caecum and appendix. The sigmoid colon formed an inverted “U” shaped loop above the sacral promontory in the median position. It entered the pelvis from the right side and descended along the lateral wall of the pelvis. The sigmoid mesocolon was attached obliquely to the posterior abdominal wall, just above the sacral promontory. Further there was a cysto-colic fold of peritoneum extending from the right colic flexure. We discuss the clinical significance of the variations.

  14. Gastric Endocrine Cell Carcinoma with Long-Term Survival Developing Metachronous Remnant Cancer

    Directory of Open Access Journals (Sweden)

    Tomoyuki Abe

    2011-04-01

    Full Text Available A rare case of primary gastric endocrine cell carcinoma in a 79-year-old man is reported. Upper gastrointestinal endoscopy showed a large Bormann’s type 2 tumour located in the middle of the stomach. On computed tomography, the gastric wall was thickened by the large tumour, and there were no distant metastases. Distal gastrectomy, lymph node dissection, and partial resection of the transverse colon were performed because the tumour involved the transverse mesocolon. The final pathological diagnosis was endocrine cell carcinoma, with tumour infiltration up to the subserous layer. Adjuvant chemotherapy was given, but metachronous remnant gastric cancer developed 2 years after surgery. Endoscopic submucosal dissection was performed for the early 0-IIc type gastric cancer, and the surgical margin was preserved. The patient has survived for 5 years after the primary surgery, remaining disease-free so far.

  15. Sigmoid Colon Elongation Evaluation by Volume Rendering Technique

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    Atilla SENAYLI

    2011-06-01

    Full Text Available Sigmoid colons have various measurements, shapes, and configurations for individuals. In this subject there are rare clinical trials to answer the question of sigmoidal colon maldevelopment predicting a risk for volvulus. Therefore, sigmoid colon measurement may be beneficial to decide for volvulus. In a study, sigmoid colon diameters were evaluated during abdominal surgeries and it was found that median length was 47 cm and median vertical mesocolon length was 13 cm. We report a 14-year-old female patient who has a sigmoidal colon measured as nearly 54 cm. We used tomographic equipments for this evaluation. We know that MRI technique was used for this purpose but, there has not been data for MRI predicting the sigmoidal volvulus. We hope that our findings by this evaluation can contribute to insufficient literature of sigmoidal elongation. [J Contemp Med 2011; 1(2.000: 71-73

  16. Pure NOTES rectosigmoid resection: transgastric endoscopic IMA dissection and transanal rectal mobilization in animal models.

    Science.gov (United States)

    Park, Sun Jin; Lee, Kil Yeon; Choi, Sung Il; Kang, Byung Mo; Huh, Chang; Choi, Dong Hyun; Lee, Chang Kyun

    2013-07-01

    We report a pure natural orifice translumenal endoscopic surgery (NOTES(®); American Society for Gastrointestinal Endoscopy [Oak Brook, IL] and the Society of American Gastrointestinal and Endoscopic Surgeons [Los Angeles, CA]) rectosigmoidectomy in animal models using transgastric endoscopic inferior mesenteric artery (IMA) dissection and transanal rectal mobilization. Ten live animals (2 pigs weighing 35-40 kg each and 8 dogs weighing 25-30 kg each) were used. A gastrotomy was made using a needle-knife puncture and the balloon dilatation technique or following the creation of a submucosal tunnel. A circular stapler shaft was transanally inserted up to the sigmoid colon for spatial orientation and traction of the mesocolon. The IMA was endoscopically dissected using a Coagrasper™ (Olympus, Tokyo, Japan) and then clipped. Endoscopic division of the sigmoid mesocolon was conducted laterally toward the marginal artery. Transanal full-thickness circumferential rectal and mesorectal dissections were performed, and a colorectal anastomosis was performed using a circular stapler with a single stapling technique. During the transanal approach, the gastrotomy was closed using four endoscopic clips. Endoscopic dissection of the IMA was successful in all cases, but minor bleedings occurred in 3 cases. The mean time from dissection and clipping to division of the IMA was 36.7 minutes (range, 25-45 minutes). The mean operation time was 180.5 minutes (range, 145-210 minutes). There were no intraoperative complications or hemodynamic instability. The mean length of the resected specimen was 11.2 cm (range, 9-17 cm). A pure NOTES approach to rectosigmoid resection using transgastric endoscopic IMA dissection is technically feasible in animal models.

  17. Quiste de ovario errante Erratic ovarian cyst

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    Ana Bertha López Milhet

    2010-12-01

    Full Text Available Se presenta el caso de un paciente de 52 años de edad, que ingresó en el Centro Nacional de Cirugía Endoscópica a causa de un dolor constante y sensación de pesadez en el bajo vientre, además de trastornos dispépticos. Después de los estudios de laboratorio e imaginológicos se diagnosticó un quiste de ovario derecho de 5-8 cm y varios cálculos menores de 10 mm en la vesícula biliar. Durante la intervención quirúrgica se encontró un quiste (ecolúcido, necrosado, adherido al mesocolon e independiente del ovario. Se practicó su exéresis y una colecistectomía. Por resultar una localización infrecuente de un quiste de ovario, se decide exponer las características clínicas y los resultados quirúrgicos y anatomopatológicos de este caso a la comunidad científica nacional e internacional. Se hace referencia además a la posibilidad que brindó el acceso por cirugía laparoscópica de realizar procedimientos asociados en un mismo paciente: colecistectomía y exéresis del quiste de ovario errante.The case of a female patient aged 52 is presented, admitted in the National Endoscopy Surgery Center due to a persistent pain and heaviness sensation in the lower stomach as well as dyspeptic disorders. After laboratory and imaging studies a cyst in right ovary of 5-8 mm diameter (echolucid, necrotic and adhered to mesocolon was diagnosed. A exeresis and a cholecystectomy were performed. Due to its infrequent location of a ovarian cyst the clinical features and the surgical and anatomical and pathological results are presented to national and international scientific community. Authors also make reference to the possibility allowed by the laparoscopic surgery approach to carry out procedures associated in a same patient: cholecystectomy and exeresis of erratic ovarian cyst.

  18. Delayed gastric emptying after pylorus-preserving pancreatoduodenectomy is strongly related to other postoperative complications.

    Science.gov (United States)

    Riediger, Hartwig; Makowiec, Frank; Schareck, Wolfgang D; Hopt, Ulrich T; Adam, Ulrich

    2003-01-01

    Patients undergoing pylorus-preserving pancreatoduodenenectomy (PPPD) have a risk of up to 50% for developing delayed gastric emptying (DGE) in the early postoperative course. From 1994 to August 2002, a total of 204 patients underwent PPPD for pancreatic or periampullary cancer (50%), chronic pancreatitis (42%), and other indications (8%). Retrocolic end-to-side duodenojejunostomy was performed below the mesocolon. DGE was defined by the inability to tolerate a regular diet after day 10 (DGE10) or day 14 (DGE14) postoperatively, as well as the need for a nasogastric tube at or beyond day 10 (DGE10GT). Postoperative morbidity was 38%, 30-day mortality was 2.9%, and median postoperative length of stay was 15 days. DGE occurred in 14.7% (DGE10), 5.9% (DGE14), and 6.4% (DGE10GT), respectively. After further exclusion of 21 patients (10.3%) with major complications and no possible oral intake (because of death, reoperation, or mechanical ventilation), the frequencies of DGE10, DGE14, and DGE10GT in the remaining group of 183 patients were 9%, 2%, and 2%, respectively. Multivariate analysis revealed postoperative complications (Pindications for surgery (P<0.01) as independent risk factors for DGE10. The overall incidence of DGE was low after PPPD. In those patients experiencing DGE, however, other postoperative complications were the most important factor associated with its occurrence.

  19. Systematic approach to the analysis of cross-sectional imaging for surveillance of recurrent colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Faria, Silvana C. [Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, 1515 Holcombe Blvd., Box 57, Houston, TX 77030 (United States); Tamm, Eric P. [Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, 1515 Holcombe Blvd., Box 57, Houston, TX 77030 (United States)]. E-mail: etamm@di.mdacc.tmc.edu; Varavithya, Vithya [Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, 1515 Holcombe Blvd., Box 57, Houston, TX 77030 (United States); Phongkitkarun, Sith [Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Rama VI Road, Phayathai, Bangkok 10400 (Thailand); Kaur, Harmeet [Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, 1515 Holcombe Blvd., Box 57, Houston, TX 77030 (United States); Szklaruk, Janio [Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, 1515 Holcombe Blvd., Box 57, Houston, TX 77030 (United States); DuBrow, Ronelle [Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, 1515 Holcombe Blvd., Box 57, Houston, TX 77030 (United States); Charnsangavej, Chusilp [Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, 1515 Holcombe Blvd., Box 57, Houston, TX 77030 (United States)

    2005-03-01

    Recurrent disease in colorectal cancer occurs in approximately 50% of patients who undergo a 'curative' operation. Tumor recurrence may occur locally (at the anastomotic site), in the mesentery or mesocolon adjacent to the post-operative site, in the nodal echelon downstream to the post-operative site, and as distant metastases to the peritoneal cavity, liver or lung. Local recurrence at the anastomosis is frequently diagnosed at follow-up endoscopic examinations as part of screening for metachronous lesions. Other types of recurrences require imaging studies, most frequently CT or MR imaging to diagnose. We developed an approach to analyze imaging obtained after curative resection of colorectal cancer. Our approach is based on the knowledge of patterns of disease spread, of types of surgical procedures and of pathologic staging. Using this approach has the potential to detect recurrent disease at an early stage because the locoregional and nodal spread of this disease is predictable. Early diagnosis of recurrent disease, even in asymptomatic cases, allows for more effective treatment that can improve the long-term survival of these patients.

  20. Mesenteric panniculitis of the sigmoid colon: a case report and review of the literature

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    Popkharitov Angel I

    2007-10-01

    Full Text Available Abstract Introduction Mesenteric panniculitis of the sigmoid colon is a rare occurrence in surgical practice. The aim of this article is to present a case of mesenteric panniculitis of the sigmoid colon and a short review of the literature. Case presentation We reviewed the hospital record of a 63-year-old man who presented with a palpable mass in the left abdomen and clinical signs of a partial bowel obstruction. The pre-operative impression was a possible cancer of the sigmoid colon. A laparotomy was performed through a midline incision. The mesentery was found to be markedly thickened, constricted and puckered. The normal architecture of the adipose tissue had been lost and replaced with an irregular nodular mass. The microscopic pathologic sections demonstrated a chronic reactive inflammatory process with an exuberant proliferation of fibroblasts and fibrocytes. The adipose tissue contained scattered areas of steatonecrosis with foci of lipid-laden macrophages, lymphocytes and plasma cells. The sigmoid colon and its mesocolon were resected. The postoperative course was uneventful and the patient was discharged in good condition, and followed up for the next two years. Conclusion Mesenteric panniculitis of sigmoid is an extremely rare entity of unknown origin in which the normal architecture of the mesentery is replaced by fibrosis, necrosis and calcification. On gross examination the alterations may be mistaken for a neoplastic process. A frozen section may be necessary for confirmation of the diagnosis. When the advanced inflammatory changes became irreversible and bowel obstruction occurs, resection may be indicated.

  1. Omental transposition for low pelvic anastomoses.

    Science.gov (United States)

    Topor, B; Acland, R D; Kolodko, V; Galandiuk, S

    2001-11-01

    Surgeons' opinions differ regarding the role of the omentum in low pelvic intestinal anastomoses. This study was undertaken to define the anatomy and surgical technique of omental transposition to the pelvis. We studied 45 cadavers to elucidate surgical aspects of omental mobilization, lengthening, and transposition into the pelvic cavity. In addition, intraoperative studies of omental transposition to the pelvis were performed in 20 patients with chronic ulcerative colitis, familial adenomatous polyposis, and rectal cancer who were undergoing ileal J-pouch anal anastomosis or low anterior resection. The most important anatomic variables for omental transposition are three variants of arterial blood supply: (1) In 56% of patients, there is one right, one (or two) middle, and one left omental artery. (2) In 26% of patients, the middle omental artery is absent. (3) In the remaining 18% of patients, the gastroepiploic artery is continued as a left omental artery but with various smaller connections to the right or middle omental artery. The first stage of omental lengthening is detachment of the omentum from the transverse colon mesentery. This must be performed carefully, as the omentum is closely adherent to the right transverse mesocolon. The second stage is the actual lengthening of the omentum. The third stage is placement of the omental flap into the pelvis. Creation of an omental pedicle is a simple surgical procedure. This procedure can be performed quickly, does not involve significant blood loss, and may reduce the frequency of complications after low pelvic anastomoses.

  2. Anatomy of the transverse colon revisited with respect to complete mesocolic excision and possible pathways of aberrant lymphatic tumor spread.

    Science.gov (United States)

    Stelzner, Sigmar; Hohenberger, Werner; Weber, Klaus; West, Nicholas P; Witzigmann, Helmut; Wedel, Thilo

    2016-02-01

    Although lymph node metastases to pancreatic and gastroepiploic lymph node stations in transverse colon cancer have been described, the mode of lymphatic spread in this area remains unclear. This study was undertaken to describe possible pathways of aberrant lymphatic spread in the complex anatomic area of the proximal superior mesenteric artery and vein, the greater omentum, and the lower pancreatic border. Abdominal specimens obtained from four cadaveric donors were dissected according to the principles of complete mesocolic excision. The vascular architecture of the transverse colon was scrutinized in search of possible pathways of lymphatic spread to the pancreatic and gastroepiploic lymph nodes. Vascular connections between the transverse colon and the greater omentum at the level of both the hepatic and the splenic flexures could be identified. In addition, small vessels running from the transverse mesocolon to the lower pancreatic border in the area between the middle colic artery and the inferior mesenteric vein were demonstrated. Moreover, venous tributaries to the gastrocolic trunk could be exposed to highlight its surgical importance as a guiding structure for complete mesocolic excision. The technical feasibility to clearly separate embryologic compartments by predefined tissue planes in complete mesocolic excision was confirmed. However, the vicinity of all three endodermal intestinal segments (foregut, midgut, and hindgut) obviously gives way to vascular connections that might serve as potential pathways for lymphatic metastatic spread of transverse colon cancer.

  3. Laparoscopic resection of transverse colon cancer at splenic flexure: technical aspects and results.

    Science.gov (United States)

    Okuda, Junji; Yamamoto, Masashi; Tanaka, Keitaro; Masubuchi, Shinsuke; Uchiyama, Kazuhisa

    2016-03-01

    Laparoscopic resection of transverse colon cancer at splenic flexure is technical demanding and its efficacy remains controversial. The aim of this study was to investigate its technical aspects such as pitfalls and overcoming them, and to demonstrate the short-term and oncologic long-term outcomes. To overcome the difficulty in laparoscopic resection of transverse colon cancer at splenic flexure, we recognized the following technical tips as essential. First of all, we have to precisely identify major vessels variations feeding tumor. Secondary, anatomical dissection of mesocolon through medial approach is indispensible. Third, safe takedown of splenic flexure to fully mobilization of left hemicolon is mandatory. This cohort study analyzed 95 patients with stage II (43) and III (52) underwent resection of transverse colon cancer at splenic flexure. 61 laparoscopic surgeries (LAC) and 34 conventional open surgeries (OC) from December 1996 to December 2009 were evaluated. Short-term and oncologic long-term outcomes were recorded. Operative time was longer in LAC. However, blood loss was less, recovery of bowel function and hospital stay were shorter in LAC. There was no conversion in LAC and no significant difference in the postoperative complications. Regarding oncologic long-term outcomes, there were no significant differences between OC and LAC. Laparoscopic resection of transverse colon cancer at splenic flexure resulted in acceptable short-term and oncologic long-term outcomes. Once technical tips acquired, laparoscopic resection of transverse colon cancer at splenic flexure could be feasible as minimally invasive surgery.

  4. An unusual colon atresia in a calf: at the junction of the distal loop and transverse colon. A brief overview.

    Science.gov (United States)

    Lombardero, Matilde; Yllera, María del Mar

    2014-01-01

    Congenital defects are those abnormalities present at birth. During embryogenesis, many anomalies can occur. The primitive gut tube lengthens quickly and rotates, allowing the gastrointestinal tract acquire its final position and orientation. Because the colon of large animals is complex, most changes occur in this segment. Thus, in ruminants, colon atresia is the most frequent malformation, affecting mainly ascending colon, at the level of the spiral loop. There are no previous references about a very atypical colon atresia at the junction of distal loop and transverse colon, such we have described in a 5-day-old calf, after a history of abdominal distention and absence of feces at birth, even with a patent anal opening. Atresia coli was detected at distal position of the typical colon atresia, at the junction of distal loop and transverse colon. In addition, the distal blind end was bent into a U-shape supported by the mesocolon. Besides the anatomical findings of this worthwhile atresia coli we discuss its possible etiology, in which local factors, such as a compromised blood supply during embryogenesis, are more consistent than genetic factors. Finding out the causes of atresia coli would help to reduce its incidence, lessen animal suffering and economic loss.

  5. [The clinical and pathological research of complete mesocolic excision on the treatment of right colon cancer].

    Science.gov (United States)

    Yang, Yingchi; Wang, Jin; Jin, Lan; Zhao, Xiaomu; Wu, Guocong; Wang, Kangli; Zhang, Zhongtao

    2016-01-01

    differences from operation safety when CME group was compared with the control group. The pathological large slices of colon cancer were prepared successfully and dyed evenly than those large slices were used to observe whether the lymph tube and lymph node metastasis inside the mesocolon. Existence of direct tumor invasion could be confirmed by investigating the large slices. Cancer embolus in intravascular and micro infiltration in mesocolon also could be found. CME operation can get the standard excision according the mesocolic area and integrity, as well as to harvest the maximum number of lymph node. The clinical application of CME is safe and does not increase the risk of operation. Circumferential resection margins can be detected by pathological large slices.

  6. Single-incision laparoscopic surgery in a survival animal model using a transabdominal magnetic anchoring system.

    Science.gov (United States)

    Cho, Yong Beom; Park, Chan Ho; Kim, Hee Cheol; Yun, Seong Hyeon; Lee, Woo Yong; Chun, Ho-Kyung

    2011-12-01

    Though single-incision laparoscopic surgery (SILS) can reduce operative scarring and facilitates postoperative recovery, it does have some limitations, such as reduction in instrument working, difficulty in triangulation, and collision of instruments. To overcome these limitations, development of new instruments is needed. The aim of this study is to evaluate the feasibility and safety of a magnetic anchoring system in performing SILS ileocecectomy. Experiments were performed in a living dog model. Five dogs (26.3-29.2 kg) underwent ileocecectomy using a multichannel single port (OCTO port; Darim, Seoul, Korea). The port was inserted at the umbilicus and maintained a CO(2) pneumoperitoneum. Two magnet-fixated vascular clips were attached to the colon using an endoclip applicator, and it was held together across the abdominal wall by using an external handheld magnet. The cecum was then retracted in an upward direction by moving the external handheld magnet, and the mesocolon was dissected with Ultracision(®). Extracorporeal functional end-to-end anastomosis was done using a linear stapler. All animals survived during the observational period of 2 weeks, and then re-exploration was performed under general anesthesia for evaluation of intra-abdominal healing and complications. Mean operation time was 70 min (range 55-100 min), with each subsequent case taking less time. The magnetic anchoring system was effective in achieving adequate exposure in all cases. All animals survived and convalesced normally without evidence of clinical complication during the observation period. At re-exploration, all anastomoses were completely healed and there were no complications such as abscess, bleeding or organ injury. SILS ileocecectomy using a magnetic anchoring system was safe and effective in a dog model. The development of magnetic anchoring systems may be beneficial for overcoming the limitations of SILS.

  7. CT of pancreatitis

    International Nuclear Information System (INIS)

    Fukuda, Toshio

    1990-01-01

    One hundred and two cases of acute and chronic pancreatitis were studied by computed tomography. Fluid collection was detected by CT in 45 cases, and the common extrapancreatic sites of involvement included the lesser sac (13 cases), anterior pararenal space (9 cases), transverse mesocolon (7 cases) and posterior pararenal space (5 cases). Ten cases of spontaneous resolution of pancreatic pseudocysts were encountered. Cystojejunostomy was done on 6 patients. A 4-to-6-weeks time interval has been currently accepted as necessary for pseudocyst wall maturation. However, the surgery was not possible in two patients in this series since the cyst wall was too thin. It is considered that the time over 3 months is required for surgical anastomosis of the cyst to the gastrointestinal tract. Pancreatic abscess has become the most common cause of death from pancreatitis. In this series pancreatic abscess occurred in 8 patients. Gas collection in the pancreas was observed in only one patient. In the other patients, pseudocysts had become infected and converted to abscesses. The CT number of 4 infected pseudocysts was less than 15 HU. Thus, it was not possible to distinguish infected from noninfected pseudocysts by CT. The author studied 9 patients with focal inflammatory mass of the pancreas with histologically proved severe fibrosis. All masses were small. Angiography showed occlusion or marked stenosis of the splenic vein in 3 cases. The postcontract CT (after intravenous bolus injection) in 7 cases of focal inflammatory mass demonstrated almost equal enhanced effect of the mass as compared with the adjacent normal pancreatic parenchyma. This finding is considered to be useful in distinguishing inflammatory mass from pancreatic carcinoma. (author)

  8. CT of pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Fukuda, Toshio (Nagasaki Univ. (Japan). School of Medicine)

    1990-09-01

    One hundred and two cases of acute and chronic pancreatitis were studied by computed tomography. Fluid collection was detected by CT in 45 cases, and the common extrapancreatic sites of involvement included the lesser sac (13 cases), anterior pararenal space (9 cases), transverse mesocolon (7 cases) and posterior pararenal space (5 cases). Ten cases of spontaneous resolution of pancreatic pseudocysts were encountered. Cystojejunostomy was done on 6 patients. A 4-to-6-weeks time interval has been currently accepted as necessary for pseudocyst wall maturation. However, the surgery was not possible in two patients in this series since the cyst wall was too thin. It is considered that the time over 3 months is required for surgical anastomosis of the cyst to the gastrointestinal tract. Pancreatic abscess has become the most common cause of death from pancreatitis. In this series pancreatic abscess occurred in 8 patients. Gas collection in the pancreas was observed in only one patient. In the other patients, pseudocysts had become infected and converted to abscesses. The CT number of 4 infected pseudocysts was less than 15 HU. Thus, it was not possible to distinguish infected from noninfected pseudocysts by CT. The author studied 9 patients with focal inflammatory mass of the pancreas with histologically proved severe fibrosis. All masses were small. Angiography showed occlusion or marked stenosis of the splenic vein in 3 cases. The postcontract CT (after intravenous bolus injection) in 7 cases of focal inflammatory mass demonstrated almost equal enhanced effect of the mass as compared with the adjacent normal pancreatic parenchyma. This finding is considered to be useful in distinguishing inflammatory mass from pancreatic carcinoma. (author).

  9. Diagnostic significance of gas distension technique of the stomach with gas-forming agent on CT scan of stomach cancer

    International Nuclear Information System (INIS)

    Rho, Tae Jin; Song, Chang June; Choi, Joong Chan; Park, Cheong Hee; Cho, June Sik; Rhee, Byung Chull

    1988-01-01

    CT is a valuable method for preoperative staging of patients with stomach cancers. However, in patients with poor distension of the stomach and scanty fat between the stomach and adjacent organs, CT findings may indicate a false impression of gastric wall thickening and cannot provide the precise extent of stomach cancer. We studied the usefulness of gastric distension by gas-forming agent in 28 cases of pathologically confirmed gastric cancers on CT. Comparative analysis between CT findings and surgical pathologic findings was done in 22 cases who underwent surgery. The results were as follows; 1. Conventional CT failed to define the wall thickening or masses of the stomach, in 14 cases of 23 advanced gastric cancers, while CT with gas distension technique allowed good visualization in all advanced gastric cancers. 2. In 2 cases of 5 early gastric cancers, CT with gas distension technique could detect focal thickening of the gastric wall, even less than 1cm thickness. 3. Among 13 cases with indistinguishable border between stomach and liver on conventional CT, 7 cases were diagnosed as negative invasion on CT with gas distension technique and 5 cases of these were confirmed by surgery. 4. Among 11 cases with indistinguishable border between stomach and pancreas on conventional CT, 3 cases were diagnosed as negative invasion on CT with gas distension technique, all of which were confirmed by surgery. 5. There was no significant difference between conventional CT and CT with gas distension technique of the stomach to diagnose invasion into transverse colon, transverse colon, transverse mesocolon, lymph node metastasis, and various distant metastasis.

  10. Multidetector CT of Locally Invasive Advanced Gastric Cancer: Value of Oblique Coronal Reconstructed Images for the Assessment of Local Invasion

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Jin Hee; Kim, Ah Yong; Kim, Hye Jin; Yook, Jeong Hwan; Yu, Eun Sil; Jang, Yoon Jin; Park, Seong Ho; Shin, Yong Moon; Ha, Hyun Kwon [Asan Medical Center, Seoul (Korea, Republic of)

    2010-01-15

    To evaluate the diagnostic value of oblique coronal reconstructed CT images to determine the local invasion of advanced gastric cancer (AGC). Thirty-four consecutive patients, who were suspected to have locally invasive advanced gastric cancer (more than T3 stage) on a preoperative MDCT scan and underwent a diagnostic or curative laparotomy, were enrolled in this study. Two reviewers performed an independent blind review of three series of MDCT images in random order; axial (AXI), conventional coronal (CCI), and oblique coronal (OCI) (parallel to long axis of gastric body and pancreas) images. In assessing the local invasion, the reader's confidence for the local invasion of AGC was graded using a five point scale (1 = definitely negative, 5 = definitely positive: T4). With surgical findings and histopathological proofs as reference standards, the diagnostic performance of the three different plans of CT images was employed for the verification of local invasion of AGC on a preoperative CT scan using the receiver operating characteristic (ROC) method. Agreements between the two reviewers were analyzed using weighted kappa statistics. Results: In 19 out of 34 patients, local invasion was confirmed surgically or histopathologically (13 pancreas invasion, 6 liver invasion, 4 major vascular invasion, 3 colon and mesocolon invasion, and 2 spleen invasion). The diagnostic performance of OCI was superior to AXI or CCI in the local invasion of AGC. The differences in the area under the curve of AXI (0.770 {+-} 0.087, 0.700 {+-} 0.094), CCI (0.884 {+-} 0.058, 0.958 {+-} 0.038), and OCI (0.954 {+-} 0.050, 0.956 {+-} 0.049), were statistically significant for both reviewers. Inter-observer agreement was excellent for OCI ({kappa}= .973), which was greater than CCI (({kappa}= .839), and AXI (({kappa}= .763). On a CT scan, OCI might be a useful imaging technique in evaluating locally invasive advanced gastric cancer.

  11. Single-access laparoscopic low anterior resection with vertical suspension of the rectum.

    Science.gov (United States)

    Uematsu, Dai; Akiyama, Gaku; Narita, Maiko; Magishi, Akiko

    2011-05-01

    Single-access laparoscopic surgery was first introduced for colectomy and later adapted for anterior resection. During single-access laparoscopic pelvic procedures, such as total mesorectal excision, it is often difficult to obtain an adequate operative field. By suspending the rectum vertically, we were able to execute a total mesorectal excision with single-access laparoscopy. We describe here the use of this new procedure to treat rectal cancer. The selected 7 patients (1 male and 6 female) with stage II or III rectal cancer underwent the procedure. Single-port access to the abdomen was provided by a 3.0-cm incision at the right iliac fossa. The descending mesocolon was dissected by use of a medial approach, and a columnar magnet was placed on the surface of the abdominal wall to restore triangulation. The inferior mesenteric artery was skeletonized and the superior rectal artery divided during lymph node dissection. The total mesorectal excision extended to the pelvic floor and the rectum was vertically retracted with a suspending bar in collaboration with an extracorporeal magnet tool. The rectum was then transected below the reflection of the peritoneum. Intracorporeal anastomosis was performed with the double-stapling technique. Two pelvic drains were inserted through the single incision and the anus, respectively, for all patients. A defunctioning ileostomy was not created in any patient. Median total surgical time was 205 minutes (range, 175-245 min). Intraoperative blood loss was minimal in all patients (range, 1-20 mL). None of the cases required conversion to open surgery or addition of a second port. The only preoperative or postoperative complication occurred in one patient with clinical anastomotic leakage. Low anterior single-access laparoscopic resection seems safe and feasible when the rectum is suspended like a swing to ensure an adequate operative field.

  12. Single-incision laparoscopic surgery using colon-lifting technique for colorectal cancer: a matched case-control comparison with standard multiport laparoscopic surgery in terms of short-term results and access instrument cost.

    Science.gov (United States)

    Fujii, Shoichi; Watanabe, Kazuteru; Ota, Mitsuyoshi; Watanabe, Jun; Ichikawa, Yasushi; Yamagishi, Shigeru; Tatsumi, Kenji; Suwa, Hirokazu; Kunisaki, Chikara; Taguri, Masataka; Morita, Satoshi; Endo, Itaru

    2012-05-01

    Single-incision laparoscopic surgery (SILS) has been used for colorectal cancer as a minimally invasive procedure. However, there are still difficulties concerning effective triangulation and countertraction. The study's purpose was to clarify the usefulness of the colon-lifting technique (CLT) in SILS for colorectal cancer. SILS was performed for cancer (cT2N0 or less) of the right-sided colon (near the ileocecum), sigmoid, or rectosigmoid. The SILS™ Port was used for transumbilical access. A suture string was inserted through the abdominal wall and passed through the mesocolon. The colon was retracted anteriorly and fixed to the abdominal wall. The main mesenteric vessels were placed under tension. Lymph node dissection was performed by medial approach. Short-term surgical outcomes and access port costs were compared between SILS (using CLT) and the standard multiport technique (MPT). The two groups were case-matched by propensity scoring. Analyzed variables included preoperative Dukes stage and tumor location. From June 2009 to April 2011, 27 patients underwent SILS, and from April 2005 to April 2011, 85 patients underwent MPT. Propensity scoring generated 23 matched patients per group for SILS versus MPT comparisons. There were no significant differences in operating time, blood loss, early complications, postoperative analgesic frequency, or length of hospital stay. One MPT patient was converted to open surgery (4.5%); no SILS patients were converted. There were no significant differences in the length of distal cut margin and the number of harvested lymph nodes, except incision length (SILS vs. MPT: 33 vs. 55 mm, P Japanese yen, P CLT was safe and effective in providing radical treatment of cT2N0 cancer in the right-sided colon, sigmoid, or rectosigmoid. SILS was advantageous with respect to cosmesis and lower cost of access instruments.

  13. Robotic-assisted laparoscopic Nissen fundoplication with gastrostomy preservation in neurologically impaired children.

    Science.gov (United States)

    Margaron, Franklin C; Oiticica, Claudio; Lanning, David A

    2010-06-01

    Robotic fundoplication has equivalent safety profiles, hospital stay, and time to alimentation, compared to laparoscopic fundoplication, but is not indicated for routine repair due to higher cost, decreased availability, and longer procedure time. Robotic surgery does offer key advantages over standard laparoscopy by employing internally articulating arms, a stable camera platform, and three dimensional imaging. Children presenting for initial or redo fundoplication after feeding gastrostomy are a subset of patients that may benefit from the robotic approach. Minimal dissection of the phrenoesophageal ligament, in combination with four anchoring sutures from the esophagus to the crura, has been shown to lead to less wrap herniation in children. This technique is particularly difficult in standard laparoscopy without dislodgement of the gastrostomy, particularly if there are abundant adhesions or a replaced left hepatic artery to preserve. In this article, we present 15 children with neurologic impairment and previous gastrostomy who underwent Nissen fundoplication, using the da Vinci surgical robot (Intuitive Surgical, Inc., Sunnyvale, CA). All patients underwent a floppy Nissen fundoplication after crural closure and placement of four anchoring stitches to the crura. Six patients (40%) had redo Nissens and 5 (33.3%) had replaced left hepatic or accessory arteries that were preserved. Seven patients underwent repair of a hiatal hernia and 2 had biologic mesh placed. There were no conversions to open or intraoperative complications. One child had a revision of the gastrostomy site, because the prior percutaneous endoscopic gastrostomy had been placed through the transverse mesocolon. There were only a few minor postoperative complications. All children were doing well at latest follow-up (average, 32 months). The da Vinci surgical robot can be used to safely perform fundoplications in patients with gastrostomy tubes. The articulating instruments allow for the

  14. Complete mesocolic excision an assessment of feasibility and outcome.

    Science.gov (United States)

    Bertelsen, Claus Anders

    2017-02-01

    Surgery is the most important factor for radical treatment of colon cancer, and the long-term prognosis can be improved by improving the surgical treatment without increased risk of perioperative mortality. Complete mesocolic excision (CME), in which more extensive lymph node (LN) dissection is performed, has been shown in single-centre studies with historical controls to be associated with better oncological outcome. However, better evidence is needed. The main purpose of this PhD thesis was to investigate whether CME could be implemented in a colorectal surgical department in Denmark, whether more extensive dissection could demonstrate LN metastases outside the mesocolon, and to demonstrate a possible association between CME and improved oncological results without increased risk of perioperative mortality. This thesis includes five articles. Two articles (IV and V) are based on the population of patients undergoing elective resection for colon cancer in the Capital Region from June 2008 to December 2013. Two articles (II and III) are based on data from the local colon database in Hillerød, and the last article (I) is a systematic review concerning the risk of metastases from colon cancer to the central LNs in the mesocolon. Article I found a risk of metastases in central LNs to be reported in 1-22% of the cases of right-sided colon cancers, and in up to 12% of the cases with sigmoid tumours. The populations included and methods used in the studies were very heterogeneous and no definitive conclusions can be drawn. It was shown in article II that the surgical quality, i.e. quality of the specimens assessed by the pathologists, improved with implementation of CME in Hillerød. The vascular tie was higher, and the implementation was not associated with an increased risk of perioperative mortality. Article III demonstrated a risk of LN metastases in the gastrocolic ligament along the stomach for tumours located in the transverse colon, in the ascending or

  15. Colopexia laparoscópica com retalho de tela de polipropileno em cães Laparoscopic colopexy with polyprolyne mesh in dogs

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    M.V. Brun

    2007-02-01

    Full Text Available Avaliou-se uma nova técnica de colopexia laparoscópica, sem necessidade de suturas intracorpóreas em cães, utilizando a implantação de segmento de tela de polipropileno em 11 animais. As superfícies serosas do cólon descendente e parede muscular foram mantidas em contato com o implante posicionado por meio de lesão produzida no mesocólon e sob o retalho bipediculado de músculo transverso abdominal. As extremidades da tela foram unidas com a aplicação de clipe de titânio. Os procedimentos duraram 36,00±13,15min, sem a ocorrência de complicações. No período pós-operatório, foi verificada a manutenção da colopexia em sete animais, a formação de fixação parcial entre o intestino e a parede em três cães, e a não formação de aderências do cólon em um paciente. Conclui-se que o procedimento proposto é viável para cães, porém necessita de ajustes técnicos.A new laparoscopic colopexy technique was tested in dogs without intracorporeal sutures. The use of polypropylene mesh in eleven mongrel dogs was evaluated. The serosal surface of the descendent colon and transverse abdominal muscle were put in contact with the mesh application, taking into consideration that the polypropylene implant was positioned through the mesocolon and under the muscle flap. Finally, the extremities of the mesh were clipped. The procedures lasted 36:00±13:15min, without any kind of complications. In the post-operative period, adequate colopexy in seven dogs was observed. In three dogs the colopexy was partial and in one the bowel did not adhere to the muscles or mesh. The proposed procedure is viable for dogs, however, it is necessary to make some adjustments.

  16. Adrenomedulline improves ischemic left colonic anastomotic healing in an experimental rodent model

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    Oguzhan Karatepe

    2011-01-01

    Full Text Available BACKGROUND: Leakage from colonic anastomosis is a major complication causing increased mortality and morbidity. Ischemia is a well-known cause of this event. This study was designed to investigate the effects of adrenomedullin on the healing of ischemic colon anastomosis in a rat model. METHODS: Standardized left colon resection 3 cm above the peritoneal reflection and colonic anastomosis were performed in 40 Wistar rats that were divided into four groups. To mimic ischemia, the mesocolon was ligated 2 cm from either side of the anastomosis in all of the groups. The control groups (1 and 2 received no further treatment. The experimental groups (3 and 4 received adrenomedullin treatment. Adrenomedullin therapy was started in the perioperative period in group 3 and 4 rats (the therapeutic groups. Group 1 and group 3 rats were sacrificed on postoperative day 3. Group 2 and group 4 rats were sacrificed on postoperative day 7. After careful relaparotomy, bursting pressure, hydroxyproline, malondialdehyde, interleukin 6, nitric oxide, vascular endothelial growth factor, and tumor necrosis factor alpha levels were measured. Histopathological characteristics of the anastomosis were analyzed. RESULTS: The group 3 animals had a significantly higher bursting pressure than group 1 (p<0.05. Hydroxyproline levels in group 1 were significantly lower than in group 3 (p<0.05. The mean bursting pressure was significantly different between group 2 and group 4 (p<0.05. Hydroxyproline levels in groups 3 and 4 were significantly increased by adrenomedullin therapy relative to the control groups (p<0.05. When all groups were compared, malondialdehyde and nitric oxide were significantly lower in the control groups (p<0.05. When vascular endothelial growth factor levels were compared, no statistically significant difference between groups was observed. Interleukin 6 and tumor necrosis factor alpha were significantly decreased by adrenomedullin therapy (p<0.05. The

  17. [Laparoscopic resection of the colon for adenocarcinoma. Report of a series of 218 cases].

    Science.gov (United States)

    Trebuchet, G; Le Calvé, J; Launois, B

    1998-09-01

    The aim of this retrospective study was to report the results of a series of 218 laparoscopic resections for adenocarcinoma of the colon by the same surgical team over a 6-year period. Laparoscopic procedures included, for the right and the left colon, at first a ligature of the vascular pedicles, secondarily a dissection of the mesocolons, and were almost identical to the conventional procedures. A conversion to open laparotomy was necessary in 8.3% of the patients. Among 218 patients, there were 117 men and 101 women; the mean age was 69 years. Twenty nine per cent of the patients had already undergone open laparotomy. Mean ASA grade was 2.1. An emergency operation was necessary for 9% of the patients in relation with colonic obstruction (n = 20) or peritonitis (n = 3). Colonic resections were considered curative in 180 patients (82.6%). The mean duration of surgery was 157 minutes for the right colectomies and 148 for the left. The proportion of A, B, C, D Dukes stage tumours was respectively 19.3%, 38.5%, 27.5% and 14.7%. There was one post-operative death related to a serious epileptic seizure due to unknown cerebral metastases. The morbidity rate was 5.5% and the early reintervention rate 2.8%. There was no lost to follow-up. With a mean 35-month follow-up. 82.2% of the patients were alive after curative surgery. Abdominal wall recurrence at port sites occurred in four patients operated on for a Dukes C cancer before 1994. Prognosis was significantly dependent on cellular differentiation, lymph node extension, pericolic extension and Dukes stage. The 5-year actuarial survival rate, according to Kaplan-Meier method was 65.36%. Laparoscopic colon cancer resection was used by the authors in 92% of patients during 1997. The conversion rate to open laparotomy has been lower than 5% since 1995. Post-operative mortality was 0.4% and post-operative morbidity 5.5%. After curative colonic cancer resection, the 5-year actuarial survival rate was 65%.

  18. Modelo de suprimento sanguíneo do intestino grosso do tamanduá bandeira (Myrmecophaga tridactyla Model of blood supply to the intestine of Giant anteater (Myrmecophaga tridactyla

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    Ana Lúcia Rezende de Souza

    2010-03-01

    Full Text Available Em seis animais adultos Myrmecophaga tridactyla estudou-se o modelo de suprimento sanguíneo do intestino grosso, que é dependente das artérias mesentérica cranial (AMCr e caudal (AMC. Os espécimes coletados conforme as normas do IBAMA (Instituto Brasileiro do Meio Ambiente e dos Recursos Naturais Renováveis foram perfundidos com água (40 C, injetados com látex corado, fixados em formol e conservados em solução alcoólica (50%. O mesocólon está disposto na linha sagital mediana e fixa o intestino grosso à parede dorsal do abdome. Derivaram da AMC: a artéria retal cranial, sete a 14 artérias cólicas e uma ou duas artérias ileocólicas, que apresentaram anastomoses de irrigação com a AMCr. A AMC finaliza-se na borda mesocólica das alças intestinais, emitindo ramos cólicos retos a partir das arcadas justacólicas, que penetram na intimidade da musculatura longitudinal. Ao longo do trajeto da AMC foram observadas ilhas arteriais, e a região ileocólica apresentou maior densidade vascular.This research aimed to study the model of large intestine blood supply, which is dependent on the cranial mesenteric artery (AMCr and caudal mesenteric artery (AMC, in six adults of Myrmecophaga tridactyla. The specimens were collected in accordance with the IBAMA standards (Brazilian Institute of the Environment and were perfused with water (40 C, injected with colored latex, fixed in formaldehyde and preserved in alcohol solution (50%. The mesocolon is positioned in the median sagittal line and fixes the large intestine to the dorsal wall of the abdomen. The following is derived from the AMC: the cranial rectal artery, from 7 to 14 colic arteries and one or two ileocolic arteries, which present irrigation anastomosis with AMCr. The AMC finishes at the mesocolic edge of the bowel loop, generating straight colic branches from juxtacolic arcades, which penetrate the intimacy of longitudinal muscles. Arterial islands were observed along the AMC

  19. [Key vessels assessment and operation highlights in laparoscopic extended right hemicolectomy].

    Science.gov (United States)

    Wang, Hao; Zhao, Quanquan

    2018-03-25

    Laparoscopic radical colectomies have been more widely used gradually, among which laparoscopic extended right hemicolectomy is considered as the most difficult procedure. The difficulty of extended right hemicolectomy lies in the need to dissect lymph nodes along the superior mesenteric vein (SMV) and disconnect numerous and possible aberrant vessels. To address this problem, we emphasize two points in key vessel assessment: getting familiar with the anatomy along the medial-to-lateral approach and having a good understanding about the preoperative imaging presentations. An accurately preoperative imaging assessment by abdominal enhanced CT can help the surgeon understand the relative position of the key vessels to be dealt with during operation and the situation of the possible aberrant vessels so as to guide the procedure more effectively and facilitate the prevention and management of the intraoperative complications. During operation, the operator should pay special attention to the management of the vessels in the ileocolic vessel region, Henle's trunk and middle colon vessels. The operation highlights of the key vessels are as follows: (1) The ileocolic vessels: identifying the Toldt's gap correctly and opening the vascular sheath of the SMV securely; making sure that the duodenum is well protected. (2) Henle's trunk: dissecting along the surface of the Henle's trunk; preserving the anterior superior pancreaticoduodenal vein (ASPDV) and main trunk of the Henle's trunk; disconnecting the roots of the right colic vein (RCV) and right gastroepiploic vein (RGEV), and then dissecting lymph nodes along the surface of the pancreas. (3) The middle colon vessels: identifying the root of the middle colon vessel along the lower edge of the pancreas; avoiding entering behind the pancreas; mobilizing the transverse mesocolon sufficiently along the surface of the pancreas. Finally, we discuss and analyze the disputes currently existing in laparoscopic extended right

  20. Tips and Tricks of Percutaneous Gastrostomy Under Image Guidance in Patients with Limited Access

    Energy Technology Data Exchange (ETDEWEB)

    Marcy, Pierre-Yves; Figl, Andrea; Thariat, Juliette [Sophia Antipolis University, Nice cedex (France); Lacout, Alexis [Centre Me' dico-Chirurgical, Aurillac (France)

    2011-10-15

    -gastrectomized patients who were contraindicated for endoscopic gastrostomy (2). Another condition precluding the traditional supracolic approach is the Chilaiditi sign, i.e. a usually asymptomatic interposition of the colon between liver and diaphragm. This condition may occur in patients with dolichocolon, chronic lung disease, cirrhosis, as well as ascites and right hemi-diaphragm palsy. Colonic opacification should always be performed prior to a gastrostomy to prevent the potential risk of gastrocolic fistula. Colonic opacification can be achieved using air inflation when starting a gastrostomy (1) or barium swallow 12 hours prior. We and others perform PFG using an uncomplicated controlled percutaneous gastropexy below the transverse mesocolon (2,4). The PFG tract is made centrally on the gastropexy using a true right-angle 18G-needle to the skin surface, a 0.0038-inch Amplatz guidewire and serial dilators following cutaneous anesthesia down to peritoneum with 40 ml of 1% Lidocaine chlorhydrate. The needle (N) traverses the greater omentum (GO), transverse mesocolon (TM), gastrocolic ligament (GCL), and lesser sac (between TM and GCL). Four anchor hooks were then inserted with limited pressure, and a 17-Fr catheter subsequently placed through a peel-away sheath inside the stomach and below the transverse colon (Fig. 1). We noted that GO is known as the so-called 'abdominal policeman' because it wraps itself around an inflamed organ thereby protecting other viscera from it. Literature data on infracolic PFG insertion are scarce (4): less than ten (uncomplicated) cases have been performed worldwide. The real contraindication of infracolic PFG includes hypopharyngeal/cervical esophageal neoplasia since the gastropexy precludes any further pull-up technique attempt. In conclusion, contraindications for endoscopic gastrostomy include UDTO and Chilaiditi sign. We suggest that the fluoroscopy-guided gastrostomy Chan's technique can be improved using effervescent sodium

  1. Tips and Tricks of Percutaneous Gastrostomy Under Image Guidance in Patients with Limited Access

    International Nuclear Information System (INIS)

    Marcy, Pierre-Yves; Figl, Andrea; Thariat, Juliette; Lacout, Alexis

    2011-01-01

    -gastrectomized patients who were contraindicated for endoscopic gastrostomy (2). Another condition precluding the traditional supracolic approach is the Chilaiditi sign, i.e. a usually asymptomatic interposition of the colon between liver and diaphragm. This condition may occur in patients with dolichocolon, chronic lung disease, cirrhosis, as well as ascites and right hemi-diaphragm palsy. Colonic opacification should always be performed prior to a gastrostomy to prevent the potential risk of gastrocolic fistula. Colonic opacification can be achieved using air inflation when starting a gastrostomy (1) or barium swallow 12 hours prior. We and others perform PFG using an uncomplicated controlled percutaneous gastropexy below the transverse mesocolon (2,4). The PFG tract is made centrally on the gastropexy using a true right-angle 18G-needle to the skin surface, a 0.0038-inch Amplatz guidewire and serial dilators following cutaneous anesthesia down to peritoneum with 40 ml of 1% Lidocaine chlorhydrate. The needle (N) traverses the greater omentum (GO), transverse mesocolon (TM), gastrocolic ligament (GCL), and lesser sac (between TM and GCL). Four anchor hooks were then inserted with limited pressure, and a 17-Fr catheter subsequently placed through a peel-away sheath inside the stomach and below the transverse colon (Fig. 1). We noted that GO is known as the so-called 'abdominal policeman' because it wraps itself around an inflamed organ thereby protecting other viscera from it. Literature data on infracolic PFG insertion are scarce (4): less than ten (uncomplicated) cases have been performed worldwide. The real contraindication of infracolic PFG includes hypopharyngeal/cervical esophageal neoplasia since the gastropexy precludes any further pull-up technique attempt. In conclusion, contraindications for endoscopic gastrostomy include UDTO and Chilaiditi sign. We suggest that the fluoroscopy-guided gastrostomy Chan's technique can be improved using effervescent sodium bicarbonate powder

  2. Effect of early intrajejunal nutrition on pancreatic pathological features and gut barrier function in dogs with acute pancreatitis.

    Science.gov (United States)

    Qin, H-L; Su, Z-D; Hu, L-G; Ding, Z-X; Lin, Q-T I

    2002-12-01

    In patients with major trauma and burns, total enteral nutrition (TEN) significantly decreases the acute phase response and incidence of septic complications when compared with total parenteral nutrition (TPN). Traditionally, it was believed that early intrajejunal nutrition (EIN) in severe acute pancreatitis (SAP) may exacerbate the clinical pathological features, lead to recurrence of symptoms and delay complications. To compare the effect of EIN vs TPN on the pancreatic pathological features and gut barrier function in dogs with acute pancreatitis (AP). Fifteen dogs (surviving over 7 days, the death rate being 32%, 7/22) were divided into parenteral nutrition (PN) group (n=7) and EIN group (n=8). SAP model was induced by injecting 1 ml/kg of combined solution of 2.5% sodium taurocholate and 8000-10000 BAEE units trypsin/ml into the pancreas via the pancreatic duct. Nutrients were delivered to the EIN group by catheter via a jejunostomy feeding 24 h postoperatively. The two groups were isocaloric and isonitrogenous. Systemic blood samples were obtained before and 1, 4, 7 d following AP, and cultured by aerobic as well as anaerobic bacterial growth. Systemic plasma and portal vein endotoxin levels were quantified by the chromogenic limulus amebocyte lysate (LAL) technique. Portal vein blood and specimens of tissue from mesenteriolum and mesocolon lymph nodes, lung, pulmonary portal lymph nodes and pancreas were adopted before the experiment was finished. Aliquots of the homogenata were cultured as blood mentioned above. Serum glucose, calcium, amylase and lysosomal enzymes were determined. All dogs were injected with 50 microCi (125)I-BSA 4 h at the 7th day before being sacrificed. The (125)I-BSA indexes of the pancreas/muscle and pancreas/blood were measured, and pancreatitic pathological scores (PPSs) of the different partial pancreas were observed. The content of mucosa protein, DNA and the villi, the thickness of mucosa and the whole bowel wall of the ileum

  3. Modelo de suprimento sanguíneo do intestino delgado e grosso da preguiça de coleira (Bradypus torquatus Blood supply model of the small and large intestine of the maned three-toed sloth (Bradypus torquatus

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    Jussara Rocha Ferreira

    2013-06-01

    formaldehyde (10%, preservation in modified Laskowski solution and dissection under mesoscopic light (Lupa LTS® 3700. The blood supply of small and large intestine depends on the abdominal aorta, whose ventral visceral branch identified as the common mesenteric artery was distributed in the mesentery and mesocolon. A sequence of 9 to 25 primary collateral branches cranial is allocated to the duodenum, jejunum, ileum and part of the cecum. Another sequence of 4 to 11 caudal branches are destined to the cecum and colon pouch. The vascular pattern of adult maned three-toed sloth intestine differs from those of other previously described vertebrates, because there is no occurrence of coalescence peritoneal through small and large intestine.

  4. Surto de aflatoxicose em bezerros no Rio Grande do Sul Outbreak of aflatoxicosis in calves in southern Brazil

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    Felipe Pierezan

    2010-05-01

    and rolling. The clinical course, as observed by the owners, was 2-3 days; however many calves in this lot that did not die, remained underdeveloped. Three calves were necropsied. Necropsy findings included firm, light tan livers and marked hydrothorax, ascites and edema of the mesentery, mesocolon and of the mucosal folds of the abomasum. Main histopathological changes were restricted to the liver and consisted of fibrosis, moderate megalocytosis, biliary duct hyperplasia and veno-occlusive disease. The search for Senecio spp. contamination in the alfalfa hay resulted negative. The analysis by thin layer chromatography of the corn fed to calves revealed 5,136 ppb of aflatoxin B1. A diagnosis of aflatoxicosis was made based on the characteristic clinical signs and pathology, on the absence of Senecio spp. in the food and on the presence of high levels of aflatoxin in the corn fed to the calves.

  5. [D2 radical resection of omental bursa and No.12p and No.8p for gastric carcinoma: a retrospectively analysis from a single center in China].

    Science.gov (United States)

    Chen, Luchuan; Wei, Shenghong; Ye, Zaisheng; Xiao, Jun; Zeng, Yi; Wang, Yi; Lin, Zhenmeng; Lin, Zhitao; Chen, Xiaoling

    2018-02-25

    To evaluate the safty and feasibility of the D2 radical resection of omental bursa and No.12p and No.8p for gastric carcinoma (GC). Clinical data of 1801 GC patients undergoing D2 radical resection of omental bursa and No.12p and No.8p at Fujian Medical University Cancer Hospital from January 2000 to January 2010 were analyzed retrospectively. Inclusion case criteria: (1)age of 18 to 90 years;(2)pathologically diagnosed as GC and receiving D2 radical resection of omental bursa and No.12p and No.8p;(3)complete clinical, pathological and follow-up data; (4)operation performed by same leading surgeon;(5)exclusion of other gastric malignancies, postoperative relapse of GC, and other simultaneous or heterochronous primary malignancies. Surgical procedure points: (1)The outer part of the peritoneum of duodenum descending was cut; the serosa was migrated to the anterior leaf of the gastrointestinal ligament. (2)The posterior lobe of the gastrocolic ligament and the transverse mesocolon were separated bluntly from left side to reach the omentum attaching to the colon portion; incision was made at the edge of the omentum attaching to the transverse colon behind the gastrocolic ligament; the leaves were turned to the anterior mesenteric anterior leaflets, and the entire anterior leaflet of the transverse mesentery was free.(3)The pancreas was separated, and resection of the posterior wall of the omentum sac continued up so that the entire retinal capsule was free; along the edge of the liver the attachment of the omentum was cut to reach the front of esophagus, and transverse incision was made in abdominal peritoneal layer of the esophagus, and then turned to the spleen on the pole; from the obturator to the esophagus incision was performed behind the peritoneum for the net; the uppermost edge of the resection of the capsule was performed as the posterior peritoneal incision to the right edge of the esophagus and was connected with the posterior parietal lobe of the previous