The 'malignant colon polyp'. A critique and opinion.

There is some controversy about the indications for surgical resection above the distal rectum following colonoscopic removal of a polyp which proves to be malignant. Sessile, villous adenomas are generally considered to carry greater risk of spreading malignancy than pedunculated, tubular or villous adenomas. Resection is usually recommended in the presence of carcinomatous invasion beyond the muscularis mucosae and/or insufficient tumor-free margin of the stalk if the patient's condition permits.

Colonoscopy in the evaluation of strictures.

This is a review of 181 consecutive colonoscopic procedures performed to resolve the etiology of colonic strictures when the barium enema was inconclusive. In 54 percent, it was possible to intubate the colon above the stricture and thus resolve the problem. In 46 percent, it was impossible to traverse the stricture.

Recurrence rates for colorectal polyps.

Of 276 patients who underwent an initial colonoscopic polypectomy for adenomatous polyps over a 45-month period, 118 subsequently had one or more repeat screening colonoscopies. The mean follow-up time was 26 months with an overall polyp recurrence rate of 30%. Analysis of these data retrospectively suggests that the bulk of the recurrences occurred within the first year.

The psychological impact of immediate breast reconstruction for women with early breast cancer.

Twenty-five patients were evaluated, 13 who had immediate breast reconstruction and 12 who had delayed breast reconstruction for early breast cancer. Data were elicited about the psychological impact of the cancer, the mastectomy, and the reconstruction. Our results support the conclusion that immediate breast reconstruction is accompanied by a lower incidence of psychological morbidity postoperatively, and we recommend that immediate breast reconstruction be offered as an alternative to women with early breast cancer.

Primary melanocytic schwannoma of the stomach. Evidence of dual melanocytic and schwannian differentiation in an extra-axial site in a patient without neurofibromatosis.

Pigmented neoplasms of the peripheral nervous system are uncommon. Such lesions, while well documented in the para-axial region, are infrequently encountered in more peripheral extra-axial sites. The authors present a case of a melanocytic schwannoma arising in the gastric antrum of a 51-year-old woman.

Polypoid endometrioma of the rectosigmoid.

Endometriosis of the bowel most often involves the sigmoid and rectosigmoid and appears as an intramural mass protruding into the lumen in a polypoid or constricting fashion. Occasionally there is an intraluminal mass without obvious intramural involvement. Endometriosis of bowel is rarely diagnosed at endoscopic biopsy.

Effect of CO2 laser on the luminal surface of blood vessels in vivo.

The use of lasers as surgical tools may open up new possibilities for the treatment of atherosclerotic occlusive vascular disease. However, basic information regarding the effect of laser radiation to the lumen of normal blood vessels is needed prior to clinical application. This work investigates the nature of the CO2 laser-induced vascular wound and the time course of its healing in the rabbit aorta.

Impact of modern diagnostic methods on the management of active rectal bleeding. Ten year experience.

We analyzed 178 patients admitted with a diagnosis of lower gastrointestinal hemorrhage from 1970 to 1979. Fifty-four percent had a subsequent or previous episode of bleeding and 78 percent required transfusions. One hundred eighteen patients had rigid sigmoidoscopy, with positive findings in 10 (8.

Endoscopic polypectomy: inadequate treatment for invasive colorectal carcinoma.

Endoscopic polypectomy has greatly decreased the necessity for transabdominal resection of adenomatous polyps of the colon and rectum. In addition, the routine removal of these presumed precancerous lesions may well decrease the incidence of colon cancer in these patients. However, some authors have proposed that endoscopic resection alone of certain pedunculated polyps containing invasive carcinoma is adequate treatment for these lesions.

Giant pseudopolyposis and antegrade colonic obstruction: report of a case.

A case is described in which massive development of pseudopolyps resulted in left colonic obstruction in a patient with a history of ulcerative colitis. Problems of diagnosis and management are discussed, with emphasis on the need for close radiographic and endoscopic follow-up of such patients.

Inflammatory tumor of the cecum simulating neoplasm.

Barium enema performed on a 36-year old man prior to the operative repair of a rectal stricture demonstrated a large cecal filling defect which radiologically was consistent with a villous adenoma or carcinoma. At the time of exploratory celiotomy (for possible ileocolectomy) intraoperative colonoscopy revealed a necrotic appearing lesion in the cecum which did not look neoplastic. Local excision of the mass was therefore performed.

Colonoscopy as an adjunctive technique in evaluating acquired colonic narrowing.

Fiberoptic colonscopy is a useful adjunct to the barium enema in establishing the nature of colonic narrowing for which surgical intervention is being considered in patients who are not clinically obstructed. When the mucosa can be demonstrated to be free of disease, celiotomy and resection can be avoided. Even without significant narrowing, it is sometimes possible to limit the extent of resection by proving the process to be benign.

Volvulus of the cecum: choice of operation.

Although it is clear that there is a significant frequency of recurrent volvulus after cecopexy, there is no evidence from either this series or previous reports that resection is associated with a lower recurrence rate than tube cecostomy. In the absence of data suggesting a clear superiority of colon resection, it appears that tube cecostomy should be the treatment of choice for cases of cecal volvulus that are not complicated by vascular compromise.

Lower gastrointestinal bleeding with negative or inconclusive radiographic studies: the role of colonoscopy.

The records of more than 1,000 patients who underwent colonoscopy were reviewed. The study group consisted of 55 of these 1,000 patients who had persistent unexplained bleeding per rectum and negative radiographic examinations. Colonoscopy was helpful in defining the site of bleeding in approximately 50 per cent of the patients studied.

The endoscopy corner: reversible ischemic colitis--correlation of colonoscopic and pathologic changes.

Ischemic colitis is a well described complication following distal aortic replacement. The diagnosis is typically made by correlating clinical signs such as the occurrence of abdominal pain and bloody diarrhea with supporting radiographic changes. In this report, the diagnosis of ischemic colitis was confirmed on the basis of colonoscopic and associated histopathological findings.

Giant pseudopolyposis in colitis with colonic intussusception.

When an area of giant pseudopolyp formation resulted in intussusception in a patient with known ulcerative colitis, operative intervention was required. The double contrast barium enema and fiberoptic colonoscopy were valuable complimentary diagnostic techniques in the evaluation of such a patient.

Ulcerative esophagitis and colitis in a pediatric pantient with Behcet's syndrome. Response to steroid therapy.

The gastrointestinal manifestations of Behcet's syndrome including colitis and esophageal ulceration have been recognized in recent years. In the present case, a girl with Behcet's syndrome was followed since age 11 for oral, vaginal, perianal ulcers and neurological involvement. At age 16 she developed esophageal ulceration and colitis, was treated with steroids and improved.