MedWorm: Barium Enema

Natural Language Processing Improves Identification of Colorectal Cancer Testing in the Electronic Medical Record

Medical Decision Making — Tue, 31 Jan 2012 05:00:00 +0100

Conclusions. Applying NLP to EHR records detected more CRC tests than either manual chart review or billing records review alone. NLP had better precision but marginally lower recall to identify patients who were due for CRC screening than billing record review. (Source: Medical Decision Making)

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Role of Radiologic Imaging in Irritable Bowel Syndrome: Evidence-based Review [Evidence-based Practice]

Radiology — Thu, 26 Jan 2012 05:00:00 +0100

Conclusion: Although widely used, there is a surprising paucity of evidence guiding radiologic imaging in IBS. Radiologic imaging may not be required in patients with IBS without potentially concerning symptoms but should be considered where such symptoms exist, and choice of imaging study should be influenced by predominant symptoms. Definitive recommendations must await further research. © RSNA, 2011 (Source: Radiology)

Diagnostic laparoscopy and preoperative planning in ischiopagus tripus conjoined twins: a surgical first, with detailed demonstration of the complex anatomical relationships

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:51 +0100

Conclusions Diagnostic laparoscopy is a useful tool in evaluation of ischiopagus tripus conjoined twins. It is an important adjunct to preoperative studies in preparing for an expeditious and safe separation procedure. Content Type Journal ArticleCategory VideoPages 1-1DOI 10.1007/s00464-011-2069-3Authors Felix C. Blanco, Department of General and Thoracic Surgery, Children’s National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010, USAKatherine P. Davenport, Department of General and Thoracic Surgery, Children’s National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010, USATimothy D. Kane, Department of General and Thoracic Surgery, Children’s National Medical Center, 111 Michigan Avenue, NW, Washington, DC 20010, USAJoseph E. Losee,...

Adult ileoileal intussusception induced by an ileal lipoma diagnosed preoperatively: report of a case and review of the literature

Surgery Today — Tue, 13 Dec 2011 17:05:20 +0100

Abstract We herein report a case of adult ileoileal intussusception induced by an ileal lipoma. A 68-year-old woman with a history of small intestinal tumors was admitted to our hospital with severe, colicky lower abdominal pain, similar to episodes experienced in the past. A barium meal enema at the initial admission demonstrated a small intestinal tumor in the ileum 30 cm proximal to the ileocecal valve. Abdominal ultrasound sonography and computed tomography showed a sausage-shaped mass presenting as a target sign in the right lower abdomen, suggestive of intussusception. There was also a round mass of fat attenuation representing a lipoma, which was considered the lead point of the intussusception. The patient underwent emergency surgery and partial resection of t...

Magnetic resonance colonography without bowel cleansing or water enema: a pilot study.

The British Journal of Radiology — Tue, 13 Dec 2011 05:00:00 +0100

Conclusion: This pilot study has demonstrated the feasibility of performing MR colonography without bowel preparation or water enema. This would seem to be a promising modality for colorectal cancer screening. Larger studies are required to determine the accuracy of this modality for the detection of colorectal neoplasia. PMID: 22167505 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)

Transanal repair for treatment of rectocele in obstructed defaecation: manual or stapled

Colorectal Disease — Sat, 10 Dec 2011 10:02:48 +0100

Conclusion Transanal repair of rectocele is a safe and effective technique in improving symptomatic rectocele. Stapled repair offers the advantage of short operative time, no comorbidity, and shorter hospital stay. (Source: Colorectal Disease)

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Acute Abdomen and Perforated Bowel with a Rare Pathology: Nonfamilial Visceral Myopathy

Computational Intelligence and Neuroscience — Fri, 09 Dec 2011 01:09:02 +0100

We report an atypical case of an eighty-nine-year-old woman with no prior history of abdominal illness who was admitted to our hospital with 2 days of increasing nausea, abdominal distension, and abdominal pain. On arrival at the hospital, she was critically ill. Abdominal X-ray showed distended loops of the colon and liquid levels resembling colonic obstruction. A subsequent abdominal CT scan confirmed the colonic obstruction. A suspicion of sigmoid volvulus was raised, that is why a barium enema was performed but no lower colonic obstruction could be confirmed. Acute laparotomy showed perforated cecum without intestinal obstruction. Postoperatively, the patient became septic which was fatal for the patient. Pathology gave the diagnosis visceral myopathy. It is very difficult to make the ...

Evaluation of Bioabsorbable Seamguard for Staple Line Reinforcement in Stapled Rectal Anastomoses.

Surgical Innovation — Wed, 07 Dec 2011 05:00:00 +0100

Conclusions. The routine use of BSG bolsters in stapled rectal anastomoses is safe and results in equivalent anastomotic strength as traditional stapled anastomoses. PMID: 22158845 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

Validity of self-reported colorectal cancer test use in different racial/ethnic groups

Family Practice — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions. Self-report prevalence data are overestimating CRC test use in all groups; current measures are less sensitive in Hispanics. (Source: Family Practice)

STARR With PPH-01 and CCS30 Contour Transtar for Obstructed Defecation Syndrome.

Surgical Innovation — Thu, 10 Nov 2011 05:00:00 +0100

Conclusion. Transtar is a more complex technique with more severe complications. A major resection is not always more effective. PMID: 22075438 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

Hypothyroidism in preterm infants following normal screening

Annals of Clinical Biochemistry — Tue, 01 Nov 2011 04:00:00 +0100

Congenital hypothyroidism is screened for in the UK using blood spot thyroid-stimulating hormone (TSH) screening at 5–8 d of age. Although standards are set by the UK Newborn Screening Programme Centre, there are variations in TSH cut-offs used. The introduction of repeat screening of preterm babies at 36 weeks' gestational age in 2005 was controversial in its utility and timing. Two cases of preterm babies are presented, who had normal blood spot TSH values on the first test and who became screen positive when re-tested at term. The first with Trisomy 21 was born at 29 + 6 weeks with an initial blood spot TSH of 3.3 mU/L rising to 263 mU/L at term-corrected gestational age (plasma TSH 476.5 mU/L). The second was born at 24 + 6 weeks’ gestational age and on day 7, the heel pric...

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Isolated congenital megacystis without intestinal obstruction: a mild variant of chronic intestinal pseudoobstruction syndrome?

Journal of Pediatric Surgery — Tue, 01 Nov 2011 04:00:00 +0100

We present the case of a female patient with isolated congenital megacystis without severe intestinal obstruction. In this case, barium enema did not reveal any significant findings; however, histologic evaluation of her rectum showed hypoganglionosis of the submucous and myenteric plexuses. These findings indicate that this case may be a mild variant of chronic intestinal pseudoobstruction syndrome. The presence of megacystis should alert the physician to the possibility of chronic intestinal pseudoobstruction syndrome. (Source: Journal of Pediatric Surgery)

Radiation dose measurement in gastrointestinal studies

Radiation Protection Dosimetry — Fri, 28 Oct 2011 04:00:00 +0100

Barium studies investigations (barium swallow, barium meal and barium enema) are the basic routine radiological examination, where barium sulphate suspension is introduced to enhance image contrast of gastrointestinal tracts. The aim of this study was to quantify the patients’ radiation doses during barium studies and to estimate the organ equivalent dose and effective dose with those procedures. A total of 33 investigations of barium studies were measured by using thermoluminescence dosemeters. The result showed that the patient entrance surface doses were 12.6±10, 44.5±49 and 35.7±50 mGy for barium swallow, barium meal, follow through and enema, respectively. Effective doses were 0.2, 0.35 and 1.4 mSv per procedure for barium swallow, meal and enema respectivel...

Adherence to follow‐up after a positive fecal occult blood test in an organized colorectal cancer screening program in Korea, 2004‐2008

Journal of Gastroenterology and Hepatology — Mon, 17 Oct 2011 04:00:00 +0100

Conclusion: These findings suggest that targeting participants for follow‐up, based on age and previous screening history, could be a good way to improve the follow‐up rate. (Source: Journal of Gastroenterology and Hepatology)

Is a flexible sigmoidoscopy necessary in the event of a normal CT colonoscopy?

International Journal of Surgery — Thu, 06 Oct 2011 22:52:31 +0100

Aims: To determine whether flexible sigmoidoscopy is required in the event of a normal CT colonoscopy. Investigation of the large bowel for suspected colorectal cancer (CRC) is traditionally performed with either colonoscopy or flexible sigmoidoscopy and barium enema. CT colonoscopy (CT Colon) has revolutionised the diagnosis of CRC and many studies have shown a comparative sensitivity with colonoscopy. (Source: International Journal of Surgery)

Preferences for colorectal cancer screening tests and screening test use in a large multispecialty primary care practice

Cancer — Wed, 21 Sep 2011 17:11:29 +0100

CONCLUSIONS:Lack of concordance between patient preference and test completed suggests that patients' preferences are not well incorporated into screening discussions and test decisions, which could contribute to low screening uptake. Physicians should acknowledge patients' preferences when discussing test options and making recommendations, which may increase patients' receptivity to screening. Cancer 2011. © 2011 American Cancer Society. (Source: Cancer)

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Guidelines for the management of iron deficiency anaemia

Gut — Sun, 04 Sep 2011 23:00:00 +0100

Background Iron deficiency anaemia (IDA) occurs in 2–5% of adult men and postmenopausal women in the developed world and is a common cause of referral to gastroenterologists. Gastrointestinal (GI) blood loss from colonic cancer or gastric cancer, and malabsorption in coeliac disease are the most important causes that need to be sought. Defining iron deficiency anaemia The lower limit of the normal range for the laboratory performing the test should be used to define anaemia (B). Any level of anaemia should be investigated in the presence of iron deficiency (B). The lower the haemoglobin the more likely there is to be serious underlying pathology and the more urgent is the need for investigation (B). Red cell indices provide a sensitive indication of iron deficiency in the absence...

Effectiveness of high‐dose barium enema filling for colonic diverticular bleeding

Colorectal Disease — Wed, 20 Jul 2011 17:59:04 +0100

Conclusion High‐dose barium enema is as effective as endoscopic haemostasis for the prevention of recurrent diverticular bleeding. (Source: Colorectal Disease)

Evaluation of patient doses due to fluoroscopic exposures

Radiation Protection Dosimetry — Mon, 04 Jul 2011 23:00:00 +0100

The present study measures entrance surface doses of radiation administered to patients during various fluoroscopic procedures using a dose–area product meter as well as the duration of each procedure. A conversion factor for entrance skin dose to patients was calculated. The average dose to patient during the insertion of intravenous hyperalimentation was 10.2 (maximum, 74.0) mGy, during a barium meal, 58.4 (maximum, 184.0) mGy, for endoscopic retrograde cholangio-pancreatography (ERCP), 97.3 (maximum, 376.0) mGy and for a barium enema, 86.1 (maximum, 271.0) mGy. Doses tended to increase in the abdominal domain and when patients undergo not only diagnostic evaluation but also treatment requiring procedures such as drainage. The management of radiation doses determined using a dose&n...

Imaging assessment of the modified double contrast barium enema using carboxymethylcellulose on radiography and ultrasonography in dogs

Veterinary Radiology and Ultrasound — Thu, 30 Jun 2011 23:00:00 +0100

A modified double contrast barium enema using carboxymethylcellulose was evaluated in beagle dogs and compared with dogs receiving a conventional barium enema. The experimental group was divided into three groups (1, 2, and 3) and given 30 ml/kg of different volume ratios of a barium vs. carboxymethylcellulose mixture. Each group underwent sonography following radiography. The volume ratio of one part barium to three parts carboxymethylcellulose was judged to be the optimal mixture, resulting in a general distribution of contrast and bowel radiolucency on radiographs and adequate postradiography sonography. The modified barium enema using carboxymethylcellulose is useful for assessing the general morphology and mucosal layers of the colon simultaneously on radiographs and ultrasonographs...

Video: Barium enema

MayoClinic.com Full Feed — Fri, 24 Jun 2011 05:00:00 +0100

Barium enema — See how a barium enema is done. (Source: MayoClinic.com Full Feed)

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Barium enema

MayoClinic.com Full Feed — Sat, 18 Jun 2011 05:00:00 +0100

— Overview covers definition, risks, results of this exam to detect colon disease. (Source: MayoClinic.com Full Feed)

Spontaneous expulsion from rectum: a rare presentation of intestinal lipomas

BioMed Central — Sun, 12 Jun 2011 23:00:00 +0100

Lipomas are rare, subserosal, usually solitary, pedunculated small lesions appearing mainly in the large intestine with a minimal malignancy potential. They usually run asymptomatic and become symptomatic when they become enlarged or complicated causing intestinal obstruction, perforation, intusucception or massive bleeding. In rare cases they can be self-detached and expulsed via the rectum as fleshy masses. This event mainly occurs in large, pendunculated lipomas which detach from their pedicle. The reason for this event remains in most of cases unclear although in some cases a predisposing factor does exist. Abdominal pain and obstructive ileus may be observed while in many cases bleeding occurs. The expulsed mass sets the diagnosis and in most of the cases all symptoms subside. Diagnos...

Comparison of transvaginal sonography and double‐contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment

Ultrasound in Obstetrics and Gynecology — Tue, 07 Jun 2011 23:00:00 +0100

Conclusion:Sensitivity of TVS is much higher than that of DCBE in detecting the presence of posterior DIE and should thus be regarded as the first imaging modality in the presence of a clinical suspicion. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. (Source: Ultrasound in Obstetrics and Gynecology)

Comparison of transvaginal sonography and double-contrast barium enema for diagnosing deep infiltrating endometriosis of the posterior compartment.

The Ultrasound Review of Obstetrics and Gynecology — Tue, 07 Jun 2011 23:00:00 +0100

CONCLUSION: Sensitivity of TVS is much higher than that of DCBE in detecting the presence of posterior DIE and should thus be regarded as the first imaging modality in the presence of a clinical suspicion. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. PMID: 21656868 [PubMed - as supplied by publisher] (Source: The Ultrasound Review of Obstetrics and Gynecology)

Patient’s Preference for Examination of the Large Intestine With Double Contrast Barium Enema or Computed Tomography Colonography

Journal of Radiology Nursing — Tue, 31 May 2011 23:00:00 +0100

Abstract: The aim of this study was to compare Double Contrast Barium Enema (DCBE) and Computed Tomography Colonography (CT Colon) from the patient’s perspective. The study population composed of 100 patients aged 18 years or older who underwent CT Colon (n=50) or a DCBE (n=50). A 10-point questionnaire was distributed after each procedure. Responses were compared using the Mann-Whitney test, Fisher’s exact test, and Spearman’s correlation test. When compared with male patients, female patients showed a preference for female radiographers. This showed a statistically significant difference where p (Source: Journal of Radiology Nursing)

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Patient acceptability of CT colonography compared with double contrast barium enema: results from a multicentre randomised controlled trial of symptomatic patients

European Radiology — Mon, 30 May 2011 16:52:30 +0100

Conclusion CTC is associated with significant improvements in patient experience. These data support the case for CTC to replace BE. Content Type Journal ArticlePages 1-10DOI 10.1007/s00330-011-2154-yAuthors Christian von Wagner, Department of Epidemiology and Public Health, University College London, London, UKSamuel Smith, Department of Epidemiology and Public Health, University College London, London, UKSteve Halligan, Centre for Medical Imaging, University College London, London, UKAlex Ghanouni, Department of Epidemiology and Public Health, University College London, London, UKEmily Power, Department of Epidemiology and Public Health, University College London, London, UKRichard J. Lilford, Department of Epidemiology, Birmingham University, Birmingham, UKDion Morto...

Transabdominal subcostal approach in surgical management of Morgagni hernia [Original articles]

European Journal of Cardio-Thoracic Surgery — Mon, 23 May 2011 23:00:00 +0100

Conclusion: We recommend the transabdominal subcostal approach in patients with Morgagni hernia for surgical exposure, easy repair of the hernia sac, and low morbidity. (Source: European Journal of Cardio-Thoracic Surgery)

Density of CD4(+) and CD8(+) T lymphocytes in biopsy samples can be a predictor of pathological response to chemoradiotherapy (CRT) for rectal cancer

Radiation Oncology — Sun, 15 May 2011 23:00:00 +0100

Conclusions: In RC patients, T lymphocyte-mediated immune reactions play an important role in tumor response to CRT, and the quantitative measurement of TIL in biopsy samples before CRT can be used as a predictor of the clinical effectiveness of CRT for advanced RC. (Source: Radiation Oncology)

Determination of the minimal essential serum folate concentration for reduced risk of colorectal adenoma

Clinical Nutrition — Tue, 10 May 2011 04:00:00 +0100

Conclusion: Patients with serum folate concentrations above 8.0 ng/ml had the lowest risk of developing colorectal adenoma. (Source: Clinical Nutrition)

An Infant With Yellow Umbilical Drainage

Gastroenterology — Mon, 25 Apr 2011 23:00:00 +0100

Question: A 2-week-old, full-term boy was seen in the clinic with a 3-day history of yellow colored drainage coming from the umbilicus. He was initially seen by his pediatrician and subsequently referred to the tertiary hospital owing to the great concern for drainage noted from the umbilicus. He presented with no recent history of fever, rash, increased fussiness, lethargy, or signs of inflammation around the umbilicus. He was feeding well and seemed appropriate for his age. He did have other congenital anomalies, including mid cleft lip and palate and malformed ears. Physical examination revealed an alert, active, and well-developed infant. He weighed 3.54 kg (∼30th percentile), height 49.0 cm (∼20th percentile), and the head circumference was 34 cm (∼10th percentile). Vital signs ...

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Biliary-Colonic Fistula

Clinical Gastroenterology and Hepatology — Mon, 25 Apr 2011 04:00:00 +0100

An 88-year-old man presented to the surgical clinic with a 2-month history of diarrhea, weight loss, and early satiety. He had a background history of prostate carcinoma and had regular renal dialysis for idiopathic chronic renal failure. He had no previous abdominal surgery. He was cachectic but not jaundiced. Abdominal and digital rectal examination was unremarkable. He was found to have normocytic anemia (hemoglobin: 8.5 g/dL, mean cell volume: 97.7 fL) and an isolated rise in alkaline phosphatase (224 IU/L). The remaining serum liver function tests were within normal limits. Gastroscopy showed inflammation in the second part of the duodenum. On barium enema examination, there was free flow of contrast from the hepatic flexure of colon into the biliary tree demonstrating a biliary-colon...

An Uncommon Cause of Obstipation

Gastroenterology — Sun, 27 Mar 2011 23:00:00 +0100

Question: A 16-year-old boy with a history of multiple post-traumatic keloids was investigated for a 1-week history of generalized abdominal pain, increased abdominal distention, and obstipation. Physical examination was remarkable only for mild, diffuse abdominal distention and tenderness with no masses on rectal examination. Laboratory tests were unremarkable. An abdominal x-ray revealed dilated loops of small and large bowel with air–fluid levels. A double-contrast barium enema revealed a short segment of severe circumferential narrowing at the recto-sigmoid junction with mucosal abnormalities (). Subsequent abdominal magnetic resonance imaging confirmed the presence of a mass-like circumferential lesion at the recto-sigmoid junction with extension into the soft tissues anterior to th...

Role of CT colonography in symptomatic assessment, surveillance and screening

International Journal of Colorectal Disease — Sat, 19 Mar 2011 02:51:16 +0100

Conclusions The emergence of CTC could soon entirely obviate the need for barium enema. CTC now has a complementary role alongside colonoscopy in symptomatic patients and a possible future role in colorectal cancer screening in the UK. Content Type Journal ArticlePages 1-8DOI 10.1007/s00384-011-1178-8Authors L. Maximilian Almond, Department of Colorectal Surgery, Heart of England NHS Foundation Trust, Birmingham, Birmingham, UKDouglas M. Bowley, Department of Colorectal Surgery, Heart of England NHS Foundation Trust, Birmingham, Birmingham, UKSharad S. Karandikar, Department of Colorectal Surgery, Heart of England NHS Foundation Trust, Birmingham, Birmingham, UKShuvro H. Roy-Choudhury, Department of Radiology, Heart of England NHS Foundation Trust, Birmingham, Birmin...

Gastrointestinal Image: A True Giant Transverse Colon Diverticulum

Journal of Gastrointestinal Surgery — Mon, 14 Mar 2011 16:58:10 +0100

We report a case of a 22-year-old woman presenting with constipation and meteorism from childhood. A plain abdominal X-ray showed a round radiolucent air-filled cyst. Barium enema revealed a single, large diverticulum of the transverse colon. An extended right hemicolectomy with primary end-to-end anastomosis was performed. The postoperative course was uneventful, and she was discharged in 1 week without any complications. Histopathology showed a true diverticulum containing all layers of the colon. Content Type Journal ArticlePages 1-3DOI 10.1007/s11605-011-1462-5Authors Marek Olakowski, Department of Digestive Tract Surgery, Medical University of Silesia, Medyków 14 St, 40-752 Katowice, PolandBeata Jabłońska, Department of Digestive Tract Surgery, Medical Universit...

Strategies in screening for colon carcinoma.

The Netherlands Journal of Medicine — Tue, 01 Mar 2011 00:00:00 +0100

Authors: de Wijkerslooth TR, Bossuyt PM, Dekker E Colorectal cancer is the second most common cancer in Europe and meets the criteria for population screening. Population screening should lead to a reduction in CRC-related mortality and incidence. Several options are available for CRC screening, which can be itemised as stool-based tests and structural exams. Stool-based tests include guaiac and immunochemical faecal occult blood tests and DNA -marker tests. Structural exams comprise endoscopic techniques (flexible sigmoidoscopy, colonoscopy and capsule endoscopy) and radiological exams (double contrast barium enema, CT colonography and MR colonography). Each test has its own test performance characteristics and acceptability profile, which affect the participation and effectiveness of...

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Ward rounds: missed learning opportunities in diagnostic changes?

The Clinical Teacher — Thu, 17 Feb 2011 22:10:28 +0100

Conclusions: The rate of incorrect diagnoses by on‐call surgical juniors is high, and educational feedback to these doctors is important. The PTWR represents a strong educational opportunity that is missed if admitting junior doctors are not present. These results should be taken into account for any specialty that uses junior doctors to admit patients who are then reviewed by a consultant on a PTWR. (Source: The Clinical Teacher)

Long‐term follow up of abdominal rectosigmoidectomy with posterior end‐to‐side stapled anastomosis for Chagas megacolon

Colorectal Disease — Mon, 14 Feb 2011 18:26:27 +0100

Conclusion Minimal 10‐year follow up of RPESA showed excellent functional results, with no recurrence of constipation. (Source: Colorectal Disease)

Lack of Follow-up After Fecal Occult Blood Testing in Older Adults: Inappropriate Screening or Failure to Follow Up? [Original Investigation]

Archives of Internal Medicine — Mon, 14 Feb 2011 00:00:00 +0100

Conclusions While follow-up after positive FOBT results was low regardless of age or comorbidity, screening patients in whom complete evaluation would not be pursued substantially contributes to lack of follow-up. Efforts to improve follow-up should address the full chain of decision making, including decisions to screen and decisions to follow up. (Source: Archives of Internal Medicine)

Therapeutic High-Density Barium Enema in a Case of Presumed Diverticular Hemorrhage

Karger Publishers — Thu, 03 Feb 2011 15:10:34 +0100

Case Rep Gastroenterol 2011;5:88–94 (DOI:10.1159/000322911) (Source: Karger Publishers)

Malignant fibrous histiocytoma originating from the mesorectum: A case report.

World Journal of Surgical Oncology — Wed, 02 Feb 2011 00:00:00 +0100

Conclusion: This patient has survived without recurrence, for approximately 8 years since the completed tumor resection. It is important to obtain a complete resection during the MFH treatment. (Source: World Journal of Surgical Oncology)

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Experience with a wipe guaiac-based faecal occult blood test as an alternative test in a bowel screening programme

Journal of Medical Screening — Sun, 23 Jan 2011 00:00:00 +0100

The format of the traditional guaiac faecal occult blood test (gFOBT), particularly the collection technique, might cause difficulties for some. A multistage evaluation of alternative tests was performed. Firstly, four tests with different faecal collection approaches were assessed: a focus group recommended further investigation of a wipe gFOBT. Secondly, 100 faecal samples were analysed using two wipe tests and the routine gFOBT: no differences were found. Thirdly, a wipe gFOBT was introduced. Over 21 months, 400 requests were made and 311 wipe kit sets were submitted for analysis: 153 (49.2%) were negative, 21 (6.8%) positive (all 3 kits positive), 96 (30.9%) weak positive (1 or 2 positive) and 41 (13.2%) un-testable. Forty-three participants were referred for colonoscopy. Outcome data ...

Uncomplicated diverticular disease is not a common cause of colonic symptoms

Alimentary Pharmacology and Therapeutics — Sun, 19 Dec 2010 17:05:56 +0100

Conclusion Uncomplicated colonic diverticular disease is not a common cause of colonic symptoms among patients in secondary care. (Source: Alimentary Pharmacology and Therapeutics)

Laparoscopic versus open abdominoperineal rectoplasty for infants with high-type anorectal malformation

Journal of Pediatric Surgery — Wed, 01 Dec 2010 00:00:00 +0100

Conclusion: Benefits of the laparoscopic approach were reduced intraoperative bleeding and a lower incidence of postoperative anal mucosal prolapse. These results indicate that minimal dissection of the mesorectum in laparoscopic ARP may provide those better outcomes. (Source: Journal of Pediatric Surgery)

Comparison of anorectal angle and continence after Georgeson and Peña procedures for high/intermediate imperforate anus

Journal of Pediatric Surgery — Wed, 01 Dec 2010 00:00:00 +0100

Conclusions: We are the first to confirm that effective AA similar to PSARP can be achieved after GPT, although FCEQ would suggest that GPT has less detrimental functional impact. (Source: Journal of Pediatric Surgery)

Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer

Mon, 29 Nov 2010 14:16:24 +0100

Bibliographic detailsOlde Bekkink M, McCowan C, Falk GA, Teljeur C, Van de Laar FA, Fahey T. Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer. British Journal of Cancer 2010; 102(1): 48-58StatusThis record is a structured abstract produced by CRD. The original has met a set of quality criteria. Since September 1996 abstracts have been sent to authors for comment. Additional factual information is incorporated into the record. Noted as [A:....].CRD summaryThis review concluded that no individual symptom, sign or diagnostic test in patients with rectal bleeding was likely to conclusively raise probability of colorectal cancer in primary care settings. Even conventionally stated ‘red flag' sympt...

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Using VA administrative data to measure colorectal cancer screening adherence among average-risk non-elderly veterans

Health Services and Outcomes Research Methodology — Mon, 15 Nov 2010 18:17:40 +0100

This study represents a new application of Veterans Affairs (VA) administrative data for measuring VA system-wide performance of colorectal cancer (CRC) screening adherence among veterans at average-risk for CRC. Our new measurement has two features: it is specifically designed for average-risk populations and is applied repeatedly at the veteran level each year over the study period. Using 1997–2007 VA administrative data, we developed an algorithm that first constructed 7 independent cohorts of average-risk veterans eligible for CRC screening, one for each year from 2001 to 2007, and then appended the seven cohorts together to form 2001–2007 veteran-level panel data. Veterans in a cohort for a given year were considered adherent if they received fecal occult blood test (FOBT) d...

A rare endoscopic finding of GI stromal tumor

Gastrointestinal Endoscopy — Mon, 15 Nov 2010 00:00:00 +0100

A 75-year-old woman presented with bloody stools and intermittent abdominal cramping pain for 1 week. Physical examination and laboratory study results were unremarkable except for pale conjunctiva and a hemoglobin of 10.1 g/dL. EGD revealed a scarred ulcer in the stomach, and colonoscopy disclosed a fungating mass 25 cm proximal to the anal verge that was oozing blood and had an obvious orifice in the colonic wall (). Contrast-enhanced CT of the abdomen revealed a thickened colon wall with amorphous calcification and fistula tract formation in the left lower abdomen (, arrows). A double-contrast barium enema showed a narrowed segment of sigmoid colon with a fistula tract to the ileum (, arrowheads). The patient underwent a laparoscopic lower anterior resection, which confirmed a 5 cm annu...

Case of the Month #167: Intrauterine Contraceptive Device Migration to the Descending Sigmoid Colon After Uterine Perforation

Canadian Association of Radiologists Journal — Sat, 13 Nov 2010 10:39:30 +0100

A 38-year-old woman presented with a 10-month history of a change in bowel habits and abdominal pain. She described alternating constipation and diarrhoea, with bilateral abdominal cramping in the lower abdominal quadrants. Pain was especially noticeable before bowel movements and was alleviated with the passage of stool. There was no reported blood or mucous in the stool, and no fevers, chills, or night sweats. Her medical history was noncontributory, and there was no family history of colon cancer, polyps, or inflammatory bowel diseases. On physical examination, there was mild tenderness over the left lower quadrant. An air contrast barium enema was conducted (), which prompted a follow-up colonoscopy. Despite a benign colonoscopy and biopsy, 1 year later, because of persisting symptoms,...

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Chagas disease in Latin American migrants. A Spanish challenge.

Clinical Microbiology and Infection — Sat, 13 Nov 2010 00:00:00 +0100

AbstractChagas′ disease affects millions in Latin‐America and is the leading cause of cardiomyopathy and death due to cardiovascular disease in patients aged 30‐50 years. As a consequence of immigration it has settled in several European countries, where besides imported cases, autochthonous infections arise through vertical transmission and blood/organ donation.All Latin‐American immigrants attended at our Unit were screened for T. cruzi infection (ELISA and IFAT +/‐ PCR). An ECG and echocardiogram were requested for all positive patients, and esophageal manometry, barium swallow and barium enema were requested according to patient symptoms. All patients under 50 years, without severe cardiac involvement and who had not received correct treatment previously were treated with ben...

Chagas disease in Latin American migrants: a Spanish challenge

Clinical Microbiology and Infection — Sat, 13 Nov 2010 00:00:00 +0100

Clin Microbiol InfectAbstractChagas’ disease affects millions in Latin America and is the leading cause of cardiomyopathy and death due to cardiovascular disease in patients aged 30–50 years. As a consequence of immigration it has settled in several European countries, where besides imported cases, autochthonous infections arise through vertical transmission and blood/organ donation. All Latin American immigrants who attended our Unit were screened for T. cruzi infection (ELISA and IFAT ± PCR). An ECG and echocardiogram were requested for all positive patients, and oesophageal manometry, barium swallow and barium enema were requested according to patient symptoms. All patients under 50 years without severe cardiac involvement and who had not received correct treatment previou...

Clinical features’ diagnostics and treatment of Hirschsprung’s disease in adults

Colorectal Disease — Fri, 12 Nov 2010 05:06:55 +0100

Conclusion Occasionally, Hirschsprung’s disease presents in adulthood, with ongoing symptoms from early childhood or with the development of functional obstruction, faecal impaction and megacolon in later life. Diagnosis often requires multimodal investigation. A 60 mm full‐thickness strip biopsy confirms aganglionosis in 100%. A modified Duhamel procedure is the operation of choice. (Source: Colorectal Disease)

Colocolonic Intussusception With a Leading Point

Clinical Gastroenterology and Hepatology — Wed, 10 Nov 2010 00:00:00 +0100

A 47-year-old woman with uncomplicated medical history presented to our hospital with abdominal pain near the umbilicus. Physical examination showed no significant findings except mild tenderness near the umbilicus. Laboratory studies included complete blood count, electrolytes, and tumor markers, which were within normal range. The computed tomography scan showed colocolonic intussusception at the transverse colon, with a large intraluminal fat-containing mass as the leading point (). A double contrast barium enema showed a large intraluminal pedunculated mass with a smooth surface (). Additional colonoscopy revealed a huge hyperemic mass that occupied the lumen of transverse colon with central erosive region. The patient underwent a laparoscopic left hemicolectomy. A 6 × 5 × 4 cm yello...

Transanal repair for treatment of rectocele in obstructed defecation: manual or stapled

Colorectal Disease — Mon, 01 Nov 2010 00:00:00 +0100

CONCLUSION: Transanal repair of rectocele is safe and effective technique in improving symptomatic rectocele. Stapled repair offers the advantage of short operative time, no comorbidity, and shorter hospital stay. (Source: Colorectal Disease)

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Management of recurrent intussusception: nonoperative or operative reduction?

Journal of Pediatric Surgery — Fri, 29 Oct 2010 22:28:21 +0100

Conclusions: Recurrent intussusception should be initially treated by nonoperative reduction. Laparotomy is needed in cases with failure of BE or AE reduction, in cases with suspicion of a pathologic lead point, and in selected cases with several episodes of recurrence. The treatment of recurrent intussusception, in general, should be similar to that of primary intussusception. (Source: Journal of Pediatric Surgery)

Evaluation of Findings in Patients Undergoing Colonoscopy or Flexible Sigmoidoscopy Following Abnormal Barium Enema: The Implication of Possible Versus Definite Lesions Reported on Barium Enemas

International Journal of Surgery — Tue, 26 Oct 2010 07:49:47 +0100

The objective of this audit was to determine if CE following BE yielded enough pathologies to justify CE without further review of the BE. (Source: International Journal of Surgery)

Barium Enema – An Obsolete Test in Colon Cancer Imaging?

International Journal of Surgery — Tue, 26 Oct 2010 07:49:47 +0100

This study compares the localisation accuracy of three colon imaging tests with operative findings. (Source: International Journal of Surgery)

Solitary rectal ulcer syndrome mimicking rectal neoplasm on MRI.

The British Journal of Radiology — Tue, 26 Oct 2010 05:01:22 +0100

Authors: Amaechi I, Papagrigoriadis S, Hizbullah S, Ryan SM Solitary rectal ulcer syndrome (SRUS) is a rare condition that typically affects young adults and describes a spectrum of clinicopathological abnormalities. The diagnosis of SRUS is usually made on the basis of a combination of presenting symptoms and endoscopic and histological appearances. Characteristic radiological appearances have been described on transrectal and endoanal ultrasound, defecating proctography and barium enema. The radiological appearance of solitary rectal ulcer on MRI has not been previously described. MRI appearance of thickened ulcerated mucosa in the anterior rectal wall are non-specific and was indistinguishable from a malignant process. However, given that solitary rectal ulcer has a pre-disposition ...

BAROBAG ENEMA KIT (Barium Sulfate) Powder, For Suspension [Mallinckrodt Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 26 Oct 2010 05:00:00 +0100

Updated Date: Oct 26, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

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Non-laxative CT colonography with barium-based faecal tagging: is additional phosphate enema beneficial and well tolerated?

The British Journal of Radiology — Mon, 18 Oct 2010 23:00:00 +0100

In conclusion, phosphate enema use prior to non-laxative CTC leads to greater retained fluid reducing diagnostic confidence and is not recommended. PMID: 20959374 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)

Are Physicians’ Recommendations For Colorectal Cancer Screening Guideline-Consistent?

Journal of General Internal Medicine — Sun, 17 Oct 2010 18:53:57 +0100

CONCLUSIONS Physicians’ CRC screening recommendations reflect both overuse and underuse, and few made guideline-consistent CRC screening recommendations across all modalities they recommended. Interventions that focus on potentially modifiable physician and practice factors that influence overuse and underuse and address the menu of recommended screening modalities will be important for improving screening practice. Content Type Journal ArticleDOI 10.1007/s11606-010-1516-5Authors K. Robin Yabroff, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD USACarrie N. Klabunde, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD USAGigi Yuan, Information Management Services, Inc., Rockville,...

Lack of Follow-up After Fecal Occult Blood Testing in Older Adults: Inappropriate Screening or Failure to Follow Up? [Original Investigation]

Archives of Internal Medicine — Mon, 11 Oct 2010 19:42:06 +0100

Conclusions While follow-up after positive FOBT results was low regardless of age or comorbidity, screening patients in whom complete evaluation would not be pursued substantially contributes to lack of follow-up. Efforts to improve follow-up should address the full chain of decision-making, including decisions to screen and decisions to follow up. (Source: Archives of Internal Medicine)

Successful management of cholecystocolic fistula by endoscopic retrograde cholangiopancreatography: a report of two cases.

Hong Kong Med J — Thu, 30 Sep 2010 23:00:00 +0100

We report on two patients with cholecystocolic fistula presenting with severe diarrhoea. They were treated successfully by endoscopic retrograde cholangiopancreatography. PMID: 20890009 [PubMed - in process] (Source: Hong Kong Med J)

Acute Low Back Pain in an Elderly Woman

The Journal of Emergency Medicine — Tue, 07 Sep 2010 04:00:00 +0100

A 79-year-old woman presented to the Emergency Department (ED) with a 3-week history of moderate lumbar pain and fever. Her past medical history was significant for hypertension. Physical examination revealed body temperature of 38.5°C, pain under pressure and extension of the lumbar spine, positive psoas maneuver, and negative Lasègue sign (flexion of the hip is painful when the knee is extended, but painless when the knee is flexed). Neurological examination was normal. Laboratory results showed leukocytes 107 × 109/L (85% neutrophils), erythrocyte sedimentation rate 103 mm/hour, and C-reactive protein 14 mg/dL. Basic biochemistry of blood and urine was normal. Urine culture was negative. Lumbar magnetic resonance image revealed infective spondylodiscitis signs at the L2–L4 level, w...

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ACR Appropriateness Criteria® on Colorectal Cancer Screening

Journal of the American College of Radiology : JACR — Tue, 31 Aug 2010 23:00:00 +0100

Colorectal cancer remains one of the most common causes of cancer death in this country. This malignancy is ideally suited for screening because the detection and removal of the precursor adenomatous polyp can prevent most colorectal cancers from ever forming. The choice of a test for screening involves consideration of various individual parameters, including patient age and the presence of risk factors for the development of colorectal cancer. Computed tomographic colonography (CTC) has emerged as the leading imaging technique for colorectal cancer screening in average-risk individuals on the basis of the evidence presented in this paper. The double-contrast barium enema is an alternative imaging test that is appropriate particularly when CTC is not available. In 2008, the American Cance...

Crohn's disease and enterovesical fistulae: common things are common.

British Journal of Hospital Medicine — Tue, 31 Aug 2010 23:00:00 +0100

Authors: Randall DD, Tittle DV, Wright DG, Blanshard DC Enterovesical fistulae can form between any segment of bowel in the pelvis (e.g. colon, ileum) and the bladder or ureter. They are most commonly associated with colonic diverticula (50-70%), cancer, Crohn's disease, radiotherapy and trauma (Kovalcik et al, 1976; Pollard et al, 1987). They frequently present with recurrent urinary tract infections, faecaluria, pneumaturia and haematuria; sepsis or gastrointestinal symptoms are rare (unless associated with Crohn's disease). Pneumaturia and faecaluria occur in approximately 80-90% of cases (Pollard et al, 1987; Garcea et al, 2006). Gouverneur's syndrome, which describes suprapubic pain, frequency, dysuria and tenesmus, is related to enterovesical fistula. Cystoscopy is the best inves...

Colorectal cancer screening: The role of CT colonography.

World Journal of Gastroenterology : WJG — Thu, 26 Aug 2010 23:07:25 +0100

Authors: Laghi A, Iafrate F, Rengo M, Hassan C Computed tomography colonography (CTC) in colorectal cancer (CRC) screening has two roles: one present and the other potential. The present role is, without any further discussion, the integration into established screening programs as a replacement for barium enema in the case of incomplete colonoscopy. The potential role is the use of CTC as a first-line screening method together with Fecal Occult Blood Test, sigmoidoscopy and colonoscopy. However, despite the fact that CTC has been officially endorsed for CRC screening of average-risk individuals by different scientific societies including the American Cancer Society, the American College of Radiology, and the US Multisociety Task Force on Colorectal Cancer, other entities, such as the ...

Unusual nontuberculous mycobacterium infection of the rectum

Gastrointestinal Endoscopy — Thu, 05 Aug 2010 00:00:00 +0100

A 70-year-old Japanese woman was admitted for rectal bleeding and tenesmus. She had no respiratory symptoms or history of rectal trauma and was immunocompetent. Her abdomen was soft and nontender. Laboratory testing revealed mild leukocytosis, the absence of anemia, normal complement levels, and normal liver biochemical test results. The HIV test result was negative. A barium enema demonstrated a markedly nodular rectal stenosis that measured 15 cm in length (); each nodule was 5 to 10 mm in diameter. A positron emission tomography-CT scan identified a “hot” lesion in the rectum, and a colonoscopy showed a nodular polypoid mass 8 cm above the dentate line through which the colonoscope could not be passed (). Magnification endoscopy showed a regular, round-pit pattern. EUS demonstrated ...

Should barium enema be the next step following an incomplete colonoscopy?

International Journal of Colorectal Disease — Fri, 23 Jul 2010 12:25:07 +0100

Conclusion The rate of incomplete colonoscopy in a high-volume modern endoscopy unit is extremely low. DCBE following incomplete colonoscopy has limited value. A repeat colonoscopy under deeper sedation and/or better bowel preparation may be the preferred next step. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-010-1014-6Authors Kevin T. Kao, Kaiser Permanente Los Angeles Medical Center Department of Gastroenterology Los Angeles CA USAMichael Tam, Kaiser Permanente Los Angeles Medical Center Department of Surgery Los Angeles CA USAHarpreet Sekhon, Kaiser Permanente Los Angeles Medical Center Department of Gastroenterology Los Angeles CA USARanjith Wijeratne, Kaiser Permanente Los Angeles Medical Center Department of Gastroenterology Los Ange...

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BAROBAG ENEMA KIT (Barium Sulfate) Powder, For Suspension [Mallinckrodt Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Tue, 20 Jul 2010 05:00:00 +0100

Updated Date: Jul 20, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Factors associated with the intention to have colorectal cancer screening in Korean adults

European Journal of Cancer Care — Tue, 13 Jul 2010 23:00:00 +0100

HAN M.A., CHOI K.S., JUN J.K., KIM Y., PARK E.-C. & LEE H.-Y. (2010) European Journal of Cancer CareFactors associated with the intention to have colorectal cancer screening in Korean adults The purpose of this study was to investigate the factors related to screening intention in a population-based screening programme for colorectal cancer. The data were taken from the 2008 Korean National Cancer Screening Survey. We conducted a nationwide survey with trained interviewers using a questionnaire. A total of 2038 participants agreed to answer the survey. There were 955 study subjects aged [ge]50 years in the target age group for colorectal cancer screening. Colorectal cancer screening behaviour and demographic characteristics were collected to evaluate intention for colorectal cancer screeni...

Rectal endometriosis masquerading as dissemination in a patient with rectal cancer: Report of a case

Surgery Today — Sat, 26 Jun 2010 16:05:54 +0100

Abstract A 57-year-old woman was diagnosed as having rectal cancer. A barium enema study showed the apple-core sign at the rectosigmoid colon, and colonoscopy revealed an encircled ulcerated tumor. A laparoscope-assisted resection of the rectum was planned; however, the rectal cancer directly invaded the uterus body. The operation was converted to open surgery. An elastic hard tumor suspected of being peritoneal dissemination at the peritoneal reflection was detected and excised together with the rectum below the peritoneal reflection. A histological examination of this tumor revealed that cystic glands lined by nonmucinous columnar epithelial cells were seen on the serosal side and were embedded in the proper muscle of the rectum. This tumorous lesion was diagnosed as end...

1.5:1 Meshed AlloDerm Bolsters for Stapled Rectal Anastomoses Does Not Provide Any Advantage in Anastomotic Strength in a Porcine Model.

Surgical Innovation — Thu, 10 Jun 2010 23:00:00 +0100

CONCLUSIONS: The routine use of 1.5:1 meshed AlloDerm sandwich bolsters in stapled rectal anastomosis does not confer any detectable advantage in anastomotic strength. Further studies are needed to determine equivalence to traditional stapled anastomoses. PMID: 20542954 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

Essential pre-treatment imaging examinations in patients with endoscopically-diagnosed early gastric cancer

BMC Medical Informatics and Decision Making - Latest articles — Tue, 08 Jun 2010 23:00:00 +0100

Conclusions: US, BE and CR may be essential as pre-treatment imaging examinations because they occasionally detect findings which affect treatment indication and strategy, although abdominal contrast-enhanced CT rarely provide additional information. (Source: BMC Medical Informatics and Decision Making - Latest articles)

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Clinical experience with a new modified transanal endorectal pull-through for Hirschsprung’s disease

Pediatric Surgery International — Mon, 07 Jun 2010 17:08:36 +0100

Abstract Single-stage transanal endorectal pull-through (TEPT) procedure is now widely used for rectosigmoid Hirschsprung’s disease (HD). However, this procedure is associated with some common complications like stricture, enterocolitis, constipation, anastomotic dehiscence and perianal excoriation. The aim of this study was to evaluate the clinical outcomes of a modified TEPT operation in the management of rectosigmoid HD. 45 patients with rectosigmoid HD admitted between August, 2004 and July, 2008 were included in this study. Pre-operative barium enema was done in all of them. Patients in whom the transition zone was well delineated were included in the study. Frozen section biopsy was done to confirm the presence of ganglion cells in the pull-through bowel. All odd n...

Effectiveness of high dose barium enema filling for colonic diverticular bleeding

Colorectal Disease — Mon, 31 May 2010 23:00:00 +0100

(Source: Colorectal Disease)

Computed tomographic colonography in the diagnosis of colorectal cancer

British Journal of Surgery — Thu, 13 May 2010 23:00:00 +0100

This study aimed to determine the sensitivity of computed tomographic colonography (CTC) in diagnosing colorectal cancer and to explore the reasons why these cancers are missed on CTC.Patients who underwent CTC in the 56-month period from 1 January 2004 to 1 September 2008, and all cases of colorectal cancer recorded in the National Cancer Registry database from 1 January 2004 to 1 December 2008, were identified. Cases from the two data sets were then matched to identify all patients in whom CTC had been performed more than 6 weeks before a histological report was available. CTC reports and patients' records were reviewed to determine the cancer site, and images were reviewed.A total of 3888 patients underwent CTC over a 56-month interval. After matching with the National Cancer Registry d...

Colonic perforation in collagenous colitis: a systematic review of a rare complication and guidance on management

Surgical Endoscopy — Thu, 13 May 2010 08:47:49 +0100

Conclusions Conservative management of collagenous colitis-related perforation seems to be an appropriate initial approach. However, diagnosis of collagenous colitis is usually retrospective in colonic perforations related to endoscopy or barium enema, i.e. when the histology results are available, and it seems difficult to provide a management plan specific to these patients in the clinical setting. Therefore general guidelines for management of all colonoscopy- and barium enema-related perforation are required. When perforation occurs in an otherwise intact colon, diagnostic laparoscopy can be considered as appropriate initial management. Content Type Journal ArticleCategory ReviewDOI 10.1007/s00464-010-1086-yAuthors Z. Hussain, York Hospitals NHS Foundation Tru...

Effectiveness of the Immunofecal Occult Blood Test for Colorectal Cancer Screening in a Large Population

Digestive Diseases and Sciences — Tue, 11 May 2010 08:13:14 +0100

Conclusion Regular IFOBT can detect precancerous lesions and CRC in early stages and can thus reduce mortality from CRC. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-010-1264-8Authors Haiyun Yang, Shanghai Jiao Tong University School of Medicine Department of Gastroenterology, Renji Hospital, Shanghai Institute of Digestive Disease Shanghai 200001 ChinaZhizheng Ge, Shanghai Jiao Tong University School of Medicine Department of Gastroenterology, Renji Hospital, Shanghai Institute of Digestive Disease Shanghai 200001 ChinaJun Dai, Shanghai Jiao Tong University School of Medicine Department of Gastroenterology, Renji Hospital, Shanghai Institute of Digestive Disease Shanghai 200001 ChinaXiaobo Li, Shanghai Jiao Tong University School of Medicine ...

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Dose optimisation of double-contrast barium enema examinations

Radiation Protection Dosimetry — Mon, 10 May 2010 09:09:57 +0100

The purpose of the present work was to optimise the filtration and dose setting for double-contrast barium enema examinations using a Philips MultiDiagnost Eleva FD system. A phantom study was performed prior to a patient study. A CDRAD phantom was used in a study where copper and aluminium filtration, different detector doses and tube potentials were examined. The image quality was evaluated using the software CDRAD Analyser and the phantom dose was determined using the Monte Carlo-based software PCXMC. The original setting [100 % detector dose (660 nGy air kerma) and a total filtration of 3.5 mm Al, at 81 kVp] and two other settings identified by the phantom study (100 % detector dose and additional filtration of 1 mm Al and 0.2 mm Cu as well as 80 % detector dose and added filtration of...

Endoscopic rendezvous for complete colonic obstruction

The Digital Atlas of Video Education - Gastroenterology — Mon, 03 May 2010 16:05:13 +0100

A 50 year old man has a past medical history of bilateral congenital glaucoma causing him to be legally blind and metastatic rectal cancer to the liver. The patient's cancer was diagnosed because he had developed rectal obstruction. As a result, he underwent a diverting transverse loop colostomy. The patient had difficulty managing his ostomy because of his blindness. He requested resection of his rectal tumor in order to reverse his colostomy. Sixteen months after his previous surgery, he underwent a low anterior resection, reversal of his colostomy, and creation of a temporary loop ileostomy. Six months later, a barium enema was performed prior to his ileostomy takedown and the barium enema showed a widely patent rectal anastomosis. The patient was brought to the operating room...

[Congenital stenosis of the colon with foreign bodies. Case report.]

Cirugia y Cirujanos — Fri, 30 Apr 2010 23:00:00 +0100

Conclusions: Colonic stenosis is uncommon. Abu-Judeh reported on one case and a review of the literature revealed eight cases of congenital colonic stenosis since 1941. Symptoms are abdominal distension, vomiting and constipation with symptom remission, making diagnosis difficult. This is the first report involving foreign bodies. Barium enema and colonoscopy are necessary for diagnosis. Resection of the stenotic segment with end-to-end anastomosis or colostomy is the treatment of choice. Laparoscopy is analternative procedure. PMID: 20642911 [PubMed - in process] (Source: Cirugia y Cirujanos)

Transanal one-stage endorectal pull-through for Hirschsprung disease: experiences with 51 newborn patients

Pediatric Surgery International — Tue, 27 Apr 2010 06:47:25 +0100

Conclusion Our data suggested that TOSEPT is efficacious and safe in the management of newborn with HD. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-010-2599-0Authors Phạm Anh Vũ, Hue College of Medicine and Pharmacy Department of Surgery Hue VietnamHồ Hữu Thiện, Hue Central Hospital Hue VietnamPhạm Như Hiệp, Hue Central Hospital Hue Vietnam Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358 (Source: Pediatric Surgery International)

The interrelationships between and contributions of background, cognitive, and environmental factors to colorectal cancer screening adherence

Cancer Causes and Control — Sat, 24 Apr 2010 08:08:05 +0100

Conclusions Efforts to increase physician screening recommendations for younger, healthy patients at facilities with the lowest screening rates may improve CRC adherence in this setting. Content Type Journal ArticleCategory Original paperDOI 10.1007/s10552-010-9563-0Authors Melissa R. Partin, Minneapolis Veterans Affairs Medical Center Center for Chronic Disease Outcomes Research 1 Veterans Drive (2E/152) Minneapolis MN 55417 USASiamak Noorbaloochi, Minneapolis Veterans Affairs Medical Center Center for Chronic Disease Outcomes Research 1 Veterans Drive (2E/152) Minneapolis MN 55417 USAJoseph Grill, Minneapolis Veterans Affairs Medical Center Center for Chronic Disease Outcomes Research 1 Veterans Drive (2E/152) Minneapolis MN 55417 USADiana J. Burgess, Minneapolis V...

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[Polygonal mosaic-like pattern of the colonic mucosa in cecal volvulus: CT findings.]

Radiologia — Wed, 21 Apr 2010 23:00:00 +0100

We describe the CT findings of this pattern in a case of cecal volvulus. PMID: 20417537 [PubMed - as supplied by publisher] (Source: Radiologia)

Colon ischemia: Respice, adspice, prospice

Surgery — Sun, 18 Apr 2010 23:00:00 +0100

It is for less than 50 years that we have appreciated that colon ischemia (CI) may manifest a wide spectrum of injury, including reversible colopathy (subepithelial hemorrhage and edema), transient colitis, chronic colitis, stricture, gangrene, and fulminant colitis; atypical manifestations include protein-losing colopathy and recurrent sepsis. We have learned to diagnose CI by relatively noninvasive means such as barium enema and colonoscopy, but absent gangrene, we usually struggle to prove the diagnosis beyond reasonable certainty; proof is an especially difficult challenge for early or mild CI. We are only in the infancy of understanding the etiopathogenesis of CI and, hence, its treatment. Fortunately, most patients with CI have an excellent prognosis, and it is unusual for CI to recu...

CT colonography standards

Clinical Radiology — Sun, 04 Apr 2010 23:00:00 +0100

This article summarizes the background, evolution and recommendations of the CT colonography standards document () developed by the International CT Colonography Standards Collaboration, which included highly experienced radiologists, radiographers, gastroenterologists, and screening experts. These standards are intended to guide and support radiology teams across the world by promoting methods for improving the quality of CT colonography technique and the patient experience. (Source: Clinical Radiology)

Preoperative assessment of intestinal endometriosis: a comparison of Transvaginal Sonography with Water-Contrast in the Rectum, Transrectal Sonography, and Barium Enema

Abdominal Imaging — Sat, 03 Apr 2010 07:20:03 +0100

Abstract To evaluate the accuracy of Transrectal Sonography (TRS) and a new technique, Transvaginal Sonography with Water-Contrast in the Rectum (RWC-TVS), in the diagnosis of rectosigmoid endometriosis, and the accuracy of Barium Enema (BE) and RWC-TVS in the detection of intestinal stenosis due to endometriosis. In a prospective study, we compared the findings of TRS and RWC-TVS performed before surgery with the operative and pathologic findings in 61 consecutive patients who underwent laparoscopy or laparotomy for suspected rectosigmoid endometriosis. The accuracy of BE and RWC-TVS in the detection of intestinal stenosis was evaluated comparing the radiologic and ultrasonographic results with the macroscopic findings at surgery and pathology. RWC-TVS diagnosed rectosigm...

Sp276: Endoscopic Rendezvous for Complete Colonic Obstruction

Gastrointestinal Endoscopy — Wed, 31 Mar 2010 23:00:00 +0100

A 50 year old man with metastatic rectal cancer to the liver underwent a diverting transverse loop colostomy due to rectal obstruction. The patient requested resection of his rectal tumor due to difficulty managing his ostomy because of congenital blindness. Sixteen months after his previous surgery, he underwent a low anterior resection, reversal of his transverse colostomy, and creation of a temporary loop ileostomy. Six months later, prior to his ileostomy takedown, a barium enema showed a widely patent rectal anastomosis. The patient was brought to the operating room for closure of his ileostomy. On post-operative day four, the patient developed nausea, vomiting, and abdominal distention. Abdominal imaging revealed a large bowel obstruction. A colonoscopy revealed an obstruction at the...

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CT Colonography: Perforation Rates and Potential Radiation Risks

Gastrointestinal Endoscopy Clinics of North America — Wed, 31 Mar 2010 23:00:00 +0100

Computed tomographic colonography (CTC) has emerged as an alternative screening tool for colorectal cancer due to the potential to provide good efficacy combined with greater acceptability than optical colonoscopy or fecal occult blood testing. However, some organizations have raised concerns about the potential harms, including perforation rates and radiation-related cancer risks, and have not recommended that it currently be used as a screening tool in the general population in the US. In this article the authors review the current evidence for these potential harms from CTC and compare them to the potential harms from the alternatives including colonoscopy and double-contrast barium enema. (Source: Gastrointestinal Endoscopy Clinics of North America)

Left Paraduodenal Hernia Incidentally Diagnosed during Operation for Transverse Colon Cancer.

Journal of Nippon Medical School — Wed, 31 Mar 2010 23:00:00 +0100

We report the case of a patient with paraduodenal hernia diagnosed incidentally during an operation for transverse colon cancer. The patient was a 77-year-old woman who complained of dizziness. Laboratory data revealed no abnormal findings except slight anemia. Barium enema and colonoscopic examination revealed an irregular surfaced mass, about 5.0 cm in size, located near the flexure of the spleen of the transverse colon. A biopsy of the mass was performed, and a moderately differentiated adenocarcinoma was diagnosed. In April 2009, following the diagnosis of transverse colon cancer, laparotomy was performed, which revealed that a few loops of the jejunum were herniated through the orifice into the space posterior to the transverse mesocolon. Moreover, the jejunal loops were located right...

An Official ATS Clinical Policy Statement: Congenital Central Hypoventilation Syndrome: Genetic Basis, Diagnosis, and Management.

Am J Respir Crit Car... — Tue, 09 Mar 2010 16:52:05 +0100

Conclusions: A PHOX2B mutation is required to confirm the diagnosis of CCHS. Knowledge of the specific PHOX2B mutation aids in anticipating the CCHS phenotype severity. Parents of patients with CCHS should be tested for PHOX2B mutations. Maintaining a high index of suspicion in cases of unexplained alveolar hypoventilation will likely identify a higher incidence of milder cases of CCHS. Recommended management options aimed toward maximizing safety and optimizing neurocognitive outcome include: (1) biannual then annual in-hospital comprehensive evaluation with (i) physiologic studies during awake and asleep states to assess ventilatory needs during varying levels of activity and concentration, in all stages of sleep, with spontaneous breathing, and with artificial ventilation, and to assess...

For Best Colon Cancer Screening, Know Your Options

About.com Colon Cancer — Mon, 08 Mar 2010 00:00:00 +0100

Colon cancer screening options run the gamut in terms of accuracy, scientific evidence for effectiveness, amount of the colon examined, the need for sedation, and more. New research shows that having a full understanding of all of the aspects of each type of colon cancer screening method can help people better determine which test meets their needs. Which Tests, Which Outcomes Researchers wanted to find out how people felt about different colon cancer screening methods before and after being educated about thirteen aspects of each test. The colon cancer screening methods studied were: Fecal occult blood testing Flexible sigmoidoscopy Colonoscopy Double-contrast barium enema The aspects of each test that study participants learned about were: Accuracy: How well does the...

Rectosigmoid tubular duplication presenting as perineal sepsis in a neonate

Journal of Pediatric Surgery — Mon, 01 Mar 2010 00:00:00 +0100

We report a case of tubular rectal duplication in a newborn baby who presented with perianal sepsis. The diagnosis was confirmed by barium enema, magnetic resonance imaging, and at operation. We performed total mucosectomy through a posterior sagittal incision combined with laparotomy. The patient was doing quite well at 17-month follow-up examination. (Source: Journal of Pediatric Surgery)

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Informed Decision Making Changes Test Preferences for Colorectal Cancer Screening in a Diverse Population.

Annals of Family Medicine — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: Participants were clear about the attributes that they prefer, but no single test has those attributes. Preferences were varied across participants and were not predictable; clinicians should discuss the full range of recommended tests for colorectal cancer with all patients. PMID: 20212301 [PubMed - as supplied by publisher] (Source: Annals of Family Medicine)

Extensive Work-Up for IBS Rarely Needed

Clinical Psychiatry News — Mon, 01 Mar 2010 00:00:00 +0100

LAKE BUENA VISTA, FLA. — An extensive work-up that includes tests such as colonoscopy should generally be avoided for patients suspected of having irritable bowel syndrome. Only when there are atypical or alarming symptoms such as fever, anemia, hematochezia, or a family history of colon cancer should an extensive diagnostic work-up including colonoscopy or barium enema be undertaken, according to Dr. Georgine M. Lamvu. (Source: Clinical Psychiatry News)

Laparoscopic extensive colectomy with transanal Soave pull-through for intestinal neuronal dysplasia in 17 children.

World Journal of Pediatrics : WJP — Mon, 01 Feb 2010 00:00:00 +0100

CONCLUSIONS: Laparoscopic procedure for left colectomy and subtotal colectomy with transanal Soave pull-through in infants and children with IND is safe, feasible, and effective. The location of barium stagnation in proximal margin may be used as a method to predict initially the proximal margin of the resected bowel segment. PMID: 20143211 [PubMed - in process] (Source: World Journal of Pediatrics : WJP)

Functional outcome after Swenson's operation for Hirshsprung's disease

The Saudi Journal of Gastroenterology — Fri, 08 Jan 2010 14:17:48 +0100

Conclusion:</b><i> </i>Anorectal manometry is a more reliable method for diagnosis of HD than barium enema X-ray but for final diagnosis, it is reasonable to combine anorectal manometry with tissue biopsy. Functional outcome after Swenson's operation for HD may improve in some patients complaining of incontinence or constipation. Anorectal manometry may show improvement of the parameters after Swenson's operation. (Source: The Saudi Journal of Gastroenterology)

Latest updates to the CRD databases

Fri, 08 Jan 2010 13:49:25 +0100

The following resources were added to the databases from the Centre for Reviews and Dissemination during December: Added to DARE (these records are structured abstracts for published systematic reviews and meta-analyses): A systematic review on the timing of artificial nutrition in acute pancreatitis Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to prevalence of disease Critical analysis of the performance of double-contrast barium enema for detecting colorectal polyps > or = 6 mm in the era of CT colonography Early endoscopic retrograde cholangiopancreatography versus conservative management in acute biliary pancreatitis without cholangitis: a meta-analysis of randomized trials Early versus delayed feeding after placement of a p...

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Re-appraisal of clinical usefulness of67Ga-citrate scintigraphy for primary colorectal carcinoma: with evaluation of scintigram obtained from resected specimens

Annals of Nuclear Medicine — Sat, 12 Dec 2009 14:22:49 +0100

Abstract Clinical usefulness of67Ga-citrate scintigraphy for the diagnosis of colorectal carcinoma was reappraised at the standpoint of clinicopathological diagnosis. Fifty-eight patients with colonic carcinoma were subjected to this study. They underwent67Ga scintigraphy before surgery. Colorectal carcinomas were detected in 38 patients, 65.5% by this procedure. Surgical specimens from thirty-seven patients underwent postoperative scanning. The scanning of the surgical specimen revealed accumulation of67Ga-citrate in all 37 patients, suggesting that67Ga-citrate accumulated in the carcinoma of the colon. The results suggested that detectability of carcinoma of the colon by67Ga scintigraphy in this series was better than generally considered. 67Ga scintigraphy was c...

Survey Update on Implementation, Indications, and Technical Performance of Computed Tomography Colonography in Sweden.

Acta Radiologica — Mon, 07 Dec 2009 00:00:00 +0100

Conclusion: The survey reflects a further transition process from DCBE to CTC, with attitudes of radiologists increasingly in favor of CTC, although DCBE is still performed by the majority of radiology departments. DCBE should be replaced by colonoscopy and CTC, but the transition requires both human and economic resources. PMID: 19961399 [PubMed - as supplied by publisher] (Source: Acta Radiologica)

Modified Soave procedure for the treatment of vascular malformations involving anorectum and sigmoid colon

Journal of Pediatric Surgery — Tue, 01 Dec 2009 00:00:00 +0100

Conclusions: VMARS forms a unique subset of patients with vascular malformations who have rectal bleeding. The combination of Soave procedure and Sarasola-Klose hemorrhoidectomy is a safe and effective procedure for VMARS. (Source: Journal of Pediatric Surgery)

double contrast barium enema

About.com Colon Cancer — Thu, 26 Nov 2009 00:00:00 +0100

Double Contrast Barium Enema, also called DCBE, is a test that is used to screen for colon cancer and other bowel conditions and diseases. (Source: About.com Colon Cancer)

Colonic invasion of malignant peritoneal mesothelioma

Gastrointestinal Endoscopy — Fri, 13 Nov 2009 00:00:00 +0100

A 56-year-old woman presented with a several-week history of low-grade fever and diarrhea. For 4 years, she had been treated for malignant peritoneal mesothelioma with monthly or bimonthly intravenous vinorelbine ditartrate (30 mg/m2) followed by intraperitoneal cisplatin (100 mg/m2). A barium contrast enema showed a large mass in the mid-transverse colon (A), which was confirmed at colonoscopy (B). Biopsy specimens taken from the lesion revealed sarcomatous tissue with spindle cells (C). Immunostaining revealed the tissue to be carcinoembryonic antigen negative but calretinin positive (D), thereby supporting a diagnosis of malignant peritoneal mesothelioma. This patient had no evidence of asbestos exposure, and the cause for the mesothelioma was unknown. (Source: Gastrointestinal Endoscop...

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Journal of Pediatric Surgery — Sun, 01 Nov 2009 00:00:00 +0100

The aim of this paper was to assess the clinical value of anorectal manometry (ARMM) in the diagnosing of Hirschsprung's disease (HD) in neonates. From January 2003 to June 2005, 75 patients in whom HD was clinically suspected were analyzed. ARMM was performed using a desk, high rate gastrointestinal dynamic detection system and the results were compared with barium enema and rectal suction biopsy. Based on rectal suction biopsies in 52 of 75 patients, the positive, false positive, negative, and false negative rates of ARMM in the diagnosis of HD in neonates were found to be 92.3, 1.9, 1.9, and 3.8%, respectively. Forty-three of 75 patients were diagnosed with HD by both ARMM and barium enema and the diagnoses were validated by pathologic results. The diagnosis of HD was excluded in 18 pat...

Survey of medical students and junior house doctors on the effects of medical radiation: is medical education deficient?

Irish Journal of Medical Science — Sat, 10 Oct 2009 07:15:54 +0100

Conclusion The knowledge of basic radiological procedures and patient doses was extremely limited. Current undergraduate teaching needs to be expanded and continued post-qualification to improve core understanding and facilitate safe practice. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11845-009-0341-5Authors M. W. McCusker, St. James’s Hospital Department of Radiology Dublin 8 IrelandC. de Blacam, St. James’s Hospital Department of Radiology Dublin 8 IrelandM. Keogan, St. James’s Hospital Department of Radiology Dublin 8 IrelandR. McDermott, St. James’s Hospital Department of Radiology Dublin 8 IrelandP. Beddy, St. James’s Hospital Department of Radiology Dublin 8 Ireland Journal Irish Journal of Medical ScienceOnline ISSN 1863-...

Value-of-Information Analysis to Guide Future Research in Colorectal Cancer Screening [Health Policy and Practice]

Continuous Publishing articles — Mon, 28 Sep 2009 23:00:00 +0100

Conclusion: Results of value-of-information analysis show that future research on the optimal test for CRC screening has a large societal impact. Priority should be given to research on the increase in adherence with screening by using less invasive tests and to better understanding of the natural history of CRC. Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.2533090234/-/DC1 © RSNA, 2009 (Source: Continuous Publishing articles)

Value-of-Information Analysis to Guide Future Research in Colorectal Cancer Screening.

Radiology — Mon, 28 Sep 2009 23:00:00 +0100

Conclusion: Results of value-of-information analysis show that future research on the optimal test for CRC screening has a large societal impact. Priority should be given to research on the increase in adherence with screening by using less invasive tests and to better understanding of the natural history of CRC. Supplemental material: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.2533090234/-/DC1 (c) RSNA, 2009. PMID: 19789242 [PubMed - as supplied by publisher] (Source: Radiology)

Acute lower gastrointestinal bleeding in 1,112 patients admitted to an urban emergency medical center

Surgery — Mon, 28 Sep 2009 17:44:47 +0100

Conclusion: In this urban setting, diverticulosis, hemorrhoids, and carcinoma were the most common causes of severe acute lower gastrointestinal bleeding (LGIB) with diverticular bleed causing the highest recurrence. Colonoscopy allows for diagnosis in most patients with severe acute LGIB requiring hospitalization. Furthermore, it is now being used more effectively for hemostasis resulting in less operative intervention to control bleeding. (Source: Surgery)

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CT colonography versus double-contrast barium enema for screening of colorectal cancer: comparison of radiation burden

Abdominal Imaging — Thu, 24 Sep 2009 05:49:08 +0100

Abstract Our aim is to compare the radiation dose associated with a low-dose CT colonography (CTC) protocol for colorectal cancer screening with that delivered by double-contrast barium enema (DCBE). CTC of twenty asymptomatic individuals (M:F = 10:10) participating to a colorectal cancer screening program and DCBE of fifteen patients (M:F = 6:9) were evaluated. For CTC, absorbed dose was determined by calculating the dose-length product for each CTC examination from measurements on a CT dose phantom equipped with a CT ion chamber. For DCBE, the free-in-air Kerma at the patient’s X-ray entry surface and the Kerma-area product during fluoroscopy and fluorography were measured with a Barracuda system, with fluoroscopy times being recorded blinded to the ...

Patient dose assessment due to fluoroscopic exposure for some selected fluoroscopic procedures in Ghana

Radiation Protection Dosimetry — Sun, 20 Sep 2009 23:00:00 +0100

Organ and effective doses to 90 patients undergoing some selected fluoroscopic examinations at the Korle-Bu Teaching Hospital were estimated using the Monte Carlo-based program (PCXMC version 1.5). Radiation dose was estimated from free-in-air measurements. The mean effective doses were found to be 0.29 ± 0.07, 0.84 ± 0.13, 3.15 ± 0.44, 6.24 ± 0.70 and 0.38 ± 0.05 mSv for urethrogram, barium swallow, barium meal, barium enema and myelogram examinations, respectively. The dose area product was estimated to be 3.55 ± 0.95, 16.44 ± 2.60, 50.81 ± 7.04, 99.69 ± 10.85 and 9.32 ± 0.99 Gy cm2 for urethrogram, barium swallow, barium meal, barium enema and myelogram examinations, respectively. Optimisation of procedures is require...

An unusual presentation of a cystic duplication of the sigmoid colon entirely lined with squamous epithelium

Journal of Pediatric Surgery — Mon, 31 Aug 2009 23:00:00 +0100

We report a case of descending colonic communicating duplication in which clinical presentation and anatomopathologic results were unexpected.A slightly echogenic abdominal mass reaching 72 × 36 mm in the left flank was diagnosed in a female fetus during the third trimester ultrasound examination. At birth, volume of the mass rapidly evolved, and despite no intestinal obstruction was observed by compression of the adjacent gastrointestinal tract, abdomen was distended.Abdominal plain film showed a large air collection, and the barium enema demonstrated a slight leak of contrast in the aerated mass, suggesting a communication with the sigmoid colon. No other abnormalities were seen. The patient underwent surgery in emergency. The mass was then totally excised through an antimesenteric rese...

Pneumobilia, chronic diarrhea, vitamin K malabsorption: a pathognomonic triad for cholecystocolonic fistulas.

World Journal of Gastroenterology : WJG — Thu, 27 Aug 2009 23:00:00 +0100

We report a case of a spontaneous CF in a 75-year-old diabetic male admitted to hospital for the investigation of chronic watery diarrhea and weight loss. Massive pneumobilia demonstrated on abdominal ultrasound and computerized tomography, along with chronic, bile acid-induced diarrhea and a prolonged prothrombin time due to vitamin K malabsorption, led to the clinical suspicion of the fistula. Despite further investigation with barium enema and magnetic resonance cholangio-pancreatography, diagnosis of the fistulous tract between the gallbladder and the hepatic flexure of the colon could not be established preoperatively. Open cholecystectomy with fistula resection and exploration of the common bile duct was the preferred treatment of choice, resulting in an excellent postoperative clini...

Colonic perforation during barium enema in a patient without known colonic disease: a case report

Cases Journal — Thu, 13 Aug 2009 23:00:00 +0100

We report a case of colonic perforation during barium enema in a 72-year-old female patient, due to excessive barium applied into the rectum. (Source: Cases Journal)

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Primary transanal Swenson pull-through operation for Hirschsprung’s disease

Pediatric Surgery International — Sun, 09 Aug 2009 09:33:46 +0100

Conclusions Primary TSPT would be an alternative, safe technique in children with HD. The technique is not difficult, and associated with acceptable short-term outcomes. A long-term follow-up will be necessary to assess the real benefit of the technique. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2428-5Authors Paiboon Sookpotarom, Srinakharinwirot University Department of Surgery, Panyananthaphikkhu Chonprathan Medical Center Nonthaburi ThailandPaisarn Vejchapipat, Chulalongkorn University Department of Surgery, Faculty of Medicine Bangkok Thailand Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179-0358 (Source: Pediatric Surgery International)

Accuracy of Self-Reported Reason for Colorectal Cancer Testing

Annals of Epidemiology — Fri, 07 Aug 2009 12:03:28 +0100

We examined the accuracy of self-reported reason for CRC testing (screening vs. diagnosis) and its correlates in a sample of patients from a large multispecialty clinic in Houston, TX, between 2005–2007 who received at least one CRC test: fecal occult blood test, sigmoidoscopy (SIG), colonoscopy (COL), or doublecontrast barium enema. (Source: Annals of Epidemiology)

Botox injection treatment for anal outlet obstruction in patients with internal anal sphincter achalasia and Hirschsprung’s disease

Pediatric Surgery International — Fri, 07 Aug 2009 11:13:48 +0100

Conclusion Although successful in some patients, the role of BIT remains undetermined. It is difficult to predict which patients will profit from BIT. Continuing other treatment modalities after BIT may improve the results. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-009-2438-3Authors A. I. Koivusalo, LNS HUS, University of Helsinki Hospital for Children and Adolescents Stenbackinkatu 11 000290 Helsinki FinlandM. P. Pakarinen, LNS HUS, University of Helsinki Hospital for Children and Adolescents Stenbackinkatu 11 000290 Helsinki FinlandR. J. Rintala, LNS HUS, University of Helsinki Hospital for Children and Adolescents Stenbackinkatu 11 000290 Helsinki Finland Journal Pediatric Surgery InternationalOnline ISSN 1437-9813Print ISSN 0179...

Dually eligible and colorectal cancer screening: too little, too late?

Journal of Health Care for the Poor and Underserved — Fri, 31 Jul 2009 23:00:00 +0100

Conclusions. Dually eligible CRC patients were screened less and diagnosed later than Medicare patients. Fecal occult blood testing remains a less invasive and less costly screening option that may reduce late-stage diagnosis in lowincome populations. PMID: 19648712 [PubMed - in process] (Source: Journal of Health Care for the Poor and Underserved)

New screening guidelines for colorectal cancer: a practical guide for the primary care physician.

Primary Care — Wed, 22 Jul 2009 12:08:11 +0100

Authors: Allison JE, Potter MB Until recently, most clinical guidelines in the United States were in general agreement about the tests available for colorectal cancer screening, recommending fecal occult blood tests every year, flexible sigmoidoscopy every 5 years, both these tests together, double contrast barium enema every 5 years, or colonoscopy every 10 years. However, the release of two new sets of guidelines in 2008 has made it necessary for primary care physicians to update their knowledge of the recommended screening options. The most influential factor in determining whether a patient is screened is recommendation from a physician. The primary goal of this article is to review and critique the new guidelines for average-risk screening in adults older than 50 years. Armed with...

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New Screening Guidelines for Colorectal Cancer: A Practical Guide for the Primary Care Physician

Primary Care: Clinics in Office Practice — Sat, 18 Jul 2009 11:05:57 +0100

Until recently, most clinical guidelines in the United States were in general agreement about the tests available for colorectal cancer screening, recommending fecal occult blood tests every year, flexible sigmoidoscopy every 5 years, both these tests together, double contrast barium enema every 5 years, or colonoscopy every 10 years. However, the release of two new sets of guidelines in 2008 has made it necessary for primary care physicians to update their knowledge of the recommended screening options. The most influential factor in determining whether a patient is screened is recommendation from a physician. The primary goal of this article is to review and critique the new guidelines for average-risk screening in adults older than 50 years. Armed with this information, primary care phy...

[Case Report: An Intestinal Obstruction Due to Ascariasis.]

Turkish Society for Parasitology — Thu, 16 Jul 2009 00:30:03 +0100

Authors: Tamer GS, Tamer Y Ascaris lumbricoides (A. lumbricoides) with which one billion people around the world is infected is also widely seen in Turkey. This case report presents an ascariasis infection which displayed typical radiological findings in Kocaeli, a non-endemic region of Turkey. The patient was admitted to hospital with symptoms of heavy abdominal pain, nausea-vomiting and weakness. The symptoms had started weakly three weeks earlier and the patient had applied to a private health care center. After a through examination with several appropriate tests including a barium small-bowel enema, a morphological finding similar to helminth was observed filling the lumen of the jejunum. When rectal swabs were examined A. lumbricoides oocytes were discovered. The patient was trea...

Letter from the Editor

Seminars in Ultrasound CT and MRI — Tue, 14 Jul 2009 11:34:31 +0100

It was during my residency in 1973 that a junior member of the Cincinnati radiology faculty placed an ultrasound transducer on the flank of a prone patient and pointed out the kidney to me. To Michael Grossman, it was obvious, “The kidney is that oval thing with echoes in the middle,” but for me it required a leap of imagination. After all, he was showing me a bistable image on a very early piece of equipment. All I saw was a bunch of dots, and I scoffed quietly. In just less than a few years, however, improvements in image quality had made such an impact that we were actually able to put together an issue of this journal entitled, “The Kidney” (March 1981, Volume 2, Number 1). This really was an ultrasound issue (Seminars was then an ultrasound journal). The only other test that h...

What is the most cost-effective strategy to screen for second primary colorectal cancers in male cancer survivors in Korea?

World Journal of Gastroenterology : WJG — Sun, 05 Jul 2009 13:18:33 +0100

CONCLUSION: Our study suggests that more strict and frequent recommendations for colonoscopy such as COL5 and COL3 could be considered as economically reasonable second primary CRC screening strategies for Korean male cancer survivors. PMID: 19575496 [PubMed - as supplied by publisher] (Source: World Journal of Gastroenterology : WJG)

Evaluation of colonic involvement in endometriosis: double-contrast barium enema vs. magnetic resonance imaging

Abdominal Imaging — Wed, 01 Jul 2009 06:16:50 +0100

Conclusion DCBE is more accurate than unenhanced MRI in the diagnosis of bowel endometriosis, and should be preferred in the preoperative management of this disease, since it usually enables a proper surgical planning. Content Type Journal ArticleDOI 10.1007/s00261-009-9544-5Authors N. Faccioli, G.B. Rossi Hospital, University of Verona Department of Radiology Piazzale Scuro 10 37134 Verona ItalyG. Foti, G.B. Rossi Hospital, University of Verona Department of Radiology Piazzale Scuro 10 37134 Verona ItalyR. Manfredi, G.B. Rossi Hospital, University of Verona Department of Radiology Piazzale Scuro 10 37134 Verona ItalyP. Mainardi, Sacro Cuore Hospital Department of Radiology Negrar, Verona ItalyE. Spoto, Sacro Cuore Hospital Department of Radiology Negrar, Verona ItalyG...

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Direct radionuclide cystography imaging in colovesical fistula due to inguinal hernia operation complication

Annals of Nuclear Medicine — Tue, 16 Jun 2009 05:52:19 +0100

We present a case of colovesical fistula. A 57-year-old male was admitted to a local hospital with complaints of dysuria and pneumaturia. He had a past history of total extraperitoneal laparoscopic inguinal hernia repair operation 7 years previously for bilateral inguinal hernia. The case was assessed with radiologic and scintigraphic techniques. Radiologic techniques (plain abdominal radiography, intravenous pyelogram, ultrasound examination, double-contrast barium enema, CT, MRI) were inadequate to determine the colovesical fistula. The colovesical fistula was visualized with direct radionuclide voiding cystography as an alternative scintigraphic method. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s12149-009-0276-yAuthors Muge Tamam, Okmeydani Training and...

How important is it to investigate the whole of the colon after initial assessment at a rapid access colorectal clinic?

International Journal of Colorectal Disease — Fri, 05 Jun 2009 09:47:15 +0100

Conclusions A rapid access colorectal clinic using flexible sigmoidoscopy as the initial diagnostic test was safe and effective in investigating distal colonic pathologies. However, over two thirds of patients proceeded to imaging of the remaining colon, and most of them were found to have only benign pathologies. The cost effectiveness and acceptability of this were unclear. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-009-0741-zAuthors Chung Sim Lim, Forth Valley NHS Department of General Surgery, Stirling Royal Infirmary Livilands Stirling FK8 2AU UKLinnet McGeever, Forth Valley NHS Department of General Surgery, Stirling Royal Infirmary Livilands Stirling FK8 2AU UKJudith Helen Grey, Forth Valley NHS Department of General Surgery, Stirli...

Colorectal Cancer Screening Among First-Degree Relatives of Colorectal Cancer Patients: Benefits and Barriers

Annals of Surgical Oncology — Fri, 29 May 2009 08:23:56 +0100

Conclusion In this survey, 70% of FDR of CRC patients had undergone screening; age was the most important predictor. Understanding underlying constructs influencing screening behavior may improve uptake of CRC screening in this population. Content Type Journal ArticleCategory Healthcare Policy and OutcomesDOI 10.1245/s10434-009-0528-zAuthors Lloyd A. Mack, University of Calgary Department of Surgery and Oncology Calgary AB CanadaLinda S. Cook, University of New Mexico Department of Internal Medicine Albuquerque NM USAWalley J. Temple, University of Calgary Department of Surgery and Oncology Calgary AB CanadaLinda E. Carlson, University of Calgary Department of Oncology Calgary AB CanadaRobert J. Hilsden, University of Calgary Department of Medicine and Community Health...

not dread screening

About.com Colon Cancer — Wed, 20 May 2009 04:00:00 +0100

Information on what to expect when preparing for a colonoscopy, sigmoidoscopy, or double contrast barium enema (DCBE) test, plus tips on how to make this process easier. (Source: About.com Colon Cancer)

Endometriosis of the Posterior Cul-De-Sac: Clinical Presentation and Findings at Transvaginal Ultrasound

American Journal of Roentgenology — Tue, 19 May 2009 04:00:00 +0100

CONCLUSION. Patients with endometriosis of the posterior cul-de-sac frequently present with atypical noncyclic symptoms. The transvaginal ultrasound features characteristic of posterior cul-de-sac endometriosis are a solid, often spiculated, noncompressible mass near the posterior cul-de-sac that is localized at the serosal surface of the rectosigmoid, spares the mucosa and submucosa, and is vascular. (Source: American Journal of Roentgenology)

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Corrigendum to: Audit of the introduction of CT colonography for detection of colorectal carcinoma in a non-academic environment and its implications for the national bowel cancer screening programme [64 (2) 142–147]

Clinical Radiology — Fri, 15 May 2009 19:45:54 +0100

The caption to Fig. 1 in the above article should have read as below: Figure 1: Comparison of the Number of Barium Enemas and CT Colonography performed in Portsmouth NHS Hospitals Trust over the past 7 years. Prone and supine acquisitions have been recorded separately for CT Colonography. (Source: Clinical Radiology)

Colorectal Cancer Screening by Primary Care Physicians: Recommendations and Practices, 2006–2007

American Journal of Preventive Medicine — Wed, 13 May 2009 23:00:00 +0100

Conclusions: Physicians' CRC screening recommendations and practices have changed substantially since 1999–2000. Colonoscopy is now the most frequently recommended test. Most physicians do not recommend the full menu of test options prescribed in national guidelines. Few perform sigmoidoscopy. Office systems to support CRC screening are lacking in many physicians' practices. Given ongoing changes in CRC screening technologies and guidelines, the continued monitoring of physicians' CRC screening recommendations and practices is imperative. (Source: American Journal of Preventive Medicine)

Trends in Colorectal Cancer Test Use in the Medicare Population, 1998–2005

American Journal of Preventive Medicine — Thu, 07 May 2009 23:00:00 +0100

Conclusions: CRC test-use rates in the Medicare population are low. Disparities are apparent by age, race/ethnicity, gender, disability, income, and geographic residence. Much work remains to be done to increase testing to acceptable levels. (Source: American Journal of Preventive Medicine)

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Journal of Pediatric Surgery — Fri, 01 May 2009 04:00:00 +0100

Transanal one-stage endorectal pull-through (TOSEPT) has been presented as the most recent progression in treatment of Hirschsprung's disease (HD), which may be able to replace various previous techniques. This prospective study was designed to compare the efficacy and probable complications of the commonly used open surgery with those of TOSEPT technique in management of HD. Forty-two children (35 boys and 7 girls) between 3 days and 12 years of age underwent surgical treatment for HD—all after being diagnosed by barium enema over an 18-month period. In a manner of systematic random selection, 21 patients were operated by TOSEPT and the other 21 by Swenson procedures. All patients were followed-up at least for 12 months after hospital discharge. The necessary data containing age, sex, l...

Improved rates of colorectal cancer screening in an equal access population

American Journal of Surgery — Fri, 24 Apr 2009 17:01:51 +0100

Conclusions: Although ethnicity-, gender-, and age-related disparities were observed, screening rates are improved in an equal access healthcare system. (Source: American Journal of Surgery)

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Impact of age and comorbidity on colorectal cancer screening among older veterans.

Annals of Internal Medicine — Tue, 07 Apr 2009 04:00:00 +0100

CONCLUSION: Advancing age was inversely associated with colorectal cancer screening, whereas comorbidity was a weaker predictor. More attention to comorbidity is needed to better target screening to older patients with substantial life expectancies and avoid screening older patients with limited life expectancies. primary funding source: VA Health Services Research and Development. PMID: 19349631 [PubMed - in process] (Source: Annals of Internal Medicine)

Pregnancy and radiation exposure during therapeutic ERCP: time to put the baby to bed?

Gastrointestinal Endoscopy — Wed, 01 Apr 2009 04:00:00 +0100

ERCP is now almost exclusively performed for therapeutic indications, and, when performed during pregnancy, it is even more imperative that it is performed only for such purposes. This is not only because of the risks to the mother but also risks to the fetus. These risks can be caused by the usual endoscopic risks (such as bleeding, pancreatitis, or perforation) that would jeopardize the health of the mother and, subsequently, the fetus. Yet, in addition, the radiation exposure from ERCP is of particular concern because of the increased sensitivity of the fetus to radiation effects, which include adverse effects on growth and development, as well as the possibility for increased childhood cancer risk. Growth and mental retardation effects have been shown to have a threshold of 100 to 250 ...

Improved rates of colorectal cancer screening in an equal access population.

American Journal of Surgery — Sat, 21 Mar 2009 04:00:00 +0100

CONCLUSIONS: Although ethnicity-, gender-, and age-related disparities were observed, screening rates are improved in an equal access healthcare system. PMID: 19306971 [PubMed - as supplied by publisher] (Source: American Journal of Surgery)

Overview of Colon Cancer Tests

About.com Colon Cancer — Sat, 07 Mar 2009 05:00:00 +0100

There are five common colon cancer tests: colonoscopy, virtual colonoscopy, sigmoidoscopy, barium enema, and stool testing. Each has benefits and drawbacks, so it's best to ask your doctor which colon cancer test is appropriate for you. In the meantime, however, here's an overview of the most common types of colon cancer tests. (Source: About.com Colon Cancer)

Medicare Benefits

About.com Colon Cancer — Sat, 07 Mar 2009 05:00:00 +0100

Medicare benefits cover a variety of colorectal cancer screening tests, including fecal occult blood tests (FOBTs), sigmoidoscopies, colonoscopies, and barium enemas. (Source: About.com Colon Cancer)

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Wendy's Barium Enema Story

About.com Colon Cancer — Sat, 07 Mar 2009 05:00:00 +0100

Wendy is married and the proud mother of three yellow labs. She lives in Burlington, Ontario, and does not have good things to say about the barium enema she received. Learn more about Wendy's barium enema experience. (Source: About.com Colon Cancer)

Barium enema

Gastroenterology and Liver Diseases Specialist Library - Diagnostic procedures — Fri, 06 Mar 2009 16:07:50 +0100

A barium enema is a procedure that is carried out using a special type of X-ray to examine the large bowel for problems such as polyps, colitis, and tumours. (Source: Gastroenterology and Liver Diseases Specialist Library - Diagnostic procedures)

The Frequency of Early Repeat Tests After Colonoscopy in Elderly Medicare Recipients

Digestive Diseases and Sciences — Wed, 25 Feb 2009 10:10:02 +0100

Conclusions The frequency of early RAFTs after colonoscopy occurs in 8.3% of the Medicare population. Important differences exist in the frequency of RAFTs by race and provider type. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10620-009-0736-1Authors Robert J. Richards, Stony Brook University, Health Science Center Department of Gastroenterology and Hepatology Gastroenterology Level 17, Rm 060 Stony Brook NY 11794-8173 USAStephen Crystal, Rutgers University–Institute For Health Health Care Policy, and Aging Research New Brunswick NJ USA Journal Digestive Diseases and SciencesOnline ISSN 1573-2568Print ISSN 0163-2116 (Source: Digestive Diseases and Sciences)

Barium Enema

MedicineNet Digestion General — Tue, 10 Feb 2009 07:00:00 +0100

Title: Barium EnemaCategory: Procedures and TestsCreated: 12/31/1997Last Editorial Review: 2/10/2009 (Source: MedicineNet Digestion General)

Adult Segmental Hirschsprung Disease.

Southern Medical Journal — Thu, 05 Feb 2009 08:08:38 +0100

Hirschsprung disease is seldom diagnosed in adulthood, and segmental involvement is very rare. A 37-year-old man suffered from refractory constipation for twenty years; he could only defecate once a week. A barium enema showed an annular stenotic segment of the rectosigmoid colon of 8 cm in length. The narrowed segment of the rectum was resected, and at one-year follow-up, the patient no longer had trouble defecating.Page: 184DOI: 10.1097/SMJ.0b013e31817be9c6Authors: Yuksel, Ilhami MD; Ataseven, Hilmi MD; Ertugrul, Ibrahim MD; Basar, Omer MD; Sasmaz, Nurgul MD (Source: Southern Medical Journal)

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Anatomic Significance of a Positive Barium Enema in Deep Infiltrating Endometriosis of the Large Bowel

World Journal of Surgery — Wed, 04 Feb 2009 10:46:05 +0100

Conclusions Findings of mass effect with indentations and ridging of the mucosa on DCBE in a setting suspicious for large-bowel endometriosis correspond well with pathologic findings of deep infiltration of the large-bowel wall. Clinicians dealing with deep infiltrating endometriosis should be aware of these findings, which could influence their choice of surgical treatment. Content Type Journal ArticleDOI 10.1007/s00268-008-9903-3Authors Vincent Anaf, Academic Hospital Erasme. Free University of Brussels (ULB) Department of Gynecology 808, Route de Lennik 1070 Brussels BelgiumIssam El Nakadi, Academic Hospital Erasme. Free University of Brussels (ULB) Department of Digestive Surgery 808, Route de Lennik 1070 Brussels BelgiumVeronique De Moor, Academic Hospital Erasme...

[Institutional report - Esophagus] Gastrocoele: a complication of combined oesophageal and antral corrosive strictures

Interactive CardioVascular and Thoracic Surgery — Thu, 22 Jan 2009 05:00:00 +0100

We describe a previously undescribed condition called gastrocoele, a rare condition caused by combined oesophageal and antral strictures and review our results. We present our experience with nine cases of gastrocoele due to combined corrosive strictures of oesophagus and antrum between 1993 and 2005. The age group was 21–65 years with female preponderant (66%) sex distribution. The presentation was at a median of 110 days (range 45–400 days) following the corrosive ingestion. The standard investigations included barium swallow, endoscopy, jejunostomy tubogram and barium enema. The surgical procedures performed were antrectomy and coloplasty in six (one staged), antrectomy and oesophageal dilatation in two and gastrojejunostomy and coloplasty in one. There was no...

Colorectal cancer screening among underserved minority population: Discrepancy between physicians’ recommended, scheduled, and completed tests

Patient Education and Counseling — Fri, 16 Jan 2009 00:00:00 +0100

Conclusion: Effective interventions to reduce CRC mortality among underserved minority populations require an integrated approach that engages patients, providers, and health care systems.Practice implications: Designing interventions that (1) increase physician–patient communications for removing patients’ perceived barriers for CRC testing and (2) promote a non-physician-based navigator system that reinforces physicians’ recommendation are strongly recommended. (Source: Patient Education and Counseling)

A new screening test for chronic abdominal pain

EurekAlert! - Medicine and Health — Mon, 29 Dec 2008 05:00:00 +0100

(World Journal of Gastroenterology) Fifty patients with undiagnosed chronic abdominal pain of bowel origin underwent barium meal follow through (BMFT), BMFT with pneumocolon (BMFTP). Adding pneumocolon to BMFT not only helped in detecting ileo-cecal abnormalities better but also revealed other colonic abnormalities simultaneously obviating the need of colonoscopy and barium enema in a large subset of patients thereby lowering cost of screening these subjects which is quite important for developing poor nations where health budgets are quite low. (Source: EurekAlert! - Medicine and Health)