Problems in Colorectal Stapler Use

Introduction Pneumatosis intestinalis (PI) is a broad term that describes the presence of gas in the bowel walls. The colon is affected in 36% of cases. Eosinophilic colitis (EC) is a rare form of colitis that is characterized mainly by eosinophilia in blood and affected tissues. Although eosinophi...

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Autores principales:	Abbas Abdollahi, Ghodratollah Maddah, Hosein Shabahang, Hamed Golmohammadzadeh
Formato:	article
Lenguaje:	EN
Publicado:	Shiraz University of Medical Sciences 2016
Materias:	colorectal surgery surgical staplers minimally invasive surgical procedures Medicine R
Acceso en línea:	https://doaj.org/article/3e06ee5b16e74218afee49d20a9f6594
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spelling	oai:doaj.org-article:3e06ee5b16e74218afee49d20a9f65942021-11-15T09:43:49ZProblems in Colorectal Stapler Use2783-243010.17795/acr-36133https://doaj.org/article/3e06ee5b16e74218afee49d20a9f65942016-03-01T00:00:00Zhttps://colorectalresearch.sums.ac.ir/article_45511_05fb7f3fbd9edefc206f1895d44ea765.pdfhttps://doaj.org/toc/2783-2430Introduction Pneumatosis intestinalis (PI) is a broad term that describes the presence of gas in the bowel walls. The colon is affected in 36% of cases. Eosinophilic colitis (EC) is a rare form of colitis that is characterized mainly by eosinophilia in blood and affected tissues. Although eosinophilic colitis responds well to conservative treatment, yet the association of PI could be an indication of emergent surgery. Case Presentation A 48-year-old female patient with a history of recurrent attacks of abdominal pain and distention that did not respond to conservative treatment, was hospitalized and investigated thoroughly. The result of abdominal computed tomography (CT) scan indicated the presence of pneumatosis coli. Based on the findings of the CT scan, colonoscopy was done revealing hyperemic and hypertrophied mucosa at the hepatic flexure, from which multiple punch biopsies were taken for histopathological assessment. The pathological examination of these biopsies detected a diffuse active colitis of moderate severity with excess eosinophils (10 - 15/HPF), which is consistent with the diagnosis of EC. The patient improved dramatically on fluid therapy and antibiotics with complete resolution of pneumatosis coli in the follow up CT scan. However, the patient developed a severe relapse of symptoms once oral intake was resumed and this time the conservative treatment failed to improve the condition. Surgery was indicated and laparoscopic right hemicolectomy with primary anastomosis and covering ileostomy was done. The patient was free of symptoms after the operation and her postoperative course was uneventful with no complications encountered. Conclusions Eosinophilic colitis usually has a good prognosis, however its association with pneumatosis coli could reflect a serious damage to the colonic mucosa. Although eosinophilic colitis responds well to medical treatment, yet in certain cases where clinical signs are evident and pneumatosis coli is present, surgical intervention is the treatment of choice.Abbas AbdollahiGhodratollah MaddahHosein ShabahangHamed GolmohammadzadehShiraz University of Medical Sciencesarticlecolorectal surgerysurgical staplersminimally invasive surgical proceduresMedicineRENIranian Journal of Colorectal Research, Vol 4, Iss 1, Pp 0-0 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	colorectal surgery surgical staplers minimally invasive surgical procedures Medicine R
spellingShingle	colorectal surgery surgical staplers minimally invasive surgical procedures Medicine R Abbas Abdollahi Ghodratollah Maddah Hosein Shabahang Hamed Golmohammadzadeh Problems in Colorectal Stapler Use
description	Introduction Pneumatosis intestinalis (PI) is a broad term that describes the presence of gas in the bowel walls. The colon is affected in 36% of cases. Eosinophilic colitis (EC) is a rare form of colitis that is characterized mainly by eosinophilia in blood and affected tissues. Although eosinophilic colitis responds well to conservative treatment, yet the association of PI could be an indication of emergent surgery. Case Presentation A 48-year-old female patient with a history of recurrent attacks of abdominal pain and distention that did not respond to conservative treatment, was hospitalized and investigated thoroughly. The result of abdominal computed tomography (CT) scan indicated the presence of pneumatosis coli. Based on the findings of the CT scan, colonoscopy was done revealing hyperemic and hypertrophied mucosa at the hepatic flexure, from which multiple punch biopsies were taken for histopathological assessment. The pathological examination of these biopsies detected a diffuse active colitis of moderate severity with excess eosinophils (10 - 15/HPF), which is consistent with the diagnosis of EC. The patient improved dramatically on fluid therapy and antibiotics with complete resolution of pneumatosis coli in the follow up CT scan. However, the patient developed a severe relapse of symptoms once oral intake was resumed and this time the conservative treatment failed to improve the condition. Surgery was indicated and laparoscopic right hemicolectomy with primary anastomosis and covering ileostomy was done. The patient was free of symptoms after the operation and her postoperative course was uneventful with no complications encountered. Conclusions Eosinophilic colitis usually has a good prognosis, however its association with pneumatosis coli could reflect a serious damage to the colonic mucosa. Although eosinophilic colitis responds well to medical treatment, yet in certain cases where clinical signs are evident and pneumatosis coli is present, surgical intervention is the treatment of choice.
format	article
author	Abbas Abdollahi Ghodratollah Maddah Hosein Shabahang Hamed Golmohammadzadeh
author_facet	Abbas Abdollahi Ghodratollah Maddah Hosein Shabahang Hamed Golmohammadzadeh
author_sort	Abbas Abdollahi
title	Problems in Colorectal Stapler Use
title_short	Problems in Colorectal Stapler Use
title_full	Problems in Colorectal Stapler Use
title_fullStr	Problems in Colorectal Stapler Use
title_full_unstemmed	Problems in Colorectal Stapler Use
title_sort	problems in colorectal stapler use
publisher	Shiraz University of Medical Sciences
publishDate	2016
url	https://doaj.org/article/3e06ee5b16e74218afee49d20a9f6594
work_keys_str_mv	AT abbasabdollahi problemsincolorectalstapleruse AT ghodratollahmaddah problemsincolorectalstapleruse AT hoseinshabahang problemsincolorectalstapleruse AT hamedgolmohammadzadeh problemsincolorectalstapleruse
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Problems in Colorectal Stapler Use

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