Colon Syndrome Research Articles

Diagnosis and management of congenital rectourethral fistula in a child with long tubular duplication of the colon and Klippel-Feil syndrome

We describe a unique association of congenital rectourethral fistula with long tubular duplication of the colon in a boy with Klippel-Feil syndrome and Sprengel deformity. He presented with a rectourethral fistula after surgical repair of a tubular duplication of the terminal ileum, colon, and proximal rectum. Preoperative identification of the fistula was challenging and was only achieved after cystoscopy with injection of methylene blue under pressure through Foley catheters placed into the anus and distal stoma of a colostomy. Surgical repair was performed through the posterior sagittal approach. The patient is doing well after 4 years of follow-up.

T1819 The Popcol Study: Epidemiology by Endoscopy in a Swedish Adult Random Population. Intraepithelial Lymphocyte and Eosinophil Counts in the Normal Colon and Irritable Bowel Syndrome

Introduction The normal count for intraepithelial lymphocytes (IELs)/100 enterocytes in the colon has been defined at 20. Normal eosinophil counts are harder to identify. In the caecum, eosinophils are more numerous and up to 40/high power fields (HPF) is suggested to be normal. Irritable Bowel Syndrome (IBS), by definition is not associated with pathology by microscopy but colonic innate immune disorder is implicated in some patients. The aim of this study was to define cell counts in a normal group of subjects and to compare these in subjects with IBS to ascertain if these may be used as biomarkers. Methods Colonoscopy with biopsies was performed in 742 subjects (mean age 51 years, 45% male) and biopsies taken from ileum (TI), caecum, transverse (TC), sigmoid colon (SC) and rectum (R) with a completed validated questionnaire of GI symptoms from a random population sample in Stockholm. Ethical approval, Karolinska Instititet. A case control study was performed comparing 90 normal subjects and 100 subjects with IBS, subtyped,(defined by Rome III criteria) to count IELs/100 enterocytes and eosinophils/5 HPF at each site in biopsies stained by H&E. Sections were examined by two observers. For each section the number of IELs/100 enterocytes was counted, and the number of eosinophils counted in five non-overlapping HPF. Results Of 90 control subjects, mean age 52 years, (SD11.4) 53.3% men. Of 100 IBS patients, mean age 46 years (SD13.7) 39% men. In IBS subjects, 17 were classified IBS-C (35% men), 30 with IBS-D (30% men), 13 with IBS-M (15% men), 40 with unsubtyped IBS (58% men). Lin9s concordance results for inter-observer variability were 0.94 for IELs and 0.99 for eosinophils. Histopathology in controls and IBS was normal. Cell counts were compared in normal subjects categorised by gender, BMI, age and medications and no significant differences were observed between any categories. Eosinophil counts were highest in the caecum regardless of diagnosis (p Conclusion This study has defined normal cell counts for IELs and eosinophils in the TI and colon. No significant differences were found with medication, BMI, age or gender or comparing normal subjects with IBS patients.

Acute Pseudo-Obstruction of the Colon (Ogilvie's Syndrome) Following Open Heart Surgery

The acute pseudo-obstruction of the colon or Ogilvie's syndrome is a rare surgical complication with an unknown pathogenesis. It is characterized by a distention of the large bowel without distal mechanical obstruction and a normal motility of the small bowel. The cause may be a postoperative imbalance between the sympathic and parasympathic innervation of the distal colon. In about one third of the cases a spontaneous perforation of the cecum develops, with a mortality of up to 50 per cent. We report the 5th case after cardiovascular surgery in the literature overall and the first in which conservative therapy successfully prevented perforation and laparotomy. An overview of the etiology, diagnosis, and treatment of this complication is given.

5. Colon Syndrome and its Surgical Treatment

The Number of out-patients having gastric symptoms has in recent years remarkably increased. Many of them, though free from pathological findings when examined by upper 'G-I X-ray series including the biliary tract and by gastrofiberscope, were found, on illness, to have abnormal habit of defecation, full sensation of the lower abdomen, or other various :subjective symptoms all of long duration.A total of 1335 such cases have been subjected to barium enema examination of the colon (Aoyama's method). With the exception of 27 cases having organic diseases of the colon, organic in the narrow sense of the word such as its tumors. 1308 cases were further investigated.As a result, a close correlation has been found between the X-ray findings such as abnormal location, course and so-called membraneous lifting-up of the colon, together withits traction or stenosis due to mesocolitis, and the patient's subjective symptoms and defecation habits. Based on this study, the authors attempted to designate those symptoms and radiological sighs, including kinking of the splenic flexure or the descending colon, the socalled detour sign, cicatric mesocolitis of the splenic flexure or cicatric mesosigmoiditis, as"colon syndrome" for the purpose of differentiatiating it from the" irritable colon."One of the authors, Hayashida, attempted to remedy this syndrome by surgical intervention: one stage modification of abnormal course kinking, cicatrices and so no of the colon together with left hemi-colectomy. In 150 cases thus treated, 84.9 percent have been free from any subjective symptoms six months after operation.