فهرست مطالب

Annals of Colorectal Research - Volume:7 Issue: 4, 2019
  • Volume:7 Issue: 4, 2019
  • تاریخ انتشار: 1398/09/10
  • تعداد عناوین: 7
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  • Brian Yadegari *, Roozbeh Houshyar, Mohammad Helmy, Rebbecca Bennett, Justin Glavis Bloom, Hanna K. Liu, Alexander Ushinsky, Joseph Carmichael, Courtney Bennett Page 1
    Context

    Diverticula are acquired or congenital outpouchings of the gastrointestinal tract, normally occurring at points of weakness in the wall of the alimentary canal. They can be present from esophagus to anus, with colonic diverticulosis accounting for the majority of cases. While often asymptomatic, diverticula of the gastrointestinal (GI) tract are clinically significant due to potential life-threatening complications. Familiarity with key epidemiologic, etiologic, clinical, imaging, and therapeutic features of various diverticula is therefore important. This review is meant to serve as a concise guide highlighting the distribution, epidemiology, presentation, classic imaging findings, and treatment for the spectrum of GI diverticula. Evidence Acquisition: We review fluoroscopic, computed tomography (CT), and magnetic resonance imaging (MRI) features of the most commonly encountered GI diverticula. Diverticula that are anatomically adjacent often share features such as symptomatology, optimal diagnostic imaging modality, and management. Thus below we categorize them by location along the GI tract. Esophageal (Zenker’s, Killian-Jamieson, midthoracic, epiphrenic), false and true gastric, small bowel (duodenal, jejunoileal, and Meckel’s), and large bowel (appendiceal, cecal, ascending/descending/sigmoid colonic) diverticula are discussed.

    Results and Conclusions

    Although commonly incidental, diverticula of the GI tract can be clinically significant due to complications. This pictorial essay describes the epidemiologic, etiologic, clinical, and therapeutic features and imaging findings associated with GI diverticula encountered in clinical practice.

    Keywords: Diverticula, Fluoroscopy, Gastrointestinal, esophageal, Colonic, MR
  • Isabelle Beaudry Bellefeuille *, Alison Lane, Eduardo Ramos Polo, Shelly Lane Page 2
    Background

    Adequate sensory perception and reactivity to sensory stimuli associated with defecation is key to successful stool toileting. Preliminary reports suggests that some of the difficulties that many children with FDD experience with toileting could be related to sensory hyper-reactivity.

    Objective

    This study investigated the relationship between sensory hyper-reactivity and functional defecation disorders (FDD).

    Methods

    Parents of three to six-year-old children with and without FDD completed two questionnaires; the Toileting Habit Profile Questionnaire-Revised (THPQ-R; tool that measures sensory hyper-reactivity to defecation related sensations) and the Short Sensory Profile (SSP). On both questionnaires, low scores indicate more concerns. Between group comparisons and the relationship between scores on the THPQ-R and on the sensory hyper-reactivity items of the SSP were examined.

    Results

    The sensory hyper-reactivity mean score of the SSP was lower for children with FDD. The difference was statistically significant (p < .0005). There was a positive correlation between THPQ-R and SSP hyper-reactivity scores (r274 = .485, p < .0005). Further, higher levels of sensory hyperreactivity (low SSP score) were associated with a higher frequency of the challenging defecation behaviors described in the THPQ-R (low THPQ-R score).

    Conclusion

    Health practitioners do not usually consider sensory hyper-reactivity as a possible factor contributing to the difficulties of the child with FDD. Our results indicate that routine screening for sensory hyper-reactivity may be an important practice element when working with children with FDD. In addition, the present study adds support to the validity of the THPQ-R in identifying behaviors potentially linked to sensory hyper-reactivity.

    Keywords: Functional constipation, functional defecation disorders, children, sensation disorders
  • Sara Senti Farraraons *, Anna Estival Gonzalez, Cuadrado Velazquez, Clara Gene Skrabec, Ignasi Camps Ausas Page 3

    Desmoid tumor, also called aggressive fibromatosis, is a rare fibroblastic proliferation of connective tissue and skeletal muscle aponeurosis. The aetiology of desmoid tumours is poorly understood, but they have been related with oestrogen stimuli, previous trauma, surgical interventions and pregnancy. Although it is characterized by not having potential for metastasize or differentiate, it is a non-encapsulated lesion, with an infiltrative growth and unpredictable behaviour. In this way, it could have either an aggressive pattern, when compared with other low degree malignancy sarcomas, or a very indolent one, even with spontaneous regression. Therapeutic options in desmoid tumours have been changing over these last years, as surgery upfront in asymptomatic patients has been superseded by active surveillance. However, treatment has to be individualized in some specific scenarios such as intra-abdominal lesions. We present two cases of patients diagnosed with an intra-abdominal desmoid tumour with threatening behaviour, the treatment approach and final resolution.

    Keywords: desmoid, Surgery, Oncology, Tumour
  • Sora Yasri *, Viroj Wiwanitkit Page 4

    Dear, Editor, leptospirosis is an important zoonotic leptospiral infection. This infection is common and endemic in several tropical countries. The patients with leptospirosis usually have high fever and other systematic clinical problems such as renal failure and jaundice. The colorectal manifestation of leptospirosis is possible but little mentioned. Sometimes, the colorectal presentation of leptospirosis might be missed or incorrectly diagnosed. The good example is the missed diagnosis of leptospirosis as colon cancer [1]. Colon ulcer might be detected by colonoscopy study [1]. The pathogenesis is according to colonic spirochetosis pathological process. Direct colonic involvement might be shown by histological study. Indeed, the gastrointestinal symptoms including diarrhea is observable in cases with leptospirosis [2]. The patient might also have severe abdominal pain [2]. In severe case, abdominal CT scan might reveal pancolitis [3]. In fact, colon might be an affected organ in leptospirosis. In rare case, ischemia of colon is observable [4 - 5]. In any case with atypical clinical problem, colorectal manifestation might be a clinical feature of leptospirosis. The practitioner should recognize and consider this problem in any case from or having history of visiting to tropical endemic area.

    Keywords: Colorectal, leptospirosis, tropical countries
  • Vincent Chukwudi Chijindu *, Chidiebele Udeze, Mamilus Ahaneku, Ijeoma Anarado Ezika, Kennedy Okafor Page 5

    Researchers have continued to proffer various solutions to the challenge of delineating from Trans-rectal ultrasound (TRUS) 2D-images of the prostate the regions of desired property. This paper presents an algorithm that categorises the detected regions suspected to be cancerous, hyper-echoic pixels, in the prostate gland from a 2D Trans-rectal Ultrasound images into three zones. The developed algorithm uses radial scanning of the pixels of the prostate gland image from common seed point both to detect and delineate the suspected cancerous pixels into zones, namely peripheral, transition and central, by applying ratios of the anatomical zones of the prostate gland. Expert knowledge, intensity and gradient features were implemented to delineate regions of interest. MATLAB programming tool was used for creating the codes that implemented the algorithms. Samples of TRUS 2D-images of the prostate for patients with raised PSA values (>10 ng/ml) used in a previous work by Award (2007) were used for testing the algorithm. The test results showed that the algorithm could detect zones of the prostate boundary exhibit image properties for cancer cells and also the percentage of malignancy detected in zones agreed with existing research findings. Comparison of detection results with that of an expert radiologist yielded the following performance parameters; accuracy of 88.55% and sensitivity of 71.65%.

    Keywords: Image, Hyper-echoic, Prostate, Localisation, Anatomical, Zones, Segmentation
  • Shima Fakher, Seyed Vahid Hosseini, Mozhdeh Zamani, Leila Ghahramani, Pooneh mokaram Mokaram * Page 6
    Background

    Cancer research is highly dependent of large amount of data and high quality samples which can be provided by networks to enable large-scale multi-center research projects. Biologic materials, such as blood, tissue samples, DNA, body fluids and the related data obtained in cohorts and clinical trials are valuable sources for research which should be managed by policies and standard operating procedures as biorepositories or biobanks. Methods and evidence acquisition: The authors investigated and summarized pubmed database articles using biobanks and describing the policies.

    Conclusion

    biobanking as a young discipline in different countries needs new technologies, standards and harmonization. In this review article, we have an overview on biorepository, cancer biobanking and the emerging registry in Iran.

    Background

    Cancer research is highly dependent of large amount of data and high quality samples which can be provided by networks to enable large-scale multi-center research projects. Biologic materials, such as blood, tissue samples, DNA, body fluids and the related data obtained in cohorts and clinical trials are valuable sources for research which should be managed by policies and standard operating procedures as biorepositories or biobanks. Methods and evidence acquisition: The authors investigated and summarized pubmed database articles using biobanks and describing the policies.

    Conclusion

    biobanking as a young discipline in different countries needs new technologies, standards and harmonization. In this review article, we have an overview on biorepository, cancer biobanking and the emerging registry in Iran.

    Keywords: biobank, biorepository, biobank network, colorectal cancer
  • Ahmad Izadpanah, Seyed Vahid Hosseini, Maytham Hameed Al Qanbar, Mozhdeh Zamani, Behnam Kadkhodaei * Page 7
    Background

    Colorectal cancer causes many deaths worldwide and rectal cancer includes one-third of them. Surgical mesorectal excision along with preoperative neoadjuvant chemoradiotherapy is known as the standard treatment for rectal cancer. However, inaccurate preoperative staging is a main concern which leads to large number of patients not being treated with neoadjuvant therapy. Selection of the best treatment approach for these patients is controversial. Although significant better survival was observed is patients who received postoperative adjuvant chemoradiation compared with patients who treated with surgery alone, other studies did not find such results. Due to these contradictory results, this study was designed to further evaluate the survival outcomes in rectal cancer patients who received adjuvant chemoradiotherapy without neoadjuvant therapy.

    Methods

    Totally 197 rectal cancer patients who received adjuvant chemoradiation were included in this study. The demographic and clinico-pathological characteristics of the patients were evaluated by statistical analysis.

    Results

    Based on the univariate cox regression, poor disease free survival (DFS) was significantly associated with male sex and T3 stage. Poor overall survival (OS) was also associated with stage II/III, T3/T4, NI/NII, grade II/III, positive node number (> 3), perineural invasion, lymphovascular invasion, and margin involvement. According to the multivariate cox regression, independent predictive factors for DFS were T3 andT4 stage, and for OS were also T3/ T4 stage, grade II/ III and lymphovascular invasion.

    Conclusions

    Taken together, obtained results indicated that combined adjuvant chemoradiation contributes to improve survival outcomes in the rectal cancer patients who did not received neoadjuvant therapy.

    Keywords: Rectal cancer, Adjuvant chemoradiation, Overall Survival, Disease free survival