Serosal Surface Of Colon Research Articles

Endometrioma Causing Near-Complete Obstruction of the Sigmoid Colon.

Endometriosis is characterized by extra-uterine endometrial gland and stroma implantation. Intestinal endometriosis is believed to affect about one-third of patients with endometriosis4; 72-95% of patients experience recto-sigmoid involvement.2,3 Occasionally, endometriotic lesions precipitate mass effect or infiltrate the bowel wall, mimicking a neoplasm. In the index case, we evaluated a G0P0 41-year-old perimenopausal female with near obstructing sigmoid endometrioma, clinically presented, investigated, and managed in the lines of sigmoid colon carcinoma. Computed Tomography revealed marked distention of the distal descending and proximal sigmoid colon to the level of a [possible] intraluminal mass. CA-125 was 247.4. Transvaginal ultrasound revealed a heterogeneous irregularity adjacent the left adnexa. Flexible sigmoidoscopy to 12-15 cm was unable to pass liquid or visualize the lumen secondary to extrinsic colonic obstruction. She underwent exploratory laparotomy with sigmoidectomy, oversew of rectal stump, and descending colostomy. Left fallopian tube and ovary were adherent to sigmoid mass, therefore, removed en-bloc. Histopathological report revealed extensive endometriosis involving the muscularis propria and serosal surface of colon and ovary, with fibrinous serosal adhesions of the sigmoid colon. While inconsistent clinical presentation, similar radiographic features, and colonoscopy with other inflammatory or malignant lesions of the bowel makes the preoperative diagnosis challenging, colonic endometriosis is to always be considered as one of the differential diagnoses in reproductive age women with patterned, cyclic gastrointestinal symptoms, and intestinal masses of uncertain etiology or diagnosis.

Effect of deoxycholic acid on colonic motility in the rabbit.

The purpose of the study was to determine the effect of the bile salt, deoxycholic acid, on colonic myoelectrical and contractile activity recorded from a loop of proximal colon in the anesthetized rabbit. Myoelectrical activity was recorded from bipolar electrodes attached to the serosal surface of the proximal colon. Contractile activity of the circular smooth muscle was measured with a strain gauge attached in the circular direction on the serosal surface of the colonic loop. The colonic slow wave frequency was 12.5 +/- 1.1 cycles/min. The slow wave frequency throughout the loop was homogeneous with a low coefficient of variation of the slow wave frequency (5.8 +/- 0.3). There were spike potentials superimposed on 78.1 +/- 3.4% of the slow waves. The addition of 8 or 16 mM deoxycholic acid did not change the slow wave or spike activity. However, deoxycholic acid stimulated a dose-dependent increase in migrating action potential complexes. These complexes were associated with a forceful contraction of the circular smooth muscle that propelled luminal contents in the direction of the burst. Deoxycholic acid also stimulated an increase in luminal fluid content.

An electrophysiological study of the sacral parasympathetic pathway to the colon of the cat.

1. Electrophysiological techniques were used to study the sacral parasympathetic pathway to the colon of the cat. 2. Electrical stimulation of the sacral ventral roots or the pelvic nerve elicited contractions of the colon and firing in nerve filaments on the serosal surface of the colon. Both responses were markedly reduced by the administration of ganglionic blocking agents. It is concluded that sacral preganglionic fibres to the colon make synaptic contacts with extramural ganglion cells. These cells were identified histologically in small ganglia on the serosal surface of the distal colon and rectum. 3. Transmission in extramural colonic ganglia was cholinergic and mediated by nicotinic receptors. Colonic ganglia did not exhibit large recruiting responses during repetitive (1-4 c/s) preganglionic nerve stimulation or an adrenergic inhibitory mechanism, both of which have been identified in bladder parasympathetic ganglia. It is concluded that colonic ganglia unlike bladder function primarily as simple relay stations and have little potential for modulating the neral activity arising in the central nervus system. 4. The preganglionic input to colonic ganglia was mediated by C fibres with maximal conduction velocities ranging from 0-5 to 1-4 m/sec. Bladder ganglia, on the other hand, received a preganglionic input composed of B fibres with maximal conduction velocities ranging from 8 to 10 m/sec. The possible physiological significance of different types of preganglionic fibres in the sacral outflow is discussed.