Identifying the 'Right colon lesion

A 64-year-old woman presented to the colorectal clinic with 3 months of symptoms of loose stools, flatulence and some weight loss. There was no history of abdominal pain, rectal bleeding or anaemia. A similar episode 5 years earlier resolved spontaneously but was investigated with a colonoscopy at that time and revealed diverticular disease and a 3 mm hyperplastic polyp at the hepatic flexure. To investigate the current symptoms, a repeat colonoscopy was advised but this was initially declined in favour of CT colonography (CTC) to avoid the laxative preparation and pain experienced during the previous examination. The CTC was performed following a day of modified diet and three (30 mL) split doses of Gastrografin without any other laxatives. The CTC reported diverticular disease and findings in the ascending colon, which advised a colonoscopy (figure 1A). A subsequent colonoscopy was undertaken and the colonoscope passed to the caecum. The appearance of the...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot Editor ' s quiz: GI snapshot Source Type: research

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Postoperative management of hallux valgus varies widely. Setting preoperative expectations is an important aspect of attaining a successful outcome, but this is not routinely reviewed in the literature. This chapter offers suggestions on successfully navigating this area of patient care. Current concepts focus on pain control, immobilization, and return to activities. This chapter also reviews the current literature in these areas and sets out the authors ’ preferred management in the postoperative setting.
Source: Foot and Ankle Clinics - Category: Orthopaedics Authors: Source Type: research
Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Prathiba M. De Silva, Ayesha Mahmud, Paul P. Smith, T. Justin ClarkAbstractObjectiveTo identify the most effective analgesia for women undergoing office hysteroscopy.Data sourcesMedline, Embase, CINAHL and the Cochrane library were searched from inception until August 2019 investigating the effect of different analgesics on pain control in office hysteroscopy.Methods of study selectionRandomised controlled trials were included that investigated the effect of analgesics on pain experienced by women undergoing diagnos...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Publication date: Available online 23 January 2020Source: Journal of Minimally Invasive GynecologyAuthor(s): Whitney Trotter Ross, Jordan M. Newell, Richard Zaino, Allen R. Kunselman, Gerald J. Harkins, Andrea S. BentonAbstractStudy ObjectiveTo evaluate the diagnosis of appendiceal endometriosis in coincidental appendectomy specimens using a standard versus modified histopathologic analysis.DesignProspective analysis of 300 consecutive patients undergoing coincidental appendectomy at time of a primary gynecologic procedure.SettingAcademic tertiary referral hospital in the Northeastern United States.PatientsWomen ages 22 to...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Authors: Crespo J, Carballo Álvarez F, Alberca de Las Parras F, Fernández Rodríguez CM, Vera Mendoza MI, Gómez M, Elola Somoza FJ Abstract The Spanish Society of Digestive Pathology has set a consensus document on the standards and recommendations for gastroenterology units (GU). These standards are considered as relevant in the organization and management of the unit to develop their activities with efficiency and quality. Four key groups of processes have been identified: a) care for the acutely ill adult patient; b) outpatient digestive endoscopy; c) in-hospital support to other servi...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Authors: Monsalve Alonso S, Miranda García P, Santander Vaquero C Abstract Cap-polyposis is a rare benign condition characterized by inflammatory colorectal polyps covered by a "cap" of fibrinopurulent exudate. Mucous diarrhea and rectal bleeding are frequent symtoms. It can be difficult to diagnose and it is necessary to make a differential diagnosis from other entities. Its pathogenesis is unknown and it has a variable clinical course. The optimal treatment has not been established. PMID: 31960689 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
CONCLUSIONS: acromegaly may be associated with more polyps in SB. PMID: 31960686 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We present the case of a 74-year-old man, with a history of residual schizophrenia, who underwent abdominal-pelvic CT with intravenous contrast, due to abdominal acute pain, that showed a stenosis at the origin of the celiac trunk and a large aneurysm of the hepatic artery, secondary to a mediam arcuate ligament syndrome, of the diaphragm was observed. PMID: 31960685 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We report the case of a 60-year-old male with a giant colorectal laterally spreading tumor at the recto-sigmoid junction. A single tunnel-assisted endoscopic submucosal dissection was performed that constructed a submucosal tunnel along the longitude axis of the tumor. An en bloc resection was achieved with no perforation or post-operative bleeding and a comparatively low procedure time. PMID: 31960681 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Authors: Ruiz Rebollo ML, González Obeso E, Burgueño Gómez B, Santos Fernández J Abstract A 75-year-old male was referred due to dysphagia and iron-deficiency anemia. An upper endoscopy was performed which revealed a friable mass at 30 to 37 cm from the incisors, consistent with esophageal malignancy. However, the pathology only demonstrated granulation inflammatory tissue. An endoscopic ultrasound exam showed a 2-3 cm esophageal wall thickening with a 1.5 cm lymph node, which was staged as a T2-3 N1 esophageal tumor. A CT-scan also identified a 7.5 cm esophageal malignancy surrounded by...
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Authors: Kim J, Ryu S, Kim YJ Abstract A 49-year-old woman was referred to our hospital for further treatment due to the suspicion of a submucosal tumor in a routine screening colonoscopy. On colonoscopy, a 1-cm sized subepithelial mass with normal overlying mucosa in the hepatic flexure was found. Endoscopic ultrasonography (EUS) showed a homogenous hypoechoic lesion arising from the second and third layer. We were unable to make a final diagnosis because the lesion showed a small tumor with atypical macroscopic morphology including EUS findings. Therefore, endoscopic submucosal dissection was performed for the di...
Source: Clinical Endoscopy - Category: Gastroenterology Tags: Clin Endosc Source Type: research
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