Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of carcinoma in Crohn's disease of the colon are reported. One patient was a 30-year-old man who had asymptomatic Crohn's ileocolitis resulting in an acute presentation due to toxic dilatation of the colon. This was preceded by a short prodromal period of four weeks, characterized by intermittent diarrhea on the basis of a coloileal tumor fistula. A mucus-secreting adenocarcinoma was present in the sigmoid colon associated with both adjacent and one nearby focus of high-grade mucosal dysplasia. Pelvic wall and abdominal metastases were present, and the patient died two months later. The other patient was a 60-year-old woman who had a nine-year history of biopsy-proven Crohn's proctocolitis. A stricture of the sigmoid colon due to Crohn's disease also harbored an invasive adenocarcinoma. The carcinoma was not evident preoperatively or on initial gross pathologic examination. The presentation and pathology of large intestinal carcinoma in Crohn's colitis are discussed and illustrated.
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PMID:Carcinoma in Crohn's disease of the colon. 376 96

Accuracy of the detailed per-oral small bowel series and enteroclysis was compared in 134 patients known to have (or not have) disease of the small bowel. Overall sensitivity of the per-oral examination was 92% and specificity 94%, compared to 94% and 89%, respectively, for enteroclysis. There was no difference between the two in Crohn disease, adhesions, and metastatic disease; however, enteroclysis was thought to be more effective in delineating peritoneal adhesions in patients with obstruction. The authors conclude that while the per-oral study and enteroclysis are equally valid methods of examining the small bowel, the per-oral study is preferable as a screening examination because it requires less time, has fewer side effects, and involves a lower radiation exposure.
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PMID:Detailed per-oral small bowel examination vs. enteroclysis. Part II: Radiographic accuracy. 397 14

We describe six cases of pyogenic liver abscess occurring among 1227 Crohn's disease patients admitted to The Mount Sinai Hospital from 1960 through 1982, and review the features of the seven similar cases that have been previously reported. Mechanisms of formation of liver abscess in these 13 patients included direct extension of intraabdominal abscess (three cases), propagation via the portal vein (eight cases), biliary complications (one case), or metastatic cancer (one case). Five of the 13 patients died. All five deaths occurred among the eight patients with multiple abscesses; all five patients with solitary abscess survived. The mean age of the patients who died was 56 years, versus 37 years for the survivors. Three of the four patients treated with antibiotics only died; only two of the nine patients who underwent some form of drainage succumbed. Mortality was usually attributable to failure in making the diagnosis, especially as liver function test abnormalities were often subtle. Furthermore, the generally nonspecific clinical signs and symptoms were often obscured by underlying bowel disease. If a high index of suspicion is maintained, CT scanning and ultrasonography should reveal the lesion at an early stage, so that the necessary drainage procedure can be carried out, with or without concomitant resection of affected bowel and drainage of intraabdominal abscess.
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PMID:Pyogenic liver abscess in Crohn's disease. 404 90

A considerably raised serum alpha-fetoprotein concentration was found in a patient with an ileal adenocarcinoma. alpha-fetoprotein was shown in both the primary tumour and the hepatic metastases by an immunoperoxidase technique. A raised alpha-fetoprotein concentration in association with ileal adenocarcinoma has not been described previously, and it is notable that the first such case should occur as a complication of longstanding Crohn's disease.
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PMID:Increased alpha-fetoprotein concentration in association with ileal adenocarcinoma complicating Crohn's disease. 619 75

A 52-year-old female had radical surgery on both breasts in 1971 and 1973 for infiltrating lobular carcinoma of the breast. One year later, multiple metastases simulating Crohn's disease were found radiologically and intraoperatively in the colon and small bowel. The pathological examination revealed multiple areas of linitis plastica type carcinoma in the colon and small bowel. Review of the breast slides showed that the original breast carcinoma was morphologically identical to the metastatic lesions. The literature is reviewed and arguments are presented to attest that signet-ring-cell carcinoma of the breast is a distinct entity, which not too infrequently metastasizes to the gastrointestinal tract.
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PMID:Metastatic carcinoma of breast simulating Crohn's disease. 626 68

A simple procedure is described for the detection of sialic acid in serum. After a direct addition of Ehrlich reagent to serum and an incubation at 56 degrees C for eight hours, the resulting mixture is diluted with saline. After centrifugation, the color in the supernatant is determined at 525 nm in a spectrophotometer. Serum sialic acid was significantly greater in cancer patients than in normals. Cancer patients with metastases had significantly greater sialic acid than cancer patients without metastases. In two cancer patients, sialic acid levels returned to normal after surgery. The diagnostic usefulness of 95.6% was similar to that reported with lipid-soluble sialic acid and seemed to be superior to CEA and other tumor antigens associated with a limited spectrum of tumors. However, patients with inflammatory diseases such as arthritis, Crohn's disease and psoriasis also showed elevated sialic acid levels. Ultrafiltration showed that almost all of the sialic acid was retained on an Amicon filter, which suggests that sialic acid was bound to a macromolecule. A quality control serum run 25 times had a coefficient of variation (CV) of 8.4% and the same serum ran on 42 days had a CV of 11.6%.
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PMID:Serum sialic acid in normals and in cancer patients. 651 95

There are many disease processes, both inflammatory and neoplastic, which can alter the colonic bowel wall. A retrospective study was done on surgically proven cases of colonic disease in which colonic bowel wall abnormalities were identified by computed tomography. Colonic bowel wall thickening was the most common finding, but was nonspecific. Finger-like projections extending from the bowel wall into the surrounding mesentery did help distinguish inflammatory change from neoplastic change. Examples of diverticulitis, appendicitis, Crohn's disease, carcinoma, lymphoma, and metastatic disease are presented.
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PMID:Abnormal colonic wall thickening on computed tomography. 682 55

Lesions of the small bowel are notoriously difficult to diagnose, many only coming to light at laparotomy. At this hospital the small bowel enema has been used for radiology of the small bowel for many years. The procedure is uncomfortable for the patient, as intubation of the proximal small bowel is essential, and for the radiologist it can be very time-consuming. A review of patients referred by the general surgeons over the past 5 years has demonstrated the value of the technique. It has proved to be accurate in over 90 per cent of cases with only 2 per cent false negative and 1 per cent false positive results. The most common diagnosis has been Crohn's disease which can be very accurately assessed. Other lesions diagnosed include lymphoma, involvement by metastases, benign stricture and adhesions. A normal results has prevented an unnecessary laparotomy in several patients. It is concluded that this technique is the most satisfactory method for radiology of the small bowel and it should be much more widely available.
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PMID:The value of the small bowel enema to the general surgeon. 712 44

The barium enema diagnosis of 38 cases of paracolic abscess is discussed. The importance of an appreciation of the anatomy of the peritoneum and of the paracolic region is emphasized. Five features of paracolic abscess that can be recognised on double contrast barium enema examination are analysed. These are soft tissue mass; extraluminal gas collection; barium-filled cavitation; displacement, impression or narrowing of the lumen; and mucosal changes. The commonest feature, present in 95% of cases, is displacement or impression or narrowing of the bowel lumen. An analysis according to site and aetiology is presented and the commonest causes found to be diverticulitis and appendicitis. The differential diagnosis is discussed, and differentiation from primary colonic carcinoma, metastases, Crohn's disease, ischaemia and endometriosis is described.
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PMID:The barium enema diagnosis of paracolic abscess. 721 25

Indications for surgery, operative procedures, and the early and late sequelae of surgery for Crohn's ileocolitis have been studied in a series of 250 patients admitted to Mount Sinai Hospital, New York, between 1960 and 1975. The most common indications for surgery were small-bowel obstruction in ileocolitis, and medical intractability in Crohn's colitis. Early postoperative complications (within 30 days of surgery) followed 79 operative procedures (15%), and were most commonly wound infections (7%), intra-abdominal abscess (2.6%), and postoperative intestinal obstruction (2.4%). Late sequelae (30 days to 15 years following surgery) included intestinal obstruction in 36 patients, external fistulae in 41 patients, and ileostomy problems in 19 patients, and were most frequently caused by recurrent disease in the terminal portion of the ileum. Mortality following surgery for Crohn's disease may be subdivided into two groups, early and late. All eight early postoperative deaths were secondary to sepsis, present in every instance prior to operation. The eight late deaths were caused by metastatic cancer in six and recurrent disease in two. Resection of excluded segments of bowel, as in four of the patients in this series, will reduce the late cancer risk.
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PMID:Surgery and its sequelae in Crohn's colitis and ileocolitis. 746 65


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