Enema has frequently been used for diagnostic or therapeutic purpose. However, cases of colitis from physical, chemical, and thermal injury due to enema have been reported. In severe cases, life threatening complications (perforation, rupture, peritonitis, etc.) may occasionally occur. Reports of ischemic colitis after enema is rare and there have been only 1 case of ischemic colitis after normal saline enema reported in South Korea. Sigmoidoscopy on a 58 year old female, presenting with sudden abdominal pain and hematochezia after glycerin enema, revealed ischemic injury of the rectosigmoid colon, which was improved after using antibiotics and conservative therapy.
Metastatic tumors of the spermatic cord are extremely rare, and the prognosis for patients is typically poor. In the majority of cases, the primary tumor occurs in the gastrointestinal tract. We report a case of a 62-year-old man with a metastatic spermatic cord tumor. The patient complained of groin discomfort with a tender mass in the right inguinal area. An excisional biopsy was performed, and the pathologic finding was a metastatic mucinous adenocarcinoma. We performed a systemic evaluation including colonoscopy, abdominal computed tomography, and total-body positron emission tomography, and the primary tumor was confirmed to involve the total colon, including the cecum, sigmoid colon, and rectum. The pathologic finding for rectum revealed a mucinous adenocarcinoma compatible with a metastatic spermatic cord tumor.
Collision tumors of the colon are rare. A 54-year-old man was referred to our hospital for the evaluation of hematochezia. Colonoscopy demonstrated the presence of about 3 cm sized mass in the rectosigmoid junction. After surgical resection, the colonic lesion was histologically composed of two discrete lesions: adenocarcinoma in the superficial layer and poorly differentiated neuroendocrine carcinoma in the deeper layer. We report this case of colonic collision tumor (adenocarcinoma and neuroendocrine carcinoma) with a review of the literature.
Since the first case of gastric serrated adenoma found in 2001, 35 additional cases have been reported. Among these cases, 26 cases were associated with invasive adenocarcinoma within the serrated adenoma. Gastric serrated adenoma when compared with traditional adenoma has close correlation with invasive carcinoma. Serrated colorectal polyps are classified as hyperplastic polyps, sessile serrated adenoma/polyps, and tranditional serrated adenoma (TSA) depending on histological features. Two distinct phenotypes of TSA in the colon and rectum are reported. Those are unlocked serrated crypts (US-TSA) and ectopic crypt formations (ECFs). All gastric serrated adenoma are TSA in historical aspect and ECFs on phenotype. Whereas gastric adenomas are reported with high frequency in the antrum, gastric serrated adenomas are founded in the body and cardia. We report a case of a 60-year-old woman receiving endoscopic submucosal dissection for gastric serrated adenoma with adenocarcinoma discovered during routine screening.
A 29-year-old man with nodular gastritis diagnosed by previous gastroscopy was referred to our hospital for an evaluation of laryngeal discomport and soreness. The patient had no previous history of eradication for Helicobacter pylori-associated gastritis. Gastroscopy demonstrated the presence of gooseflesh-like nodularities on antrum and whitish discoloring lesion with depression on lesser curvature of lower body. The whitish discoloring lesion with depression was histologically diagnosed a signet ring cell carcinoma by endoscopic biopsy. We report this case of a patient with nodular gastritis who received no eradication therapy and was
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