• Advances in pediatric surgery
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• v.10 no.1
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• pp.60-62
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• 2004

Leveling colostomy with a frozen-section biopsy in a Hirschsprung's disease is an important factor for a successful procedure. Two neonatal cases of Hirschsprung's disease in the descending colon are reported. In both cases, loop ileostomy was established because of the unavailability of frozen-section biopsy on an emergency basis. At the time of definitive procedure of the first case, transition zone at the splenic flexure was noted and was compatible with the frozen section biopsy. In the second case, an unexpected longer resection at a higher level than transition zone was required because of the poor vascularity after dissection. In conclusion, a leveling colostomy should be selected as a choice in long-segment Hirschsprung's disease. Confirming preservation of the marginal artery of Drummond is particularly important in case of Hirschsprung's disease in the descending colon.

• Journal of Veterinary Clinics
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• v.27 no.1
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• pp.113-116
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• 2010

A 6-years-old 30 kg male Germen Shepherd dog was presented with the history of abdominal pain, intermittent vomiting and anorexia. Abdominal survey radiography and ultrasonography revealed marked colonic distention. Positive contrast radiography revealed a colonic obstruction between the transverse colon and descending colon. Foreign bodies were identfied during colonoscopy. The descending colon was inflated by the air of endocope then foreign bodies were moved to the descending colon. Foreign bodies were removed by the enema. The dog's clinical signs resolved following foreign body removal.

• Journal of Veterinary Clinics
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• v.16 no.2
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• pp.486-491
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• 1999

One day to one week-old 3 female Korean native calves were referred to the Veterinary Teaching Hospital, Chonbuk National University, with atresia ani. The authors performed radiographic and ultrasonographic diagnosis with physical examination, general hematology and blood chemical examination as investigation. The atresia ani were type I, II, III in each 3 calves. In abdominal radiography and ultrasonography, there were ventral displacement of descending colon(gas and feces filled) and typical enlargement of the blind end of colon in all cases. Operation site was determined by radiographic and ultrasonographic findings in these cases. Surgical treatment, two cases were translocation of the colon to the body wall exiting as a colostomy and one case was corrected by making a circumcision through the skin covering the site of the anus.

• Advances in pediatric surgery
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• v.1 no.1
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• pp.68-72
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• 1995

Segmental dilatation of the colon is a very rare disease entity of unknown etiology and may mimic Hirschsprung's disease. It is characterized by dilatation of a segment of the colon of variable length with obstruction due to lack of peristalsis in a normally innervated intestine. Recently authors experienced a case of segmental dilatation of the sigmoid colon in a 6 month-old male, who presented with severe constipation, abdominal distention, and abdominal mass since 2 months of age. Down's syndrome and congenital nystagmus were associated. Barium enema demonstrated focal dilatation of the sigmoid colon, but the rectum and descending colon proximal t o the affected colon were of normal caliber. Rectal suction biopsy with acetylcholinesterase staining was normal and anorectal manometry showed normal rectosphincteric reflex. At operation, there was a massively dilated and hypertrophied sigmoid colon with increased tortuous serosal vessels, measuring 15 cm in length and 10 cm in width. Teniae coli were identifiable in the affected segment. Frozen section biopsies at the proximal, affected, and distal colon showed ganglion cells. Descending loop colostomy was constructed initially and segmental resection and end to end colocolostomy were carried out 3 months later. Final histologic examination showed 1) normal colonic mucosa with ganglion cells, 2) prominent submucosal fibrosis and marked muscular hypertrophy, 3) unremarkable acetylcholinesterase activity and immunohistochemical findings against S-100 protein. On 8 months follow-up, he has been doing well and moves bowels 1-2 times daily.

• Journal of Veterinary Clinics
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• v.28 no.3
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• pp.336-338
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• 2011

A 5-day-old male Korean native calf was referred with the primary complaint of anorexia, absence of feces, depression, and abdominal distention. Although this case was tentatively diagnosed as atresia coli, plain and contrast radiography was performed to confirm site and appearance of obstruction. A plain radiograph revealed gas distension in the large intestine, with absence of fecal material in the descending colon. In a contrast radiograph, the blind part of descending colon that was accumulated with contrast media smoothly protruded to distended colon with gas and the middle part was seen as narrow. These findings were well corresponded with the mucosal blockage junction between distended spiral loop with gas and descending colon that was hypoplasia or atropy in necropsy. In conclusion, contrast radiography was considered very useful method to identify the site and type of obstruction in diagnosis of atresia coli.

• Journal of Veterinary Clinics
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• v.31 no.5
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• pp.430-434
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• 2014

Two dogs were referred with the clinical signs of depression and constipation, respectively. One dog with depression had hypoglycemia on biochemistry. On survey abdominal radiographs, a soft tissue density round mass with calcified spots was identified cranial to the urinary bladder. On ultrasonographs, a solitary oval heterogeneous complex-echoic mass with well-defined margin was found. On surgery, the mass was pedunculated and originated from the colonic wall. The resected mass was confirmed as colonic leiomyoma. The other dog with constipation had normal CBC and biochemistry values. On survey abdominal radiographs, there was a soft tissue density round mass dorsal to the descending colon and rectum. The descending colon was displaced ventrally and narrowed by the mass. On ultrasonographs, a well-defined round heteroechoic mass compressed the colon. The mass was also pedunculated and originated from the colonic wall on surgery and confirmed as colonic leiomyoma. Two dogs recovered without any clinical signs after surgery and showed permanent resolution of the clinical signs, respectively.

• The Korean Journal of Pain
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• v.6 no.2
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• pp.199-203
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• 1993

Inferior mesenteric plexus block(IMPB) is a nerve block for lower abdominal pain originating from GI tract of distal transverse colon to sigmoid colon and other polvic organ where the inferior mesenteric plexus contains visceral afferent fibers of that organ. We performed IMPB on two patients with lower abdominal pain. Case I: 61 year old female diagnosed with cancer of stomach and uterine cervix and carcinomatosis, experienced complete relief from pain for a period of 7 months after IMPB. Case II: male, 28 years old, who had contracted cancer of the descending colon with obstructive jaundice and pancreatitis had complained of pain in the whole of the abdominal area. IMPB was performed for lower abdominal pain. Seven days after, a celiac plexus block was also performed for upper abdominal pain. The patient complained of recurring pain in the left & upper lower abdomen 30 days after the IMPB. The intensity of the pain was visual analogue scale 4 and it was managed by continuous epidural block. Conclusion: It is our recommendation that IMPB is a reliable method for treatment of lower abdominal pain originating from malignant condition of GI tract from distal transverse colon to sigmoid colon and urinary bladder.

• Journal of Neurogastroenterology and Motility
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• v.24 no.4
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• pp.614-627
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• 2018

Background/Aims Although functional abdominal pain disorders (FAPDs) are common in children, the accurate pathogenesis of FAPDs is not known yet. Micro-inflammation, particularly tissue eosinophilia of gastrointestinal (GI) tract, has been suggested as the pathophysiology observed in several GI disorders. We aimed to evaluate eosinophilic infiltration throughout the entire GI tract in children with FAPDs, compared to those with inflammatory bowel diseases (IBD) and to normal reference values. Methods We included 56 children with FAPDs, 52 children with Crohn's disease, and 23 children with ulcerative colitis. All subjects underwent esophagogastroduodenoscopic and colonoscopic examination with biopsies. Tissue eosinophil counts were assessed in 10 regions throughout the GI tract. Results Eosinophil counts of the gastric antrum, duodenum, terminal ileum, cecum, and ascending colon were significantly higher in children with FAPDs compared to normal reference values. Eosinophil counts of the stomach and the entire colon were observed to be significantly higher in children with IBD than in those with FAPDs. Even after selecting macroscopically uninvolved GI segments on endoscopy in children with IBD, eosinophil counts of the gastric body, cecum, descending colon, sigmoid colon, and the rectum were also significantly higher in children with IBD than those with FAPDs. Conclusions Significantly high eosinophil counts of the stomach and colon were observed in the order of IBD, followed by FAPDs, and normal controls, regardless of endoscopically detected macroscopic IBD lesions in children. This suggests some contribution of GI tract eosinophils in the intrinsic pathogenesis of FAPDs in children.

• Advances in pediatric surgery
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• v.4 no.2
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• pp.172-175
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• 1998

With the recent advances in instruments and techniques, laparoscopic procedure have extended to neonates with congenital anomalies. The author reports a 6-day-old boy with Hirschsprung's disease, treated successfully by the laparoscopic endorectall pull-through procedure. The technique and its potential role in the treatment of Hirschsprung's disease are described. One camera port and three working ports were used for access to the peritoneal cavity. The descending and sigmoid colon were mobilized laparoscopically. The submucosal dissection was done transanally. The colon was then pulled down in continuity, divided above the transition zone, and secured to the anal mucosa about 10 mm above the pectinate line. Author concluded that endorectal pull-through can be performed safety with the laparoscope.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.279-282
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• 2012

Background: Although more than two third of colorectal cancers are localized on the left side, recent studies suggest a right ward shift in anatomical distribution with increase in proximal colon cancers. The aim of the present study was to determine the anatomical distribution of colorectal cancer in a referral center over a 15 year period. Method: Records of patients who underwent colectomy in the Cancer Institute of Iran from 1994 to 2009 were retrieved. Data including anatomical localization, year of diagnosis, patient age and gender, tumor histology and differentiation, and disease stage were extracted. Tumors located from the cecum to the distal transverse colon were classified as right side and those occurring from the splenic flexure to the descending colon as left-sided. Cancer of rectum and recto-sigmoid junction were considered as rectal cancers. Results: A total of 442 patients including 220 (49/8%) men and 222 (50/2%) women with mean age 53 were included. Most patients were in stage II &III (47.1% and 33% respectively). There were 157 (35.5 %) colon cancers and 285 (64.5%) rectal cancers. 43.3% of the colon cancers were right sided and 56.7% were left sided. There was no statistically significant increase in right sided cancer during the period of the study. There were no significant differences in age at diagnosis, gender, grade and stage of tumor between the right and the left sided cancers. Conclusion: No proximal shift over time was identified in our study.