Colorectal cancer is one of the most common cancers in the world, and it is one of the leading causes of cancer-related death. Despite recent progress in the development of screening programs and in the management of patients with colorectal cancer, there are still many gaps to fill, ranging from the prevention and early diagnosis to the determination of prognosis factors and treatment of metastatic disease, to establish a personalized approach. The genetic profile approach has been increasingly used in the decision-making process, especially in the choice of targeted therapies and in the prediction of drug response, but there are still few validated biomarkers of colorectal cancer for clinical practice. The discovery of non-invasive, sensitive, and specific biomarkers is an urgent need, and translational proteomics play a key role in this process, as they enable better comprehension of colorectal carcinogenesis, identification of potential markers, and subsequent validation. This review provides an overview of recent advances in the search for colorectal cancer biomarkers through proteomics studies according to biomarker function and clinical application.
Patient: Female, 74Final Diagnosis: Perforated jejunal diverticulumSymptoms: Abdominal pain • Nauseas • VomitsMedication: —Clinical Procedure: —Specialty: SurgeryObjective:Rare diseaseBackground:Jejunal diverticulosis is a rare clinical condition, and the majority of patients are asymptomatic. However, some patients can develop serious complications, including perforation. We report the case of a 74-year-old female patient with a perforated jejunal diverticulum who presented with an ‘acute abdomen’ and with pneumoperitoneum on X-ray radiography.Case Report:A 74-year-old female patient presented to the emergency department with a 24-hour history of acute onset of diffuse abdominal pain associated with nausea and vomiting. Physical examination showed signs of generalized peritonitis. The chest radiograph showed a pneumoperitoneum. An emergency laparotomy was performed, and a perforated jejunal diverticulum was identified. Resection of the involved jejunal segment and a primary jejunal anastomosis were performed.Conclusions:Perforated jejunoileal diverticula should be included in the differential diagnosis for elderly patients who present with an acute abdomen. A delay in the diagnosis can be fatal in this group of patients. Although radiographic signs, such as pneumoperitoneum, are unusual in these cases, this finding should provide a diagnostic clue for the physician.
Introduction McKittrick-Wheelock syndrome is a rare condition that arises from a hypersecretory state secondary to large colorectal tumors, mainly villous adenomas, leading to an electrolytic disorder associated with chronic diarrhea that usually persists for years. It is a relatively unknown disease that can lead to severe complications such as acute kidney injury, severe hyponatremia, and hypokalemia. In fact, it causes death in most untreated cases. Surgical removal of the tumor is the most successful treatment, and symptoms tend to disappear after proper management.
Case Report A 62-year-old man with a 2-year history of mucoid diarrhea preceded by abdominal pain presented with acute kidney injury, hyponatremia, and hypokalemia. A digital rectal examination and sigmoidoscopy were performed, and revealed a large laterally-spreading tumor in the rectum. Further investigation showed a rectal tubulovillous adenoma with secondary McKittrick-Wheelock syndrome. An anterior resection of the rectum with a colonic J-pouch and a diverting ileostomy were performed, and the patient improved with the resolution of the renal failure and electrolyte disturbances. The histopathological analysis revealed an invasive rectal adenocarcinoma.
Discussion McKittrick-Wheelock syndrome is a condition with a low incidence that needs early intervention and proper diagnosis. It is of extreme importance that this disease is included in the differential diagnoses for chronic diarrhea associated with an electrolytic disorder.
Transanal endoscopic microsurgery is considered a safe, appropriate, and minimally invasive approach, and complications after endoscopic microsurgery are rare. We report a case of sepsis and pneumoretroperitoneum after resection of a rectal lateral spreading tumor. The patient presented with rectal mucous discharge. Colonoscopy revealed a rectal lateral spreading tumor. The patient underwent an endoscopic transanal resection of the lesion. He presented with sepsis of the abdominal focus, and imaging tests revealed pneumoretroperitoneum. A new surgical intervention was performed with a loop colostomy. Despite the existence of other reports on pneumoretroperitoneum after transanal endoscopic microsurgery, what draws attention to this case is the association with sepsis.
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