Peutz−Jeghers Syndrome
Dongyou Liu in Handbook of Tumor Syndromes, 2020
PJS polyps typically emerge within the first few years of life in the small intestine (typically jejunum followed by ileum and duodenum, 64% of cases), colon (63%), stomach (48%), and rectum (32%), but not esophagus (Figure 22.2) [9]. Sometimes, polyps may occur in the renal pelvis, urinary bladder, ureters, gallbladder, lungs, and nostrils. Showing erratic growth, PJS polyps may remain the same size for many years, and some polyps may regress or autoamputate spontaneously. While their potential for malignant transformation remains to be determined, PJS polyps are responsible for small intestinal obstruction and intussusception (42.8% of cases, due mainly to polyps of ≥1 .5 cm in diameter, usually between the ages of 6 and 18 years), abdominal pain due to infarction (23%), hematochezia (rectal bleeding) due to ulceration (13.5%), prolapse of colonic polyp (7%), nausea, vomiting, and secondary iron deficiency/anemia (typically occurring in the second and third decades of life) [10–12].
Benign Neoplasms of the Colon and Rectum
Philip H. Gordon, Santhat Nivatvongs, Lee E. Smith, Scott Thorn Barrows, Carla Gunn, Gregory Blew, David Ehlert, Craig Kiefer, Kim Martens in Neoplasms of the Colon, Rectum, and Anus, 2007
Adenomas of the large bowel are usually asymptomatic and are frequently discovered during routine radiologic studies or endoscopic examinations. Bleeding per rectum is the most common finding if the polyp is situated in the rectum or sigmoid colon. A large pedunculated polyp in the lower part of the rectum may prolapse through the anus. A large villous adenoma may manifest as watery diarrhea; in rare instances it causes fluid and electrolyte imbalance. Intermittent abdominal pain from recurrent intussusception or spasm may occur with a large colonic polyp but is unusual. Mild anemia may follow chronic bleeding from an ulcerative polyp. With a small polyp, up to 8 mm, biopsy and electrocoagulation can be performed, preferably using a “hot” biopsy forceps for histopathologic examination. A large polyp should be completely snared or excised and sent for histopathologic examination. A biopsy of a large polyp does not represent the entire lesion and presents difficulty in the interpretation of an invasive carcinoma. Occasionally, biopsy may cause displacement of the gland into the submucosa and can be misinterpreted as an invasive carcinoma (27). This pseudoadenomatous invasion can also be caused by trauma from hard feces, repeated twisting of the stalk with subsequent ulceration of the surface (28).
Micronutrients in Cancer Prevention
Kedar N. Prasad in Micronutrients in Health and Disease, 2019
The third stage of carcinogenesis involves the induction of random mutations in the hyperplastic cells. Most of such mutations play no role in converting hyperplastic cells to cancer cells; however, when mutations occur in specific cellular genes, oncogenes, or antioncogenes, hyperplastic cells become cancerous. This is well demonstrated in colon polyps and female breast and ovarian cysts, which remain noncancerous for a long time, but if not removed, become cancerous. Because mutation occurs randomly, the colon polyp may carry defects in more than one oncogene. The multiple, heterogeneous foci of cancer cells found in the colon polyps are not necessarily clonal with respect to a given oncogene. This heterogeneity may be the reason why, in spite of extensive research in molecular carcinogenesis, it has not been possible to establish any direct relationship between the presence of one defective oncogene or other cellular genes and tumor type or tumor behavior, although some associations between oncogene or anti-oncogene and tumor behavior have been documented.
Short-term effect of a negative colonoscopy in patients with functional constipation
Published in Baylor University Medical Center Proceedings, 2019
Qi-Shan Zeng, Juliana Yang, Chun-Cheng Wu, Lian-Song Ye, Wei Liu, Hong-Ze Zeng, Shan Jiang, Yu-Hang Zhang, Xiang-Lei Yuan, Xian-Hui Zeng, Yong-Hong Luo, Bing Hu
A total of 75 patients with chronic constipation were enrolled, with written informed consent provided for all patients. Sixty-nine patients were eligible for enrollment. Six patients were ineligible; among them, two had colon cancer and four had colonic polyp/adenoma with diameter >6 mm. Unfortunately, among the 69 patients, 8 patients were lost to follow-up after their colonoscopy. Finally, 61 patients with functional constipation completed the pre- and postcolonoscopy questionnaires. Among the 61 patients, 20 patients did not take any medicines for constipation before and after colonoscopy (group 1), 16 patients took the same medicine before and after colonoscopy (group 2), 9 patients took medicine before colonoscopy but no medicine after colonoscopy (group 3), 9 patients took different medicines before and after colonoscopy (group 4), and 7 patients did not take medicine before colonoscopy but did after colonoscopy (group 5). Therefore, only 45 patients (groups 1, 2, and 3) were included in the statistical analysis. Demographic features of this patient cohort are shown in Table 1.
Modeling spatial interaction networks of the gut microbiota
Published in Gut Microbes, 2022
Xiaocang Cao, Ang Dong, Guangbo Kang, Xiaoli Wang, Liyun Duan, Huixing Hou, Tianming Zhao, Shuang Wu, Xinjuan Liu, He Huang, Rongling Wu
Six volunteers were recruited for the study at the Department of Gastroenterology and Hepatology of Tianjin Medical University General Hospital. Disease severity in five patients infected with UC was assessed by the modified Mayo endoscopic score. One patient with colonic polyp was marked as a non-UC control (HC). Ethics approval was received from the Tianjin Medical University General Hospital Clinical Research Ethics Committee. All patients signed the informed consent form prior to their operation, and they received polyethylene glycol-based bowel preparation for colonoscopy. Demographic data and clinical characteristics of the UC and non-UC patients are shown in Table 1.
Long-term bowel dysfunction after right-sided hemicolectomy for cancer
Published in Acta Oncologica, 2020
Helene Mathilde Larsen, Hossam Elfeki, Katrine Jøssing Emmertsen, Søren Laurberg
This cross-sectional study was based on a national Danish cohort of patients with cancer in the cecum or ascending colon treated with right-sided hemicolectomy. The control group consisted of patients treated with an endoscopic polypectomy of a malignant colon polyp. All patients received a questionnaire regarding bowel function and QoL. Data from the questionnaire were compared to prospective data from the Danish Colorectal Cancer Group’s (DCCG) national database, where all patients diagnosed with colorectal cancer in Denmark since May 2001 are registered.