Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0021933 (intussusception)
3,822 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 48-year-old man of Haitian descent presented with progressive constipation, hematochezia, and weight loss. Colonoscopy and computed tomography scan revealed an obstructing colonic mass, causing intussusception and pneumatosis of the descending/upper sigmoid colon and necessitating an emergency left hemicolectomy. Gross examination revealed a 4.9-cm obstructing mass in the sigmoid colon extending through the muscularis propria. Histologically, the lesional cells were bland, spindled, with tapered and often wavy nuclei set in a loose fibromyxoid stroma. Focally, the lesional cells displayed whorling or storiform growth pattern mixed with spindle wavy cells. In many areas, the cells had bipolar cytoplasmic processes. Immunohistochemistry revealed patchy positivity for epithelial membrane antigen, CD34, vimentin, diffuse positivity for S-100, and negativity for CD117, cytokeratin (AE1/AE3), ALK1, desmin, smooth muscle actin, neuronal nuclei antigen (NeuN), and neurofilament protein. The morphology and immunohistochemical findings were consistent with hybrid perineurioma-schwannoma. Electron microscopic examination revealed the characteristic features of perineuriomal and schwannomatous differentiation. Based upon the histopathology, immunophenotype, and ultrastructure, this tumor was classified as a benign hybrid perineurioma-schwannoma, a counterpart to the tumor described in the soft tissue. This is the first case report of hybrid perineurioma-schwannoma in the colon.
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PMID:Benign hybrid perineurioma-schwannoma in the colon. A case report. 1712 57

Difficult patients with constipation mostly suffer for years, have consulted more than one physician and have had some experience with laxatives. The first step should be sorting out what exactly the patient's problem is. For this purpose technical investigations may be helpful, but the most important measures are a detailed history, symptom analysis and proctological examination. Rarely, an underlying and treatable cause of the constipation can be identified. In disordered defaecation this may be a large rectocele or an intussusception of the rectum amenable to proctosurgery. In most cases, however, some form of laxative treatment will be required. For this purpose, a detailed knowledge of their pharmacology is mandatory. The type of laxative and the schedule of administration often have to be determined on an individual basis over a number of weeks. In some patients, combination treatment with macrogol and a stimulant laxative may be the solution. Psychological features must also be taken into account in difficult patients, in particular if they ask for colectomy. Total colectomy with ileorectal anastomosis is an effective (although not universally successful) treatment of constipation, which is, however, hampered by a high rate of both early and late complications.
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PMID:The difficult patient with constipation. 1754 12

Functional disorders of defecation are common and often overlap with slow-transit constipation. They are comprised of functional obstructive conditions such as dyssynergic defecation, as well as structural obstructive conditions such as rectal prolapse, excessive perineal descent, and rectocele. Evaluation includes detailed history and rectal and pelvic exam together with physiologic tests such as anorectal manometry, balloon expulsion test, defecography, and MRI. Treatment involves several medical, behavioral, and surgical approaches. Recently, randomized controlled trials have shown that biofeedback therapy is an effective treatment for dyssynergic defecation. Stapled transanal rectal resection appears to be a promising technique for treating defecation disorders associated with rectocele, excessive perineal descent, and mucosal intussusception, but controlled trials are lacking.
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PMID:Functional disorders of defecation: evaluation and treatment. 1754 60

Generally, colon lipoma is mildly symptomatic or asymptomatic. However, sometimes it may present with symptoms, such as pain, constipation, obstruction, or bleeding and may be the leading point for intussusception, particularly in large size (>20 mm). Giant colon lipoma may warrant the removal to exclude confusion with other lesions that have a malignant potential and to control symptoms. Currently, surgical resection should be considered for giant lipoma more than 20 mm in diameter due to the high risk of perforation or bleeding, especially when the lesion is broadly-based. We report here a case of spontaneous resolution acquired after endoscopic partial resection for the symptomatic giant colon lipoma with broad-base requiring surgery.
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PMID:[A case of giant colonic lipoma showing spontaneous resolution after endoscopic partial resection]. 1788 87

Internal rectal prolapse (rectal intussusception) and rectocele are frequent clinical findings in patients suffering from refractory constipation that may be best characterized as obstructive defecation syndrome. However, there is still no clear evidence whether the stapled transanal rectal resection (STARR) procedure provides a safe and effective surgical option for symptom resolution in patients with obstructive defecation syndrome, as evidence-based guidelines and functional long-term results are still missing. On the basis of the need for objective evaluation, a European group of experts was founded (Stapled Transanal Rectal Resection Pioneers). Derived from 2 meetings (October 26-28, 2006, Gouvieux, France and November 28-29, 2007, St Gallen, Switzerland) a concept for treatment options in patients suffering from obstructive defecation syndrome was developed, including a clear decision-making algorithm specifically focusing on the role of the stapled transanal rectal resection procedure based on clinical symptoms and dynamic imaging and inclusion and exclusion criteria for the stapled transanal rectal resection procedure.
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PMID:Decision-making algorithm for the STARR procedure in obstructed defecation syndrome: position statement of the group of STARR Pioneers. 1840 78

Internal rectal prolapse (rectal intussusception) and rectocele are frequent clinical findings in patients suffering from refractory constipation that may be best characterized as "obstructive defecation syndrome" (ODS). However, there is still no clear evidence whether the STARR procedure (stapled transanal rectal resection) provides a safe and effective surgical option for symptom resolution in ODS patients, as evidence-based guidelines and functional long-term results of representative collectives are still lacking. Based on published data derived from the German STARR registry, the STARR procedure can be performed safely with low morbidity. The definitive role of the STARR procedure has to be assessed by careful and prospective evaluation of long-term function, symptom resolution, and quality of life, e. g., as provided by the German STARR registry.
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PMID:[Actual Role of Stapled Transanal Rectal Resection (STARR) for obstructed defecation syndrome]. 1841 97

A cat was presented with a history of constipation, tenesmus, and malaise. Ultrasonography revealed an ileocolic intussusception and cecal inversion. Surgical findings included an easily reducible intussusception and an inverted cecum that was moderately difficult to reduce. A typhlectomy and bowel plication was performed. The cat had an uneventful recovery.
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PMID:Cecal inversion followed by ileocolic intussusception in a cat. 1851 59

Constipation and evacuation difficulty symptoms are common in the general populace. The ROME III criteria define the latter as a subset of the former. Constipation and defaecatory symptoms rarely occur in isolation and can often form part of a global pelvic floor problem, involving bladder voiding difficulties, sexual dysfunction and pain syndromes. While there is often a functional cause for symptoms, there are a number of organic causes particularly in the elderly that should not be missed. Novel physiological and imaging insights are improving our understanding, and potentially treatment, of these symptoms. Conservative therapies focus on a holistic approach in tandem with evolving drug therapies that target intestinal secretion and transit. The role of the biofeedback specialist is continually being re-defined to an all-encompassing one of physiotherapist, behavioural psychologist and moderator for alternative therapies such as rectal irrigation. Sacral neuromodulation for constipation is an emerging minimally invasive surgical option, although the criteria for patient selection are still to be elucidated. Colectomy for functional constipation is associated with a high morbidity, and gut symptoms often persist, suggesting a global GI phenomenon. Surgical correction of rectocele and intussusception for evacuation difficulty will benefit those with anatomical symptoms; for those with predominantly functional features, surgery is best avoided to prevent a vicious cycle of multiple re-operations.
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PMID:Constipation and evacuation disorders. 1964 87

Cecorectal intussusception, a variant form of intussusception, occurs when the cecum enters through the entire course of colon and reaches to the rectum. This condition is rare but often associated with a pathologic lead point. Here, we report a 13-year-old boy, featuring insidious abdominal discomfort and constipation for 1 month, who developed cecorectal intussusception. Before surgical intervention, multi-detector row computed tomography with reconstructed images demonstrated the route of cecorectal intussusception and identified a cecal fat-containing tumor as the lead point. The patient received surgical reduction with resection of the cecal tumor. Final pathological diagnosis was a hamartoma of the cecum. The relevant literature pertaining to this condition is reviewed, and the possible pathophysiology of the condition discussed.
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PMID:Cecorectal intussusception induced by a cecal hamartoma. 2003 27

Colonic lipomas are rare benign lesions, detected accidentally. These are often asymptomatic, but large lipoma may produce symptoms as abdominal pain, nausea, weight loss, diarrhea, constipation, hemorrhage, and intussusception. Colonic lipomas are more often localized in the ascending colon: literature reports less than 20 symptomatic cases situated in the descending colon. We report the case of a young man with a colonic giant lipoma diagnosed at Computed Tomography, who presented with rectum bleeding and 5-kg weight loss. The case was interesting because of the patient's young age, the tumor's location in the left side of the colon and the giant size (5.5 cm).
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PMID:Giant lipoma of descending colon diagnosed at CT: report of a case. 2071 67


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