Annals of Coloproctology

Original Articles

Colorectal cancer

Colonic stenting: is the bridge to surgery worth its cost? A cost-effectiveness analysis at a single Asian institution: Michelle Shi Qing Khoo, Frederick H. Koh, Sharmini Su Sivarajah, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Cheryl Xi-Zi Chong, Fung Joon Foo, Winson Jianhong Tan; Ann Coloproctol. 2024;40(6):555-563. Published online August 5, 2024; DOI: https://doi.org/10.3393/ac.2023.00738.0105

2,908 View
122 Download

Abstract PDF: Purpose
In patients with acute left-sided colonic obstruction, stenting can convert an emergency operation into a semi-elective procedure. However, its use continues to be debated. We performed a cost-effective analysis using our institution’s experiences.
Methods
Endoscopic, surgical, and financial details were prospectively collected for patients who presented with acute colonic obstruction and underwent stenting between 2019 and 2022. Outcomes were defined as technical/clinical success and successful surgical resection. The financial cost of stenting was compared with the expected cost without stenting.
Results
Forty patients were included, with 29 undergoing definitive resection. The most common pathology was primary colon cancer (27 patients, 93%). Endoscopic stenting had high technical (90%) and clinical (83%) success rates, with low rates of complications such as perforation (2 patients, 7%) and migration (0 patients, 0%). As a bridge to surgery, the median procedure time was 226 minutes and the surgical outcomes also showed a low rate of complications (3 patients, 11%), such as anastomotic leakage (0 patients, 0%), intraabdominal abscesses (2 patients, 7%), and 30-day postoperative mortality (0 patients, 0%). The cumulative costs with colonic stenting were $32,900, while the expected costs with emergency surgery, including stoma reversal, were $40,700 (healthcare cost-savings of $7,800 per person). The difference was mainly due to the avoidance of upfront emergency surgery. The incremental cost-effectiveness ratio was 0.81, favoring colonic stenting over upfront emergency surgery.
Conclusion
Colonic stenting as a bridge to surgery is safe and cost-effective for treating left-sided colonic obstruction with high success rates and low complication rates.

Colorectal cancer

Obstructing colorectal cancer: a population-based review of colonic stenting in Queensland, Australia: Cian Keogh, Julie Moore, Danica Cossio, Nick Smith, David A. Clark; Ann Coloproctol. 2024;40(3):268-275. Published online June 25, 2024; DOI: https://doi.org/10.3393/ac.2023.00640.0091

1,884 View
165 Download

Abstract PDF: Purpose
Stenting is a useful treatment option for malignant colonic obstruction, but its role remains unclear. This study was designed to establish how stents have been used in Queensland, Australia, and to review outcomes.
Methods
Patients diagnosed with colorectal cancer in Queensland from January 1, 2008, to December 31, 2014, who underwent colonic stent insertion were reviewed. Primary outcomes of 5-year survival, 30-day mortality, and overall length of survival were calculated. The secondary outcomes included patient and tumor factors, and stoma rates.
Results
In total, 319 patients were included, and distant metastases were identified in 183 patients (57.4%). The 30-day mortality rate was 6.6% (n=21), and the 5-year survival was 11.9% (n=38). Median survival was 11 months (interquartile range, 4–27 months). A further operation (hazard ratio [HR], 0.19; P<0.001) and chemotherapy and/or radiotherapy (HR, 0.718; P=0.046) reduced the risk of 5-year mortality. The presence of distant metastases (HR, 2.052; P<0.001) and a comorbidity score of 3 or more (HR, 1.572; P=0.20) increased mortality. Surgery was associated with a reduced risk of mortality even in patients with metastatic disease (HR, 0.14; P<0.001). Twenty-two patients (6.9%) ended the study period with a stoma.
Conclusion
Colorectal stenting was used in Queensland in several diverse scenarios, in both localized and metastatic disease. Surgery had a survival advantage, even in patients with metastatic disease. There was no survival difference according to whether patients were socioeconomically disadvantaged, diagnosed in a major city or not, or treated at private or public hospitals. Stenting proved a valid treatment option with low stoma rates.

Malignant disease,Colorectal cancer,Complication,Biomarker & risk factor

Presepsin (soluble CD14 subtype) as a risk factor for the development of infectious and inflammatory complications in operated colorectal cancer patients: Kayrat Shakeyev, Yermek Turgunov, Alina Ogizbayeva, Olga Avdiyenko, Miras Mugazov, Sofiko Grigolashvili, Ilya Azizov; Ann Coloproctol. 2022;38(6):442-448. Published online April 4, 2022; DOI: https://doi.org/10.3393/ac.2022.00115.0016

4,154 View
135 Download
1 Web of Science
1 Citations

Abstract PDF

Purpose
In this pilot study the dynamic of presepsin (soluble CD14 subtype, sCD14-ST) in blood serum was assessed as a possible risk factor for the development of systemic inflammatory response syndrome (SIRS) and infectious and inflammatory complications in operated colorectal cancer patients.
Methods
To determine sCD14-ST by enzyme-linked immunosorbent assay method venous blood was taken 1 hour before surgery and 72 hours after it (3rd day). The presence of SIRS and organ dysfunctions (ODs) according to the Sequential Organ Failure Assessment scale were assessed.
Results
Thiry-six patients with colorectal cancer were enrolled in the study. sCD14-ST level before surgery was 269.8±103.1 pg/mL (interquartile range [IQR], 196.7–327.1 pg/mL). Despite the presepsin level on the 3rd day being higher (291.1±136.5 pg/mL; IQR, 181.2–395.5 pg/mL), there was no statistical significance in its dynamics (P=0.437). sCD14-ST value both before surgery and on the 3rd day after it was significantly higher in patients with bowel obstruction (P=0.038 and P=0.007). sCD14-ST level before surgery above 330 pg/mL showed an increase in the probability of complications, SIRS, and OD (odds ratio [OR], 5.5; 95% confidence interval [CI], 1.1–28.2; OR, 7.0; 95% CI, 1.3–36.7; and OR, 13.0; 95% CI, 1.1–147.8; respectively). Patients with OD had higher levels on the 3rd day after surgery (P=0.049).
Conclusion
sCD14-ST level in operated colorectal cancer patients was much higher if they were admitted with complication like bowel obstruction. Higher preoperative levels of sCD14-ST increase the probability of postoperative complications, SIRS, and OD. Therefore, further studies with large sample size are needed.

Citations

Citations to this article as recorded by

Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef

Benign proctology,Rare disease & stoma,Surgical technique

Comparison of blowhole colostomy and loop ostomy for palliation of acute malignant colonic obstruction: Yongjun Park, Dong Uk Choi, Hyung Ook Kim, Yong Bog Kim, Chungki Min, Jung Tack Son, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim; Ann Coloproctol. 2022;38(4):319-326. Published online March 7, 2022; DOI: https://doi.org/10.3393/ac.2021.00682.0097

10,023 View
263 Download
2 Web of Science
3 Citations

Graphical Abstract Abstract PDF

Purpose
Surgery to create a stoma for decompression might be required for unresectable stage IV cancer patients with complete colonic obstruction. The aim of this study was to compare the results of blowhole colostomy with those of loop ostomy.
Methods
Palliative ileostomy or colostomy procedures performed at a single center between January 2011 and October 2020, were analyzed retrospectively. Fifty-nine patients were identified during this period. The demographic characteristics and outcomes between the blowhole colostomy group (n=24) and the loop ostomy group (n=35) were compared.
Results
The median operative time tended to be shorter in the blowhole colostomy group (52.5 minutes; interquartile range [IQR], 43–65) than in the loop ostomy group (60 minutes; IQR, 40–107), but the difference did not reach statistical significance (P=0.162). The median length of hospital stay was significantly shorter with blowhole colostomy (blowhole, 13 days [IQR, 9–23]; loop, 21 days [IQR, 14–37]; P=0.013). Mean cecum diameter was significantly larger in the blowhole group than in the loop group (8.83±1.91 cm vs. 6.78±2.36 cm, P=0.001), and the emergency operation rate was higher in the blowhole group than in the loop group (22 of 24 [91.7%] vs. 23 of 35 [65.7%], P=0.021).
Conclusion
In surgical emergencies, diverting a blowhole colostomy can be safe and effective for palliative management of colonic obstruction in patients with end-stage cancer and might reduce the operative time in emergent situations.

Citations

Citations to this article as recorded by

A Last Resort: Dacron Vascular Graft Prosthesis for Management of a Blowhole Colostomy
Brittney A. Ehrlich, Maria C. Unuvar, Justin M. Orenich, Rebecca L. Hoffman
The American Surgeon™.2025; 91(2): 303. CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Stoma-Related Complications: A Single-Center Experience and Literature Review
Zalán Benedek, Loránd Kocsis, Orsolya Bauer, Nicolae Suciu, Sorin Sorlea, Călin Crăciun, Rareș Georgescu, Marius Florin Coroș
Journal of Interdisciplinary Medicine.2022; 7(2): 31. CrossRef

Benign diesease & IBD,Rare disease & stoma

Determining the etiology of small bowel obstruction in patients without intraabdominal operative history: a retrospective study: Youngjin Jang, Sung Min Jung, Tae Gil Heo, Pyong Wha Choi, Jae Il Kim, Sung-Won Jung, Heungman Jun, Yong Chan Shin, Eunhae Um; Ann Coloproctol. 2022;38(6):423-431. Published online December 8, 2021; DOI: https://doi.org/10.3393/ac.2021.00710.0101

5,427 View
173 Download
4 Web of Science
4 Citations

Abstract PDF Supplementary Material

Purpose
Most of the causes of small bowel obstruction (SBO) in patients without a history of abdominal surgery are unclear at initial assessment. This study was conducted to identify the etiology and clinical characteristics of SBO in virgin abdomens and discuss the proper management.
Methods
A retrospective review involving operative cases of SBO from a single institute, which had no history of abdominal surgery, was conducted between January 2010 and December 2020. Clinical information, including radiological, operative, and pathologic findings, was investigated to determine the etiology of SBO.
Results
A total of 55 patients were included in this study, with a median age of 57 years and male sex (63.6%) constituting the majority. The most frequently reported symptoms were abdominal pain and nausea or vomiting. Neoplasm as an underlying cause accounted for 34.5% of the cases, of which 25.5% were malignant cases. In patients aged ≥60 years (n=23), small bowel neoplasms were the underlying cause in 12 (52.2%), of whom 9 (39.1%) were malignant cases. Adhesions and Crohn disease were more frequent in patients aged <60 years. Coherence between preoperative computed tomography scans and intraoperative findings was found in 63.6% of the cases.
Conclusion
There were various causes of surgical cases of SBO in virgin abdomens. In older patients, hidden malignancy should be considered as a possible cause of SBO in a virgin abdomen. Patients with symptoms of recurrent bowel obstruction who have no history of prior abdominal surgery require thorough medical history and close follow-up.

Citations

Citations to this article as recorded by

Mesothelial cell responses to acute appendicitis or small bowel obstruction reactive ascites: Insights into immunoregulation of abdominal adhesion
Melissa A. Hausburg, Kaysie L. Banton, Christopher D. Cassidy, Robert M. Madayag, Carlos H. Palacio, Jason S. Williams, Raphael Bar-Or, Rebecca J. Ryznar, David Bar-Or, Eliseo A. Eugenin
PLOS ONE.2025; 20(1): e0317056. CrossRef
Spontaneous Right-Sided Diaphragmatic Hernia: A Rare Cause of Small Bowel Obstruction
Phoebe Douzenis, Ali Yasen Y Mohamedahmed, Sreekanth Sukumaran, Zbigniew Muras, Najam Husain
Cureus.2024;[Epub] CrossRef
Small bowel obstruction on food impaction after binge eating
E Van Eecke, L Crapé, I Colle
Acta Gastro Enterologica Belgica.2024; 87(3): 427. CrossRef
Colonic pseudo-obstruction in a patient with dyssynergic defecation: A case report
Yejun Jeong, Yongjae Kim, Wonhyun Kim, Seoyeon Park, Su-Jin Shin, Eun Jung Park
International Journal of Surgery Case Reports.2022; 98: 107524. CrossRef

Comparison of long-term outcomes of colonic stenting as a “bridge to surgery” and emergency surgery in patients with left-sided malignant colonic obstruction: Supakij Khomvilai, Sukit Pattarajierapan; Ann Coloproctol. 2023;39(1):17-26. Published online July 29, 2021; DOI: https://doi.org/10.3393/ac.2021.00227.0032

6,996 View
226 Download
6 Web of Science
7 Citations

Abstract PDF

Purpose
Long-term oncologic outcomes of colonic stenting as a “bridge to surgery” in patients with left-sided malignant colonic obstruction (LMCO) are unclear. This study was performed to compare long-term outcomes of self-expandable metal stent (SEMS) insertion as a bridge to surgery and emergency surgery in patients with acute LMCO.
Methods
This retrospective cohort study included patients with acute LMCO who underwent SEMS insertion as a bridge to surgery or emergency surgery. The primary outcomes were 5-year disease-free survival (DFS), overall survival (OS), and recurrence rate. Survival outcomes were determined using the Kaplan-Meier method and compared using log-rank tests.
Results
There was a trend of worsening 5-year OS rate in the SEMS group compared with emergency surgery group (45% vs. 57%, P=0.07). In stage-wise subgroup analyses, a trend of deteriorating 5-year OS rate in the SEMS group with stage III (43% vs. 59%, P=0.06) was observed. The 5-year DFS and recurrence rate were not different between groups. The overall median follow-up time was 58 months. On multivariate analysis, age of ≥65 years and American Joint Committee on Cancer stage of ≥III, and synchronous metastasis were significant poor prognostic factors for OS (hazard ratio [HR], 1.709; 95% confidence interval [CI], 1.007–2.900; P=0.05/HR, 1.988; 95% CI, 1.038–3.809; P=0.04/HR, 2.146; 95% CI, 1.191–3.866; P=0.01; respectively).
Conclusion
SEMS as a bridge to surgery may have adverse oncologic outcomes. Patients in the SEMS group had a trend of worsening 5-year OS rate without higher recurrence.

Citations

Citations to this article as recorded by

Transforming outcomes: the pivotal role of self-expanding metal stents in right- and left-sided malignant colorectal obstructions-bridge to surgery: a comprehensive review and meta-analysis
Sheza Malik, Priyadarshini Loganathan, Hajra Khan, Abul Hasan Shadali, Pradeep Yarra, Saurabh Chandan, Babu P. Mohan, Douglas G. Adler, Shivangi Kothari
Clinical Endoscopy.2025; 58(2): 240. CrossRef
Controversial issues of colon stenting in case of tumor obstructive intestinal obstruction: surgical and oncological aspects
S.A. Aliyev, E.S. Aliyev, T.K. Aliyev
Endoscopic Surgery.2025; 31(2): 65. CrossRef
Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Can we use colon stenting in accelerated recovery programs for surgical treatment colon cancer complicated by obstructive intestinal obstruction? A literature review
Saday A. Aliyev, Emil S. Aliyev
Russian Journal of Oncology.2024; 29(2): 130. CrossRef
Colonic stenting: is the bridge to surgery worth its cost? A cost-effectiveness analysis at a single Asian institution
Michelle Shi Qing Khoo, Frederick H. Koh, Sharmini Su Sivarajah, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Cheryl Xi-Zi Chong, Fung Joon Foo, Winson Jianhong Tan
Annals of Coloproctology.2024; 40(6): 555. CrossRef
Comparison of colonic stenting and stoma creation as palliative treatment for incurable malignant colonic obstruction
Sukit Pattarajierapan, Chatiyaporn Manomayangoon, Panat Tipsuwannakul, Supakij Khomvilai
JGH Open.2022; 6(9): 630. CrossRef
Oncologic safety of colonic stenting as a bridge to surgery in left-sided malignant colonic obstruction: Current evidence and prospects
Sukit Pattarajierapan, Nattapanee Sukphol, Karuna Junmitsakul, Supakij Khomvilai
World Journal of Clinical Oncology.2022; 13(12): 943. CrossRef

Case Reports

Multiple gastrointestinal melanoma causing small bowel intussusception: Jian Yang Eng, Salehah Tahkin, Huzairi Yaacob, Nor Hayati Yunus, Ahmad Shan Wani Mohamed Sidek, Michael Pak-Kai Wong; Ann Coloproctol. 2023;39(1):85-88. Published online July 21, 2021; DOI: https://doi.org/10.3393/ac.2021.00143.0020

4,570 View
141 Download
1 Web of Science
2 Citations

Abstract PDF

A 61-year-old gentleman presented with small bowel intussusception from small bowel melanoma intussusceptum. He complains of intermittent abdominal distension but no history of intestinal obstruction. Apart from this, he was also symptomatic anemia which required repeated transfusion for the past few months. The contrast-enhanced computed tomography of the abdomen shows an omental mass with small bowel intussusception. He then underwent an exploratory laparotomy with segmental resection of the affected segment. Histopathological examination confirmed primary gastrointestinal melanoma. Multiple small bowel malignant melanoma is a rare disease. It remains a controversial diagnosis as it may be a primary or metastasis from an unidentified or regressed primary cutaneous melanoma. Prompt surgical intervention enables us to obtain tissue diagnosis, prevent complete intestinal obstruction and strategize the goals of treatment for the patient.

Citations

Citations to this article as recorded by

Small bowel melanoma causing obstruction: A case report and a literature review
Ammar Mattit, Ibrahim Marrawi, Safouh Kheir, Taha Khamis, Safaa Qatleesh, Muhammad Ali Ousta
International Journal of Surgery Case Reports.2024; 116: 109388. CrossRef
Epidemiology and outcomes of gastrointestinal mucosal melanomas: a national database analysis
Niraj James Shah, Mark M. Aloysius, Eldrin Bhanat, Shweta Gupta, Ganesh Aswath, Savio John, Shou-Jiang Tang, Hemant Goyal
BMC Gastroenterology.2022;[Epub] CrossRef

Malignant disease

Early Postoperative Anastomotic Obstruction Due to an Intraluminal Blood Clot After Laparoscopic Anterior Resection: A Case Report: Soon Keun Kwon, Jin Soo Han, Jihyun Seo, Yong Sik Yoon; Ann Coloproctol. 2020;36(5):349-352. Published online October 31, 2020; DOI: https://doi.org/10.3393/ac.2020.06.11.2

4,010 View
63 Download

Abstract PDF: Early postoperative anastomotic obstruction after colorectal surgery rarely develops. Herein, we present a case of a 50-year-old healthy woman who had an early postoperative anastomotic obstruction which was revealed caused by a blood clot and successfully managed by endoscopic approach. The patient was discharged after laparoscopic anterior resection and visited the emergency department one day after because of abdominal pain. Computed tomography showed that the anastomosis site was obstructed with low-density material. Intraoperative endoscopy was performed under general anesthesia and blood clot filling the lumen were identified. As the scope was advanced to the blood clot with air inflation, the blood clot was evacuated. The anastomosis site could be obstructed by blot clot with mucous debris albeit it is a rare condition. An endoscopic approach seems to be the first option in the diagnosis and treatment of postoperative obstruction at the anastomosis site and it could prevent unnecessary laparotomy.

Original Articles

Malignant disease, Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Biomarker & risk factor

Surgical Risk and Pathological Results of Emergency Resection in the Treatment of Acutely Obstructing Colorectal Cancers: A Retrospective Cohort Study: Giovanni Domenico Tebala, Andrea Mingoli, Andrea Natili, Abdul Qayyum Khan, Gioia Brachini; Ann Coloproctol. 2021;37(1):21-28. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.03.10.1

4,403 View
152 Download
5 Web of Science
6 Citations

Abstract PDF

Purpose
The treatment of acutely obstructing colorectal cancers is still a matter of debate. The prevailing opinion is that an immediate resection should be performed whenever possible. This study sought to determine whether immediate resection is safe and oncologically valid.
Methods
We completed a retrospective 2-center cohort study using the medical records of patients admitted for acutely obstructing colorectal cancer under the care of the Colorectal Team, Noble’s Hospital, Isle of Man, and the Emergency Surgery Unit, Umberto I University Hospital, Rome, from March 2013 to May 2017. The primary endpoints were 90-day mortality and morbidity, reoperation rate, and length of stay. The secondary endpoints were status of margins, number of lymph nodes retrieved, and the rate of adequate nodal harvest.
Results
Sixty-three patients were retrospectively enrolled in the study. Mortality was associated with age > 80 years and Dukes B tumors. The length of hospital stay was shorter in patients who had their resection less than 24 hours from their admission, in those who had laparoscopic resection and in those with distal tumors. The number of lymph nodes retrieved and rate of R0 resections were similar to those reported in elective colorectal surgery and were greater in laparoscopic resections and in patients operated on within 24 hours, respectively.
Conclusion
Immediate resection is a safe and reliable option in patients with acutely obstructing colorectal cancer.

Citations

Citations to this article as recorded by

Complete Obstruction, a Real Risk Factor: A Comprehensive Study on Obstruction in Stage IIA Colon Cancer With Propensity Score Matching Analysis
Soo Young Oh, Chan Wook Kim, Seonok Kim, Min Hyun Kim, Young Il Kim, Jong Lyul Lee, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Clinical Colorectal Cancer.2024; 23(2): 135. CrossRef
Can clinicopathologic high-risk features in T3N0 colon cancer be reliable prognostic factors?
Hyun Gu Lee, Young IL Kim, In Ja Park, Seok-Byung Lim, Chang Sik Yu
Annals of Surgical Treatment and Research.2023; 104(2): 109. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
Surgical safety in the COVID-19 era: present and future considerations
Young Il Kim, In Ja Park
Annals of Surgical Treatment and Research.2022; 102(6): 295. CrossRef
Failure to rescue after reoperation for major complications of elective and emergency colorectal surgery: A population-based multicenter cohort study
Marie T. Grönroos-Korhonen, Laura E. Koskenvuo, Panu J. Mentula, Selja K. Koskensalo, Ari K. Leppäniemi, Ville J. Sallinen
Surgery.2022; 172(4): 1076. CrossRef
Quality issues in emergency colorectal surgery
Tara Russell, Formosa Chen
Seminars in Colon and Rectal Surgery.2020; 31(4): 100784. CrossRef

Obstructive Ileocolitis in Patients With Obstructed Colorectal Cancer – A Matched Case Control Study: Ning-Qi Pang, Tian-Zhi Lim, Yuanpei Zhou, Ker-Kan Tan; Ann Coloproctol. 2018;34(4):175-179. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2017.06.14.1

3,938 View
87 Download
1 Web of Science
1 Citations

Abstract PDF

Purpose
Obstructive ileocolitis is an ulcero-inflammatory condition which typically occurs in the ileum or colon proximal to an obstructing colorectal lesion. If left unresolved, it often leads to intestinal perforation. We present a matched case control study of patients with obstructive ileocolitis caused by colorectal cancer to determine if any factors can predict this condition.
Methods
This is a retrospective review of 21 patients with obstructive colorectal cancer and histologically proven obstructive ileocolitis from 2005 to 2015 matched for age and sex with 21 controls with obstructing colorectal cancer without obstructive ileocolitis.
Results
The 21 patients with obstructive ileocolitis had a median age of 71 years (range, 52–86 years). The most common presenting symptom was abdominal pain (n = 16, 76.2%), followed by vomiting/nausea (n = 14, 66.7%) and abdominal distension (n = 12, 57.1%). Interestingly, the radiological feature of pneumatosis intestinalis was noted in only 1 case. No significant differences were observed in baseline comorbidities, clinical presentations, or tumor characteristics between the 2 groups. Patients with obstructive ileocolitis were found to have a significantly higher total leucocyte count (17.1 ± 9.4×109/L vs. 12.0 ± 6.8×109/L, P = 0.016), lower pCO2 (32.3 ± 8.2 mmHg vs. 34.8 ± 4.9 mmHg, P = 0.013), lower HCO3 (18.8 ± 4.5 mmol/L vs. 23.6 ± 2.7 mmol/L, P < 0.001), lower base excess (-6.53 ± 5.32 mmol/L vs. -0.57 ± 2.99 mmol/L, P < 0.001) and higher serum lactate levels (3.14 ± 2.19 mmol/L vs. 1.19 ± 0.91 mmol/L, P = 0.007) compared to controls. No radiological features were predictive of obstructive ileocolitis.
Conclusion
Patients with obstructive ileocolitis tend to present with metabolic acidosis with respiratory compensation, raised lactate, and worse leucocytosis. Radiological features are not useful for predicting this condition.

Citations

Citations to this article as recorded by

Prognostic Value of Neutrophil-to-Lymphocyte Ratio in Obstructing Colorectal Cancer Treated by Endoscopic Stenting as a Bridge to Surgery
Jiwei Guo, Aik Yong Chok, Hui Jun Lim, Wei Xuan Tay, Weng Kit Lye, Lasitha Bhagya Samarakoon, Emile John Tan, Ronnie Mathew
Annals of Coloproctology.2021; 37(3): 159. CrossRef

Obstructive Left Colon Cancer Should Be Managed by Using a Subtotal Colectomy Instead of Colonic Stenting: Chung Ki Min, Hyung Ook Kim, Donghyoun Lee, Kyung Uk Jung, Sung Ryol Lee, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2016;32(6):215-220. Published online December 31, 2016; DOI: https://doi.org/10.3393/ac.2016.32.6.215

6,105 View
78 Download
14 Web of Science
10 Citations

Abstract PDF

Purpose

This study compared a subtotal colectomy to self-expandable metallic stent (SEMS) insertion as a bridge to surgery for patients with left colon-cancer obstruction.

Methods

Ninety-four consecutive patients with left colon-cancer obstruction underwent an emergency subtotal colectomy or elective SEMS insertion between January 2007 and August 2014. Using prospectively collected data, we performed a retrospective comparative analysis on an intention-to-treat basis.

Results

A subtotal colectomy and SEMS insertion were attempted in 24 and 70 patients, respectively. SEMS insertion technically failed in 5 patients (7.1%). The mean age and rate of obstruction in the descending colon were higher in the subtotal colectomy group than the SEMS group. Sex, underlying disease, American Society of Anesthesiologists physical status, and pathological stage showed no statistical difference. Laparoscopic surgery was performed more frequently in patients in the SEMS group (62 of 70, 88.6%) than in patients in the subtotal colectomy group (4 of 24, 16.7%). The overall rate of postoperative morbidity was higher in the SEMS group. No Clavien-Dindo grade III or IV complications occurred in the subtotal colectomy group, but 2 patients (2.9%) died from septic complications in the SEMS group. One patient (4.2%) in the subtotal colectomy group had synchronous cancer. The total hospital stay was shorter in the subtotal colectomy group. The median number of bowel movements in the subtotal colectomy group was twice per day at postoperative 3–6 months.

Conclusion

A subtotal colectomy for patients with obstructive left-colon cancer is a clinically and oncologically safer, 1-stage, surgical strategy compared to SEMS insertion as a bridge to surgery.

Citations

Citations to this article as recorded by

Colonic stenting: is the bridge to surgery worth its cost? A cost-effectiveness analysis at a single Asian institution
Michelle Shi Qing Khoo, Frederick H. Koh, Sharmini Su Sivarajah, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Cheryl Xi-Zi Chong, Fung Joon Foo, Winson Jianhong Tan
Annals of Coloproctology.2024; 40(6): 555. CrossRef
Short- and long-term outcomes of subtotal/total colectomy in the management of obstructive left colon cancer
Jung Tak Son, Yong Bog Kim, Hyung Ook Kim, Chungki Min, Yongjun Park, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim
Annals of Coloproctology.2023; 39(3): 260. CrossRef
Outcomes After Colonic Self-Expanding Metal Stent Insertion Without Fluoroscopy: A Surgeon-Led 10-Year Experience
Tara M. Connelly, Jessica Ryan, Niamh M. Foley, Helen Earley, Shaheel M. Sahebally, Carl O'Brien, Peter McCullough, Peter Neary, Fiachra Cooke
Journal of Surgical Research.2023; 281: 275. CrossRef
Which treatment strategy is optimal for acute left-sided malignant colonic obstruction? A Bayesian meta-analysis
Kaibo Ouyang, Zifeng Yang, Yuesheng Yang, Junjiang Wang, Deqing Wu, Yong Li
International Journal of Colorectal Disease.2023;[Epub] CrossRef
New Challenges in Surgical Approaches for Colorectal Cancer during the COVID-19 Pandemic
Dragos Serban, Geta Vancea, Catalin Gabriel Smarandache, Simona Andreea Balasescu, Gabriel Andrei Gangura, Daniel Ovidiu Costea, Mihail Silviu Tudosie, Corneliu Tudor, Dan Dumitrescu, Ana Maria Dascalu, Ciprian Tanasescu, Laura Carina Tribus
Applied Sciences.2022; 12(11): 5337. CrossRef
Functional outcomes of surgery for colon cancer: A systematic review and meta-analysis
Sanne J. Verkuijl, Jara E. Jonker, Monika Trzpis, Johannes G.M. Burgerhof, Paul M.A. Broens, Edgar J.B. Furnée
European Journal of Surgical Oncology.2021; 47(5): 960. CrossRef
Short-term outcomes of stents in obstructive rectal cancer
Nora H. Trabulsi, Hajar M. Halawani, Esraa A. Alshahrani, Rawan M. Alamoudi, Sama K. Jambi, Nouf Y. Akeel, Ali H. Farsi, Mohammed O. Nassif, Ali A. Samkari, Abdulaziz M. Saleem, Nadim H. Malibary, Mohammad M. Abbas, Luca Gianotti, Antonietta Lamazza, Jin
Saudi Journal of Gastroenterology.2021; 27(3): 127. CrossRef
Fluoroscopic Stenting as a Bridge to Surgery versus Emergency Management for Malignant Obstruction of the Colon
Fan Xue, Feng Lin, Jun Zhou, Ning Feng, You-Gang Cui, Xu Zhang, Yu-Peng Yi, Wen-Zhi Liu
Emergency Medicine International.2020; 2020: 1. CrossRef
Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation
Eun-Do Kim, Jin-Kwon Lee, Jin-Kyu Cho, Jae-Myung Kim, Ji-Ho Park, Ju-Yeon Kim, Sang-Ho Jeong, Young-Tae Ju, Chi-Young Jeong, Eun-Jung Jung, Young-Joon Lee, Soon-Chan Hong, Seung-Jin Kwag
Korean Journal of Clinical Oncology.2019; 15(2): 106. CrossRef
Laparoscopic assisted insertion of a colonic self-expandable metallic stent
Y. M. Ho, V. Shenoy, J. Alberts, N. Ward
Techniques in Coloproctology.2018; 22(10): 809. CrossRef

Case Report

Spontaneous Transomental Hernia: Seung Hun Lee, Seung Hyun Lee; Ann Coloproctol. 2016;32(1):38-41. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.38

5,529 View
47 Download
13 Web of Science
14 Citations

Abstract PDF

A transomental hernia through the greater or lesser omentum is rare, accounting for approximately 4% of internal hernias. Transomental hernias are generally reported in patients aged over fifty. In such instances, acquired transomental hernias are usual, are commonly iatrogenic, and result from surgical interventions or from trauma or peritoneal inflammation. In rare cases, such as the one described in this study, internal hernias through the greater or lesser omentum occur spontaneously as the result of senile atrophy without history of surgery, trauma, or inflammation. A transomental hernia has a high postoperative mortality rate of 30%, and emergency diagnosis and treatment are critical. We report a case of a spontaneous transomental hernia of the small intestine causing intestinal obstruction. An internal hernia with strangulation of the small bowel in the lesser sac was suspected from the image study. After an emergency laparotomy, a transomental hernia was diagnosed.

Citations

Citations to this article as recorded by

Spontaneous transomental hernia: a rare cause of closed loop bowel obstruction
Caitlin Zhang, Marie Shella De Robles
Journal of Surgical Case Reports.2025;[Epub] CrossRef
Real‐time ancillary diagnostics for intraoperative assessment of intestinal viability in horses–looking for answers across species
Nicole Verhaar, Florian Geburek
Veterinary Surgery.2025; 54(4): 648. CrossRef
CT imaging of a rare combined internal hernia traversing the lesser sac via the gastrocolic ligament and foramen of Winslow
Quanxu Ge, Peixia Cong
Egyptian Journal of Radiology and Nuclear Medicine.2025;[Epub] CrossRef
Spontaneous transomental hernia: a case report of a rare internal hernia with a challenging diagnosis
Mohamed Ben Khalifa, Mossaab Ghannouchi, Achref Sarraj, Sabri Aouadi, Mohamed Maatouk, Moez Boudokhane
Annals of Medicine & Surgery.2024; 86(11): 6865. CrossRef
Case Report: A small bowel occlusion revealed by a strangulated transomental hernia
AHMED MENIF, SOUHAIB ATRI, WASSIM RIAHI, HELMI ZEBDA
F1000Research.2024; 13: 1394. CrossRef
Internal Hernia: An Uncommon and Often-Missed Differential Diagnosis of Abdominal Pain
Chaitanya Mishra, Khawaja O Omar
Cureus.2024;[Epub] CrossRef
Transomental Hernia: Rare Presentation in a Virgin Abdomen
Asiyah Shafi, Fatema Karmustaji, Muhammad Umar Younis, Monis Ahmed, Roger Gergy
Cureus.2024;[Epub] CrossRef
Lesser omental hernia through a defect in the posterior layer of the lesser omentum
Hirotaka Shibuya, Keita Sato, Yosuke Yamauchi, Yoshihisa Tamura, Koji Takahashi, Yasushi Asari
Surgical Case Reports.2023;[Epub] CrossRef
Spontaneous lesser omental herniation resolved by laparoscopic surgery: case report and systematic literature review
André S. Alves, Alexandre Balaphas, Katie Zuo, Philipp Hauser, Angeliki Neroladaki, Toni Raffoul
Surgical Endoscopy.2023; 37(9): 6704. CrossRef
Strangulated transomental hernia in virgin abdomen: laparoscopic surgery with a small laparotomy may be useful to assess the indeterminate viability of the bowel
Toyoaki Sawano, Tomohiro Kurokawa, Akihiko Ozaki, Divya Bhandari, Mioko Furuya, Yoshiaki Kanemoto, Masaharu Tsubokura, Tomozo Ejiri, Norio Kanzaki
Journal of Surgical Case Reports.2022;[Epub] CrossRef
Small Bowel Obstruction Caused by Spontaneous Transomental Hernia: A Case Report
So Ra Ahn, Keun Young Kim, Joo Hyun Lee
The Korean Journal of Gastroenterology.2022; 80(4): 186. CrossRef
Transomental hernia – An enigmatic case report causing bowel obstruction in a virgin abdomen
Latifa Al Buainain, Kiran B. Kaundinya, Faizal N. Hammed
International Journal of Surgery Case Reports.2020; 66: 88. CrossRef
Laparoscopic surgery for two patients with strangulated transomental hernias
Yuka Fujimoto, Yuki Ohya, Shintaro Hayashida, Masayoshi Iizaka, Yuto Maeda, Sayahito Kumamoto, Akira Tsuji, Hidekatsu Shibata, Kunitaka Kuramoto, Hironori Hayashi, Osamu Nakahara, Shinjiro Tomiyasu, Yukihiro Inomata
Surgical Case Reports.2020;[Epub] CrossRef
Displacement of the transverse colon is a highly specific computed tomography finding for the preoperative diagnosis of a transomental hernia
Ryota Ito, Kazuhiko Mori, Keisuke Minamimura, Toru Hirata, Takashi Kobayashi, Seiji Kawasaki
Japanese Journal of Radiology.2019; 37(8): 605. CrossRef

Original Article

Bezoar-induced Small Bowel Obstruction: Se Heon Oh, Hwan Namgung, Mi Hyun Park, Dong-Guk Park; J Korean Soc Coloproctol. 2012;28(2):89-93. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.89

6,009 View
63 Download
44 Citations

Abstract PDF

Purpose

The aim of this study was to observe the clinical features of a bezoar-induced small bowel obstruction and to investigate the role of abdominal computed tomography (CT) in establishing the diagnosis.

Methods

We retrospectively reviewed 20 cases of bezoar-induced small bowel obstruction in our hospital from 1996 to 2010.

Results

Thirteen patients (65%) had a history of abdominal surgery. Nine patients (45%) were diagnosed with a bezoar before surgery, seven patients were diagnosed by using abdominal CT, and two patients were diagnosed with a small bowel series. Abdominal CT was performed in 15 patients, and the diagnostic accuracy was 47% (7/15). Surgery revealed ten bezoars in the jejunum and 11 in the ileum. Two patients had bezoars found concurrently in the stomach. Spontaneous removal took place in two patients. An enterotomy and bezoar extraction was performed in 15 patients. Fragmentation and milking, a small bowel resection, and a Meckel's diverticulectomy were performed in one patient each. Early operative treatment was possible (P = 0.036) once the bezoar had been diagnosed by using abdominal CT. There tended to be fewer postoperative complications in patients who were diagnosed with a bezoar by using abdominal CT, but the result was not statistically significant (P = 0.712).

Conclusion

A preoperative diagnosis of bezoar-induced small bowel obstruction by using clinical features was difficult. Increased use of abdominal CT led to a more accurate diagnosis and to earlier surgery for bezoar-induced small bowel obstructions, thereby reducing the rate of complications.

Citations

Citations to this article as recorded by

Small intestinal obstruction caused by the gastric bezoars in elderly diabetic patients: A case report
Yifan Huang, Jie Meng, Shuo Zhang
International Journal of Surgery Case Reports.2025; 127: 110761. CrossRef
Small bowel obstruction caused by dehydrated apple ingestion: the challenges of preoperative radiological diagnosis and surgical management
Rama Hala Gamal Mikhail, Siobhan McKay, Mark Goodwin, Osamu Yoshino
BMJ Case Reports.2024; 17(2): e256710. CrossRef
Small bowel obstruction due to a meat bolus bezoar: the second case report in literature
Ammar Albostani, Fadi Kfelati, Wafaa Alsaadi, Rufaida Ahmad Faraman, Aasem Farman
Annals of Medicine & Surgery.2024; 86(2): 1139. CrossRef
Endoscopic lithotripsy combined with drug lithotripsy vs. drug lithotripsy for the treatment of phytobezoars: analysis of 165 cases
Xiao Zheng, Bin Qiu, Xiao-wei Jin, Lin-na Liu, Peng Wang, Hai-jing Yu, Juan Zhang, Wen-jing Geng, Rui Wang, Hua Liu
Surgical Endoscopy.2024; 38(5): 2788. CrossRef
A Rare Case of Gastric Phytobezoar (Diospyrobezoar) in a Healthy Adult
Ahmed M Odeh, Ahmed A Alkhalifa, Mohammed A AlHajji, Alwayah J Alahmed, Jawad H Alsalman, Abdulrahman M AlMulhem, Mohammed S AlGhadeer, Ezzeddin Kurdi, Fatima S Albader, Abdulmohsen Alsuwaigh, Mohammad A Khan
Cureus.2024;[Epub] CrossRef
Evaluation of the location, number and diameter of bezoars in patients with a history of previous gastrointestinal surgery
Ali Muhtaroğlu, Merve Yiğit, Hakan Demir, Uğur Dülger, Muhammed Doğangün, İbrahim Furkan Küçük, Fatih Altintoprak
European Journal of Trauma and Emergency Surgery.2023; 49(4): 1783. CrossRef
Diagnosis of a rare pediatric case of small-bowel obstruction secondary to a phytobezoar in a Meckel’s diverticulum aided by point-of-care ultrasound
Anastasia Zello, David Kirschner
Canadian Journal of Emergency Medicine.2023; 25(3): 244. CrossRef
Phytobezoar-Induced Mechanical Ileus and Incipient Intussusception: A Case Report
Christoforos S. Kosmidis, Chrysi Maria Mystakidou, Nikolaos Varsamis, Charilaos Koulouris, Christina Sevva, Konstantina Papadopoulou, Christina Michael, Nikolaos Iason Katsios, Vasiliki Theodorou, Petrina Miltiadous, Konstantinos Papadopoulos, Konstantino
Medicina.2023; 59(7): 1227. CrossRef
Small Bowel Obstruction by a Phytobezoar in a Patient With Previous Antrectomy and Billroth II Reconstruction
Alberto Abreu da Silva, Jéssica Ricardo, Andreia Ferreira, Diogo Sousa, José Augusto Martins
Cureus.2023;[Epub] CrossRef
Intestinal bezoar aggravated by hypomotility of ischemic small intestine: A case report
Ting‐Hsuan Chiang, Hsing‐Jung Yeh, Chun‐Chao Chang, Kuan‐Chieh Fang
Advances in Digestive Medicine.2022; 9(1): 52. CrossRef
Khat induced bezoar; a rare cause of small bowel obstruction:a case report
Badhaasaa Beyene, Burka Mohammadsani, Minewor Abdlhadi, Kedest Getachew, Hatae Ahmedin
International Journal of Surgery Case Reports.2022; 91: 106811. CrossRef
Impending perforation near ileocecal junction due to phytobezoar impaction and intraluminal polyp: a case report
Mehwish Mooghal, Asrar Ahmad, Adnan Safi, Wajiha Khan, Naveed Ahmad
Journal of Medical Case Reports.2022;[Epub] CrossRef
Inflammation and Obstruction of the Small Intestine Due to Phytobezoar: a Case Report
Van Trung Hoang, The Huan Hoang, Ngoc Trinh Thi Pham, Vichit Chansomphou, Duc Thanh Hoang
SN Comprehensive Clinical Medicine.2022;[Epub] CrossRef
Small bowel obstruction secondary to a plastic bezoar
Sarah Li-Ling Goh, Christopher Steen, Enoch Wong, Monique Scott
BMJ Case Reports.2022; 15(11): e251438. CrossRef
Small Bowel Obstruction Caused by an Aggressive Weight Loss Diet in a Patient With No Predisposing Factors
Samara C Hassranah, Aryaa Ramnarine, Sangeeta Parbhu, Vijay Naraynsingh
Cureus.2022;[Epub] CrossRef
Hematological manifestations of trichobezoar in a child
S.O. Nykytyuk, R.V. Bodnarchuk, O.R. Boyarchuk, S.S. Levenets, M.V. Dolynna
CHILD`S HEALTH.2022; 16(6): 435. CrossRef
Clinical characteristics and indications for surgery for bezoar-induced small bowel obstruction
Shuai Wang, Xiaohui Yang, Yixiong Zheng, Yulian Wu
Journal of International Medical Research.2021;[Epub] CrossRef
When eating makes you sick – Gastric stump obstruction caused by a phytobezoar. A case report and literature review
Mariana Claro, Daniel Costa Santos, Alberto Abreu Silva, Cláudia Deus, João Grilo, Diogo Sousa, José Augusto Martins
International Journal of Surgery Case Reports.2021; 79: 263. CrossRef
Phytobezoar: A train can hide another
Atef Mejri, Emna Trigui
International Journal of Surgery Case Reports.2021; 81: 105814. CrossRef
From Blocking Shots to Blocking GI Transit, This Professional Basketball Player Does It All: A Case Report on Small Bowel Obstruction
Emily L. DeMaio, Richard C. Jarvis, Jessica A. Cohen, Courtney N. Gleason, Aristomenis K. Exadaktylos
Case Reports in Medicine.2021; 2021: 1. CrossRef
Intestinal Obstruction Secondary to Multiple Gastrointestinal phytobezoars, A Rare presentation
Abdullah G. Alsahwan, Ameen M. Almarhoon, Jihad AlSafwani, Hanan Alsahwan, Neamat Alturki
International Journal of Surgery Case Reports.2021; 83: 106004. CrossRef
Bezoar as a cause of jejunal afferent loop mass after pylorus preserving pancreaticoduodedectomy: A case report
Woo Yong Lee
International Journal of Surgery Case Reports.2021; 85: 106177. CrossRef
A rare giant gastric trichobezoar in a young female patient: Case report and review of the literature
Dimitra G. Delimpaltadaki, Ioannis G. Gkionis, Mathaios E. Flamourakis, Andreas F. Strehle, Emmanouil N. Bachlitzanakis, Michail I. Giakoumakis, Manousos S. Christodoulakis, Konstantinos G. Spiridakis
Clinical Case Reports.2021;[Epub] CrossRef
A case series of intestinal obstruction secondary to shiitake mushroom intake during Chinese New Year
Gaik Huey Ng, Li Ying Teoh, Mei Sze Teh, Suniza Jamaris, Mee Hoong See
Journal of Surgical Case Reports.2020;[Epub] CrossRef
Clinical Case of a Patient with Small Bowel Obstruction and Multiple Diospirobesoaras of the Gastrointestinal Tract
A. S. Harutyunyan, V. D. Levitsky, V. V. Kiselev, P. A. Yartsev, A. V. Vodyasov, N. V. Shavrina
Russian Sklifosovsky Journal "Emergency Medical Care".2020; 9(2): 281. CrossRef
Adhesive small bowel obstruction – an update
Jia Wei Valerie Tong, Pravin Lingam, Vishalkumar Girishchandra Shelat
Acute Medicine & Surgery.2020;[Epub] CrossRef
Intestinal obstruction by a phytobezoar in a patient with a history of gastroplasty
Luiz de Abreu Junior, Gustavo Garcia Marques, Ingredy Tavares da Silva, Flávia Munhos Granja, Marcelo Zindel Salem
Radiologia Brasileira.2019; 52(2): 133. CrossRef
Parsnip phytobezoar causing small bowel obstruction
Denise I. Garcia, William Taylor Head, Aaron P. Lesher
Journal of Pediatric Surgery Case Reports.2019; 47: 101227. CrossRef
Clinics in diagnostic imaging (198)
YQA Soon, HM Low, CWT Huey, GKL Wansaicheong
Singapore Medical Journal.2019; 60(8): 397. CrossRef
When a cure becomes the pathology: mechanical bowel obstruction due to herbal pharmacobezoar. A case report with review of literature
Saurabh Gandhi, Eham Arora, Ajay Bhandarwar, Arun Patil, Amol Wagh, Shubham Gupta
Clinical Journal of Gastroenterology.2018; 11(5): 396. CrossRef
An unusual cause of small bowel obstruction due to an ingested mango seed: a case report
A. R. Fernando, R. Bulathsinghela, D. N. Samarasekera
BMC Research Notes.2017;[Epub] CrossRef
Small Bowel Obstruction Caused by Aloe vera Bezoars: A Case Report
In Taik Hong, Jae Myung Cha, Hye Jin Ki, Min Seob Kwak, Jin Young Yoon, Hyun Phil Shin, Jung Won Jeoun, Sung Il Choi
The Korean Journal of Gastroenterology.2017; 69(5): 312. CrossRef
Small bowel obstruction attributable to phytobezoar
Nasrin Razavianzadeh, Behzad Foroutan, Farhad Honarvar, Mohammad Forozeshfard
Oxford Medical Case Reports.2016; 2016(12): omw092. CrossRef
Intestinal obstruction due to phytobezoars: An update
Enis Dikicier
World Journal of Clinical Cases.2015; 3(8): 721. CrossRef
Bezoar-induced small bowel obstruction: Clinical characteristics and diagnostic value of multi-slice spiral computed tomography
Pei-Yuan Wang
World Journal of Gastroenterology.2015; 21(33): 9774. CrossRef
Imaging differentiation of phytobezoar and small-bowel faeces: CT characteristics with quantitative analysis in patients with small- bowel obstruction
Ya-Cheng Chen, Chang-Hsien Liu, Hsian-He Hsu, Chih-Yung Yu, Hong-Hau Wang, Hsiu-Lung Fan, Ran-Chou Chen, Wei-Chou Chang
European Radiology.2015; 25(4): 922. CrossRef
Ultrasonographic differentiation of bezoar from feces in small bowel obstruction
Kyung Hoon Lee, Hyun Young Han, Hee Jin Kim, Hee Kyung Kim, Moon Soo Lee
Ultrasonography.2015; 34(3): 211. CrossRef
Bulbus psododivertikülde mide çıkış obstrüksiyonuna neden olan ve gastroskopi ile mideye alınması sonrası ileus gelişen bezoar: olgu sunumu ve literatürün gözden geçirilmesi (duodenal bezoar)
Ahmet UYANIKOĞLU, Haşim NAR, Ahmet ŞEKER, Ferzan AYDIN, Yusuf YÜCEL, Necati YENİCE
Endoskopi Gastrointestinal.2015; 23(2): 58. CrossRef
Two cases of small bowel obstruction secondary to a swallowed potato
E Castren, A Hakeem, N S Mahmood, K Aryal
BMJ Case Reports.2015; 2015: bcr2015213744. CrossRef
Phytobezoar: an unexpected cause of bowel obstruction in a pregnant woman with a history of Roux-en-Y gastric bypass
Faustine Deront Bourdin, Antonio Iannelli, Jerôme Delotte
Surgery for Obesity and Related Diseases.2014; 10(6): e49. CrossRef
Bezoar: An unusual cause of intestinal obstruction
K. Stratakis, A. Tsepelaki, E. Karallas, K. Koutsopoulos
Hellenic Journal of Surgery.2014; 86(1): 29. CrossRef
Intussusception caused by dried apricot: A case report
Yana Puckett, Jon Nathan, Sharmila Dissanaike
International Journal of Surgery Case Reports.2014; 5(12): 1254. CrossRef
Acute small bowel obstruction in a girl, caused by a jejunal bezoar composed of textile fibers
S. Zwaveling, D.C. van der Zee
Journal of Pediatric Surgery Case Reports.2013; 1(8): 192. CrossRef
Complications of Bezoar in Children: What Is New?
Kam Lun Ellis Hon, Jean Cheng, Chung Mo Chow, Hon Ming Cheung, Kam Lau Cheung, Yuk Him Tam, Alexander K. C. Leung
Case Reports in Pediatrics.2013; 2013: 1. CrossRef

Case Report

A Case of Successful Colonoscopic Treatment of Colonic Obstruction Caused by Phytobezoar: Sang Seok Yoon, Min Seong Kim, Dong Yoon Kang, Tack Su Yun, Jun Ho Jeon, Yong Kyu Lee, Se Woong Choi, Chi Hoon Kim; J Korean Soc Coloproctol. 2011;27(4):211-214. Published online August 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.4.211

6,340 View
41 Download
11 Citations

Abstract PDF

A phytobezoar is the most common type of bezoar, which is a gastrointestinal mass composed of vegetable. A persimmon is a common cause of a phytobezoar. The majority of bezoars are found in the stomach, with the small intestine being the next most commonly involved site. The colon is a rare site for a bezoar. Recently, we experienced a colonic bezoar that caused colonic obstruction in a 66-year-old female patient who took persimmons regularly. The patient came to the hospital because of abdominal pain and distension. To differentiate a tumor or other problems that can cause intestinal obstruction, we performed an abdominal computed tomography scan and found an ovoid intraluminal mass with a mottled gas pattern in the distal descending colon. A large impacted bezoar was seen in the sigmoid colon, which was completely obstructed, and it was successfully removed by using colonoscopy.

Citations

Citations to this article as recorded by

Diagnosis and treatment of giant colonic fecalith in a child: a case report
Wei Su, Jing Chen, Yuxia Zhao, Pingping Xu, Jingwen Yuan, Chunqi Luo, Jie Liu, Baoxiang Wang
Frontiers in Pediatrics.2025;[Epub] CrossRef
A Rectal Sunflower Seed Bezoar Causing Fecal Impaction in a Healthy Young Woman
Yucel Aydin, Lasha Gogokhia, Syed Mustajab Ahmed, Salim I Turan, Bethel Shiferaw
Cureus.2023;[Epub] CrossRef
Unusual causes of large bowel obstruction
Nicholas G. Farkas, Ted Joseph P. Welman, Talisa Ross, Sarah Brown, Jason J. Smith, Nikhil Pawa
Current Problems in Surgery.2019; 56(2): 49. CrossRef
An Obstructing Fecal Bezoar in a Patient with Scleroderma with Successful Colonoscopic Disimpaction
Rachel Sarnoff, Blen Girmay, Dimpal Bhakta, Robert Mocharla, Renee Williams
ACG Case Reports Journal.2019; 6(4): e00059. CrossRef
A Rare Case of Fatal Bowel Obstruction Secondary to a Colonic Bezoar
Fiorella Caputo, Rosario Barranco, Alessandro Bonsignore, Giulio Fraternali Orcioni, Francesco Ventura
American Journal of Forensic Medicine & Pathology.2018; 39(1): 38. CrossRef
Colonic phytobezoar
Cláudio Franco do Amaral Kfouri, Maria Clara Ferreira Nonato Romania, Rennan Josely Moreira Julião, André Domingos Pippa Tomazella, Guilherme Paulo Carvalho de Amorim, Cleibe Nicácio da Silva, Claudinei da Silva, Maria Cristina Sartor
Journal of Coloproctology.2018; 38(03): 246. CrossRef
A huge mass causing colonic obstruction at the hepatic flexure
Chang Hwi Yoon, Byoung Wook Bang, Kye Sook Kwon, Hyung Kil Kim, Yong Woon Shin
Intestinal Research.2018; 16(2): 323. CrossRef
Successful Removal of Hard Sigmoid Fecaloma Using Endoscopic Cola Injection
Jong Jin Lee, Jeong Wook Kim
The Korean Journal of Gastroenterology.2015; 66(1): 46. CrossRef
Colonic phytobezoar as a rare cause of large bowel obstruction
Gin Way Law, Diwei Lin, Rebecca Thomas
BMJ Case Reports.2015; 2015: bcr2014208493. CrossRef
PERSIMMON PHYTOBEZOARS IN MEERKATS (SURICATA SURICATTA)
Alicia Hahn, Jennifer D'Agostino, Gretchen Cole, Michael Garner
Journal of Zoo and Wildlife Medicine.2013; 44(2): 505. CrossRef
Gastric Electrical Stimulation for the Treatment of Obesity: From Entrainment to Bezoars—A Functional Review
Martin P. Mintchev
ISRN Gastroenterology.2013; 2013: 1. CrossRef

Original Article

Changes in Migrating Motor Complex after Bowel Obstruction in the Murine Ileum.: Moon, Sang Hui , Oh, Heung Kwon , Ryoo, Seungbum , Choe, Eun Kyung , Moon, Jung Sun , Park, Kyu Joo; J Korean Soc Coloproctol. 2010;26(3):171-178.; DOI: https://doi.org/10.3393/jksc.2010.26.3.171

2,190 View
12 Download
1 Citations

Abstract PDF

PURPOSE
Partial obstruction of the small bowel causes hypertrophy of smooth muscle cells and enteric neurons. After small bowel obstruction, slow waves have also been reported to disappear or to be greatly reduced at the oral site of the obstruction in the murine ileum. The purpose of this research was to study the changes in migrating motor complexes (MMCs) after partial obstruction in order to compensate for the attenuated function of slow waves.
METHODS
A ring of film (6 mm in length, 4 mm in internal diameter) was placed over the small intestine 5-6 cm oral to the ileocecal valve in 8-10 wk old female ICR mice. These rings resulted in a partial obstruction of the intestine after 2 wk. The mechanical activities of the small intestine were recorded and the amplitude, interval, and half-duration of the MMCs were analyzed.
RESULTS
The MMCs from a partially obstructed ileum occurred every 1.58+/-1.06 min and had a half-duration of 6.90+/-5.54 sec. The interval and the half-duration of the control MMCs were 3.60+/-1.11 min and 31.5+/-11.4 sec, respectively. The difference in interval and the half-duration of the MMCs reached statistical significance (P=0.03; P=0.00). The amplitude and the area under the curve (AUC) of the MMCs of the obstructed ileum were much higher than those of the control (31.3+/-8.86 vs. 6.05+/-1.92 mN; 161.18+/-44.09 vs. 72.95+/-2.45 mN . sec/MMC wave; P=0.00, 0.02).
CONCLUSION
The MMCs with higher amplitude and AUC, with shorter interval, and with shorter half-duration, compared with those of the control, were recorded from the partially obstructed murine ileum, reflecting efforts to overcome the effect of obstruction by increasing the power of contractions.

Citations

Citations to this article as recorded by

Migrating motor complex changes after side-to-side ileal bypass in mouse ileumex-vivo: mechanism underlying the blind loop syndrome?
Suk-Bae Moon, Kyu-Joo Park, Jung-Sun Moon, Eun-Kyoung Choe, In-Suk So, Sung-Eun Jung
Journal of the Korean Surgical Society.2011; 80(4): 251. CrossRef

First
Prev
Page of 2
Next
Last

Search