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Query: UMLS:C0699790 (colon cancer)
 28,837 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to determine the frequency of tumours in patients presenting with frank rectal bleeding, a prospective study was carried out in 337 patients over the age of 40 attending our Proctology Clinic. After making a clinical diagnosis, flexible sigmoidoscopy followed by barium enema was performed. Excluding 7 digitally palpable rectal cancers, there were 30 cancers (9.1%), 34 polyps (10.3%), 7 proctocolitis (2.1%) and 25 diverticula (7.6%) detected, giving a total diagnostic yield of 29.1%. A clinical diagnosis of bleeding sources other than haemorrhoids was made in 80% of the cancers. Flexible sigmoidoscopy detected 93.3% of the cancers and 88.2% of the polyps. Barium enema diagnosed the remaining cancers and polyps but there was a false-positive rate of 3.8%. From our results, we conclude that patients with frank rectal bleeding should be screened routinely for left-colon cancer irrespective of the clinical diagnosis. The flexible sigmoidoscope is a quick and useful tool. However, barium enema should be recommended to individuals with strong clinical suspicion of rectal bleeding other than haemorrhoids.
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PMID:Frank rectal bleeding: a prospective study of causes in patients over the age of 40. 314 95

The authors have reviewed 13 years of experience with 500 patients who had 1240 polypoid lesions identified at colonoscopy. An analysis of these patients' symptoms, signs, and past histories prior to initial colonoscopy were collated by computer in order to provide useful information to help in early identification of patients with polyps and to define specific risk factors in patients with polypoid cancers (71 patients with 79 cancers). This study shows that the 500 patients with colon polyps, with and without cancer, are similar in all parameters measured. Their symptoms correlated poorly with the pathology or location of the polyp. Frequently unrelated symptoms brought the patient to the attention of their private physician. A significant high-risk group of patients identified were those with prior colon polyps and cancer. A positive family history of colon cancer was not common. Barium enema, the most common examination, was performed in 90 percent of patients and was the first test to diagnose polyps in 54 percent. Flexible sigmoidoscopy, only more recently available and performed in 20 percent of the patients, established a diagnosis of polypoid disease 96 percent of the time. This study supports screening for all adults above 40 years of age with flexible sigmoidoscopy and stool occult blood.
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PMID:Risk factors and screening techniques in 500 patients with benign and malignant colon polyps. An urban community experience. 334 78

The diagnostic efficacy of routine double-contrast barium enema and fiberoptic coloscopy for detection of cancer was retrospectively studied in 303 patients consecutively operated for colorectal adenocarcinoma in a 52-month period from January 1980. Double-contrast barium enema was performed in 180 patients with 184 carcinomas, 157 (85%) of which were revealed by this examination. The detection rate of carcinoma according to site was 89% between cecum and descending colon, 92% in sigmoid colon and 71% in rectum. Fiberoptic colonoscopy was done in 176 patients with 181 carcinomas, 163 (90%) of which were detected by the endoscopical examination. The detection rate of carcinoma according to site was 86% between cecum and descending colon, 90% in sigmoid colon and 95% in rectum. The two methods were equally effective in detecting carcinoma of the colon. Colonoscopy was superior to barium enema in detection of rectal carcinoma.
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PMID:Routine double contrast barium enema and fiberoptic colonoscopy in the diagnosis of colorectal carcinoma. 335 84

Three hundred forty-five colorectal cancers were identified in 320 patients over a nine-year period. Twenty-one patients (7 percent) had synchronous cancers. Metachronous cancers were identified in five patients (2 percent). Thirteen of the synchronous cancers were foci of invasive adenocarcinoma in polyps with elements of benign neoplastic tissue. There was a trend for younger patients to have multiple colon cancers. Fifteen percent of the synchronous colon cancer patients were less than 50 years of age. The mean age of patients who presented with metachronous cancer was 54, and 11 years was the average time interval between the diagnosis of the initial and the metachronous tumor. Colonoscopy proved to be more reliable than barium-enema examinations in identifying synchronous cancers. It is concluded from this review that before elective resections, colonoscopy should be used to effectively screen patients for synchronous cancers, and following curative resection, the residual colon should be periodically examined for the remainder of the patient's life.
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PMID:Multiple adenocarcinomas of the colon and rectum. An analysis of incidences and current trends. 339 Oct 60

Colovesical fistula often presents with recurrent or persistent urinary tract infection, especially in men. The commonest cause is diverticular disease. Other causes include carcinoma of the colon, Crohn's disease, radiotherapy and trauma. Barium enema may suggest the pathology but cystoscopy is the best investigation to confirm the presence of a fistula. One-stage resection and anastomosis is suitable for most patients with diverticular disease.
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PMID:Colovesical fistulas. 339 51

We compared the use of barium enema (BE) and colonoscopy in evaluating patients with chronic gastrointestinal tract bleeding by dividing into three groups 329 consecutive colonoscopies and 207 consecutive BE examinations done with chronic gastrointestinal tract bleeding as an indication. In the first group, of 96 patients with negative results of BE studies, subsequent colonoscopy showed carcinoma of the colon in 16%, polyps larger than 1 cm in 21%, and other causes in 20%. In 43% the colonoscopy gave negative results or was incomplete. In the other two groups we directly compared findings of the 207 BE and the 233 remaining colonoscopies when each was used as a primary diagnostic test. Colonoscopy was found to have fewer negative results (74% vs 43%), fewer inconclusive examinations requiring repeat (19% vs 3%), and more positive correct findings to explain the cause of bleeding (54% vs 5%).
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PMID:Colonoscopy as a primary diagnostic procedure in chronic gastrointestinal tract bleeding. 348 19

The relationship of colonic polyps to carcinoma of the colon provides a basis for their importance. Recent advances in the detection of colonic polyps, including double contrast barium examination and colonoscopy, have provided a method for more extensive study of colonic polyps. Studies using these newer techniques indicate that many traditional concepts of colonic polyps were inaccurate. The relationships of polyp size to histology, polyp location to age, and the phenomenon of colon polyp clustering are important to both the immediate treatment of the polyp and to the long-term follow-up of the patient. The use of hemoccult stool screening as a technique for screening for colonic pathology is also of significance to the radiologist. The changing relationships of various parameters of colon polyps bring into question the utility of many of the currently recommended screening procedures for colon pathology. Undoubtedly, this will impact on the practice of radiology.
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PMID:Changing concepts of colonic polyps: clinical and radiographic implications. 353 5

In retrospective series, 17.0 to 25.5 per cent of those patients with carcinoma of the colon or rectum have been found to have concurrent inguinal herniation. This observation prompted the recommendation that patients with hernias be thoroughly screened for disease of the colon and rectum. That recommendation remains controversial in part because it has not previously been prospectively evaluated. In a one year period, 202 consecutive patients with inguinal hernias completed a preoperative protocol which included: 1, gastrointestinal history; 2, rectal examination; 3, testing of at least two stool specimens with the Hemoccult (Smith Kline Diagnostics) device; 4, sigmoidoscopy, and 5, barium enema. Malignant and premalignant diseases were discovered in five patients, only one of whom had gastrointestinal symptoms. Each malignant lesion was localized (Dukes' A or B) and, therefore, highly curable. Benign disease was found in 49 patients, including polyps in eight and one instance of tight sigmoid stricture. All of the malignant and 91 per cent of the benign lesions were in patients 50 years of age and older. The association between inguinal herniation and colorectal disease was previously attributed to luminal obstruction. In the present series, however, the sole obstructing lesion was a benign stricture. Another explanation for this association must, therefore, be sought. We conclude, on the basis of the results of this experience, however, that screening for pathologic factors of the colon and rectum is warranted in otherwise asymptomatic patients who are more than 50 years old and who present with inguinal hernias.
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PMID:Preoperative evaluation of patients with inguinal hernia for colorectal disease. 358 27

We evaluated the role of the barium enema in the diagnostic work-up of 120 gynecologic patients. Major abnormalities were detected in 10% of patients. We conclude that patients presenting with pelvic tumors or suspected gynecologic malignancies should have a pre-therapeutic barium enema in order to define the extent of the disease and to rule out colon cancer.
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PMID:Barium enema in the diagnostic work-up of gynecologic patients. 359 68

Evidence has been presented to suggest that the patient with an obstructed carcinoma of the colon may have a more malignant form of the disease independent of lymph node status or tumor encirclement of the bowel. Rate of tumor growth is never consistent in patients with this disease. Patients who develop colon obstruction early in the course of the disease seem to have more aggressive tumors with rapid growth and a much poorer long-term prognosis. Perforations frequently accompany obstructions of the colon. Patients in this group have a dismal prognosis. Individuals with obstructed carcinoma of the colon have a higher operative mortality and morbidity and a shorter long-term survival. The higher operative mortality and morbidity may depend entirely on the choice of operative procedures. Tumor location affects prognosis. Obstructing tumors in the left colon have a more favorable prognosis than those in the right colon. Obstructing right colon tumors have a much poorer survival (three times worse) than nonobstructing carcinomas of the right colon. Obstructing tumors in the rectum have a very poor prognosis. Evidence exists that resection of the tumor without preliminary proximal decompression may reduce hospital mortality and morbidity and increase long-term survival. In selected cases, primary resection can be done as safely as staged operative procedures. Primary anastomosis with resection of the left colon carries a higher operative mortality because of anastomotic leaks. Resection without anastomosis is much safer. Primary resection with anastomosis is the procedure of choice in obstructing lesions of the right colon. This has a lower operative mortality and morbidity than a staged procedure. This primary resection with anastomosis is certainly as safe as an ileotransverse colostomy. It is important not to abandon the time-honored surgical principle of never suturing obstructed bowel. Primary resection without anastomosis confirms this surgical principle. Meticulous preoperative and postoperative care employing physiological monitoring, multiple antibiotics, total parenteral hyperalimentation, and respiratory and circulatory support will further reduce the hospital mortality and morbidity. Patients who initially appear to be obstructed on barium enema, but who in truth are only partially obstructed, can be properly managed so that an elective primary resection with anastomosis can be done with the same operative mortality and morbidity as in other elective colon cancer patients.
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PMID:Obstructing malignant lesions of the colon. 373 1


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