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All ileo-cecal ulcers are not Crohn's:Changing perspectives of symptomatic ileocecal ulcers

World Journal of Gastrointestinal Endoscopy 2017年第7期9卷 327-333页

作者： Jay Toshniwal Romesh Chawlani Amit Thawrani Rajesh Sharma Anil Arora Hardik L Kotecha Mohan Goyal Vijendra Kirnake Pankaj Jain Pankaj Tyagi Naresh Bansal Munish Sachdeva Piyush Ranjan Mandhir Kumar Praveen Sharma Vikas Singla Rinkesh Bansal Vineet Shah Sunita Bhalla Ashish Kumar Department of Gastroenterology Dr.Toshniwal’s Gastro-Liver Care Department of Gastroenterology Sir Gangaram Hospital Department of Histo-pathology Sir Gangaram Hospital

AIM To investigated clinical,endoscopic and histopathological parameters of the patients presenting with ileocecal ulcers on *** Consecutive symptomatic patients undergoing colonoscopy,and diagnosed to have ulcerations in the ileocecal(I/C) region,were *** was obtained and theirclinical presentation and outcome were *** Out of 1632 colonoscopies,104 patients had ulcerations in the I/C region and were included in the *** median age was 44.5 years and 59% were *** predominant presentation was lower GI bleed(55,53%),pain abdomen ± diarrhea(36,35%),fever(32,31%),and diarrhea alone(9,9%).On colonoscopy,terminal ileum was entered in 96(92%) *** distribution of ulcers was as follows:Ileum alone 40%(38/96),cecum alone 33%(32/96),and both ileum plus cecum 27%(26/96).The ulcers were multiple in 98% and in 34% there were additional ulcers elsewhere in *** on clinical presentation and investigations,the etiology of ulcers was classified into infective causes(43%) and noninfective causes(57%).Fourteen patients(13%) were diagnosed to have Crohn's disease(CD).CONCLUSION Non-specific ileocecal ulcers are most common ulcers seen in ileo-cecal *** if all infections are clubbed together then infection is the most common(> 40%) cause of ulcerations of the I/C *** involvement and fever are important clues to infective *** the contrary CD account for only 13% cases as a cause of *** all symptomatic patients with I/C ulcers on colonoscopy are not Crohn's.

关键词： ileocecal Crohns 疾病传播大 B 房间 non-hodgkins 淋巴瘤

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Primary colonic melanoma presenting as ileocecal intussusception: Case report and literature review

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World Journal of Gastroenterology 2014年第28期20卷 9626-9630页

作者： Wen-xiang Li Ye Wei Yi Jiang Ya-Lan Liu Li Ren Yun-Shi Zhong Le-Chi Ye De-xiang Zhu Wei-xin Niu xin-Yu Qin Jian-min xu Department of Clinical Pathology Bucheon St.Mary’s HospitalThe Catholic University of KoreaCollege of Medicine epartment of Pathology Zhongshan HospitalFudan University

Primary malignant melanoma originating in the colon is an extremely rare ***,we report a case of primary melanoma of the ascending *** patient was a 57-year-old male who was admitted to our hospital for persistent abdominal pain and episodes of bloody stool,nausea and vomiting.A computed tomography scan revealed lower intestinal intussusception and enlarged lymph nodes in the abdominal cavity and *** laparoscopic operation,multiple enlarged lymph nodes were *** segments of the proximal small intestine were incarcerated into the distal small intestine,forming an internal hernia and *** necrotic terminal ileum was invaginated into the ascending ***,adhesive internal hernia reduction and palliative right hemicolectomy were *** examination of the excised specimen revealed a polypoid mass in the ascending *** examination showed epithelioid and spindle tumor cells with obvious cytoplasmic melanin *** staining revealed that the tumor cells were positive for S-100,HmB-45 and vimentin,confirming the diagnosis of *** patient history and a thorough postoperative investigation excluded the preexistence or coexistence of a primary lesion elsewhere in the skin,anus or oculus or at other ***,we consider our case to represent an aggressive primary colon melanoma presenting as ileocecal intussusception and intestinal obstruction.

关键词： melanoma Colon ileocecal intussusception metastasi

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混合的自然的孔 transluminal 为 ileocecal 的内视镜的外科切除术

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World Journal of Gastrointestinal Surgery 2012年第2期4卷 41-44页

作者： Satoru Takayama Masayasu Hara Mikinori Sato Hiromitsu Takeyama Department of Gastroenterological Surgery Nagoya City University Graduate School of Medical SciencesNagoya

Although laparoscopic colectomy is commonly performed around the world,an operative wound formed during the surgery is large but not sufficient enough to convert for the majority of open ***,a certain sized skin incision is required to remove the resected *** we report the case of a pure laparoscopic ileocecal resection which involves transanal specimen *** present a case characterized by a laterally spreading type of tumor of the *** performed a pure laparoscopic ileocecal resection and the resected specimen was removed transanally using *** functional anastomosis was then performed using a flexible linear stapling device under supporting barbed suture *** patient was discharged without complications on postoperative day *** colectomy performed with minimal incision could essentially increase the usage of this surgical *** our method is restricted to flat or small lesions,we think it is a feasible and realistic solution for minimization of operative invasion because it involves specimen extraction through a natural orifice.

关键词： Laparoscopic ileocecal resection Natural orifice transluminal endoscopic surgery Transanus Barbed suture

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