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  • 1
    ISSN: 1435-5922
    Keywords: actinomycosis ; colon ; barium enema ; CT
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A case of abdominal actinomycosis is described in a woman with recurrent right lower abdominal pain and low-grade fever without history of appendectomy. Past history included the use of an intrauterine device (IUD) until 10 years before manufestation of these symptons. We followed up the patient, via diagnostic imaging, for 7 months. On initial barium enema, a polypoid lesion was visualized at the bottom of the cecum and there was constriction of the sigmoid colon; the appendix was not seen. Seven months later, poor extension at the cecum, severe constriction in the sigmoid colon, and narrowing of the terminal ileum were also visualized. On computed tomography (CT), the lesion was initially localized only in the ileocecal region adjacent to the sigmoid colon. After 7 months, the lesion had infiltrated adjacent anatomic components and showed direct infiltration of the pelvic space. Differential diagnosis was difficult, as it was not obvious whether this was a pelvic abscess due to inflammation or appendiceal carcinoma. Laparotomy was performed. Macroscopically, the lesion was not limited to the ileocecal region, but involved the right ureter, tubes the Fallopian and ovary, bladder, psoas muscle, and abdominal wall. Pathology findings showed, chronic inflammatory tissue with evidence of actinomycosis. Although previous reports have described a lack of specific findings in this disease. When actinomycosis is suspected, CT is recommended to define its extent.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Diseases of the colon & rectum 37 (1994), S. 1108-1111 
    ISSN: 1530-0358
    Keywords: Endoscopic mucosal resection ; Endoscopic polypectomy ; Flat adenoma ; Flat cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Endoscopic mucosal resection, which is a new option for endoscopic polypectomy of colorectal polyps without stalks, was evaluated on its usefulness in polypectomy. METHODS: Three hundred thirty-seven lesions, which were removed by endoscopic mucosal resection between January 1990 and January 1993, were studied. The endoscopic configuration of neoplastic lesions were classified into four types: flat, sessile, large sessile with distinct lobulations, and semipedunculated. RESULTS: The 337 lesions included 243 adenomas, 30 mucosal cancers, 13 submucosal cancers, 3 carcinoids, 43 hyperplastic polyps, and 5 inflammatory polyps. Of the 286 neoplastic lesions, excluding 3 carcinoids, 137 were flat, 81 were sessile, 18 were large sessile, and 50 were semipedunculated. The 137 flat lesions consisted of 125 adenomas, 10 mucosal cancers, and 2 submucosal cancers. The rate of complete removal was related to their size and configuration and was 87 percent in flat neoplastic lesions. Lesion diameters of greater than 20 mm and the large sessile-type configurations were factors that were associated with incomplete removal. Two (0.7 percent) cases were complicated by perforations, and one (0.4 percent) case was complicated by bleeding. CONCLUSION: Endoscopic mucosal resection is an useful option for complete removal of colorectal nonpolypoid adenomas and cancers.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1530-0358
    Keywords: Early rectal carcinoma ; Lymph node metastasis ; Endoscopic treatment ; Quality of life
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: This study was undertaken to clarify the indications for endoscopic treatment. METHODS: Clinical and pathologic features of 191 lesions in 180 patients with early rectal carcinoma were examined, including 110 intramucosal carcinomas and 81 carcinomas with submucosal invasion (submucosal carcinomas). All lesions had been endoscopically or surgically resected at the National Cancer Center Hospital between 1976 and 1990. RESULTS: Metastasis to regional lymph nodes (LN metastasis) was seen in 0 percent (0/39) of intramucosal carcinomas and 9.2 percent (6/65) of submucosal carcinomas in the surgically treated patients. The incidence of LN metastasis was higher for lesions larger than 10 mm in diameter, for those showing massive submucosal invasion, and for moderately differentiated adenocarcinomas. LN metastases were associated significantly with lymphatic invasion. CONCLUSIONS: These results suggest that early rectal carcinomas should be resected surgically if they 1) show massive submucosal invasion, 2) are classified as moderately differentiated adenocarcinomas, and 3) are larger than 10 mm in diameter. In patients with both scanty submucosal invasion and features of well-differentiated adenocarcinoma or intramucosal carcinoma and if no other risk factors for LN metastasis are present, such as lymphatic invasion by the primary lesion, surveillance may suffice after endoscopic resection.
    Type of Medium: Electronic Resource
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