Atresia of the Colon: Etiological Aberrations, Clinical Observations, and Challenges in Management

Objective: The objective of this study is to review the clinicoradiological profile, scheme of management and the outcome in cases of colonic atresia (CA), and ascertain an optimal approach for the treatment of CA to minimize morbidity and mortality. Design and Setting: This was a retrospective observational study carried out at a tertiary health‑care center. Duration: Total of 6 years duration (January 2011–December 2016).Materials and Methods: A retrospective analysis of 10 patients of CA managed over a 6- year period. Data related to demographics, clinical presentation, associated anomalies, radiologic, intraoperative findings, postoperative stay, complications, and outcome were analyzed.Results: There were three cases of Type II atresia involving terminal ileum, cecum, and adjacent colon. Three cases had proximal ascending colon atresia (Type IIIa [n = 2]; Type I [n = 1]) Type I [n=1], and two cases of type IIIa atresia of the hepatic flexure. Two babies had atresia involving the sigmoid colon; one had Type II atresia, while we were unable to assign a type to the other within the prevailing classification. Seven babies were initially treated with a stoma either in the ileum (n = 3), hepatic flexure (n = 2), and sigmoid colon (n = 2), whereas three were treated with a primary anastomoses. Cases treated with a primary anastomoses had lesser morbidity and a better outcome than those with an ileal or ascending colon stoma.Conclusion: Contrary to the theory of an acute antenatal vascular accident, CA may rarely result from a gradual, sequential obliteration of mesenteric vasculature. Primary anastomosis should be contemplated in proximal CA wherever possible as stomal complications, especially high stoma output can result in considerable morbidity.

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Study of Cardiac Autonomic Neuropathy (CAN) in Type II Diabetes Mellitus Patients Attending a Tertiary Health Care Center in Maharashtra

International Journal of Physiology ◽

10.5958/2320-608x.2017.00091.9 ◽

2017 ◽

Vol 5 (2) ◽

pp. 224

Author(s):

Mohammed Suhail ◽

Sayed Badar Azhar Daimi ◽

Abhay D Hatekar ◽

Ashfak Ahmed Hussain

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Autonomic Neuropathy ◽

Type Ii Diabetes ◽

Care Center ◽

Type Ii Diabetes Mellitus ◽

Cardiac Autonomic Neuropathy ◽

Type Ii ◽

Health Care Center

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Electrophysiological properties of maxillary trigeminal Aβ-afferent neurons of rats

Molecular Pain ◽

10.1177/17448069211021271 ◽

2021 ◽

Vol 17 ◽

pp. 174480692110212

Author(s):

Yuya Okutsu ◽

Akihiro Yamada ◽

Sotatsu Tonomura ◽

Ryan J Vaden ◽

Jianguo G Gu

Keyword(s):

Type I ◽

Type Ii ◽

Afferent Neurons ◽

Success Rates ◽

Fast Kinetics ◽

Electrophysiological Properties ◽

Type Iiia ◽

Type Iiib ◽

Slow Kinetics ◽

Conduction Velocities

Aβ-afferents in maxillary or V2 trigeminal ganglion (TG) neurons are somatosensory neurons that may be involved in both non-nociceptive and nociceptive functions in orofacial regions. However, electrophysiological properties of these V2 trigeminal Aβ-afferent neurons have not been well characterized so far. Here, we used rat ex vivo trigeminal nerve preparations and applied patch-clamp recordings to large-sized V2 TG neurons to characterize their electrophysiological properties. All the cells recorded had afferent conduction velocities in the range of Aβ-afferent conduction speeds. However, these V2 trigeminal Aβ-afferent neurons displayed different action potential (AP) properties. APs showed fast kinetics in some cells but slow kinetics with shoulders in repolarization phases in other cells. Based on the derivatives of voltages in AP repolarization with time (dV/dt), we classified V2 trigeminal Aβ-afferent neurons into four types: type I, type II, type IIIa and type IIIb. Type I V2 trigeminal Aβ-afferent neurons had the largest dV/dt of repolarization, the fastest AP conduction velocities, the shortest AP and afterhyperpolarization (AHP) durations, and the highest AP success rates. In contrast, type IIIb V2 trigeminal Aβ-afferent neurons had the smallest dV/dt of AP repolarization, the slowest AP conduction velocities, the longest AP and AHP durations, and the lowest AP success rates. The type IIIb cells also had significantly lower voltage-activated K+ currents. For type II and type IIIa V2 trigeminal Aβ-afferent neurons, AP parameters were in the range between those of type I and type IIIb V2 trigeminal Aβ-afferent neurons. Our electrophysiological classification of V2 trigeminal Aβ-afferent neurons may be useful in future to study their non-nociceptive and nociceptive functions in orofacial regions.

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Feasibility of primary anastomosis for right-sided colonic atresia: A case report

Journal of Neonatal Surgery ◽

10.47338/jns.v10.950 ◽

2021 ◽

Vol 10 ◽

pp. 46

Author(s):

Muhammad Shamil Suhaimi ◽

Mohd Yusran Othman ◽

Khalilah Alhuda Kamilen

Keyword(s):

Case Report ◽

Primary Anastomosis ◽

Distal Colon ◽

Postoperative Recovery ◽

Ascending Colon ◽

Case Presentation ◽

Male Baby ◽

Colonic Atresia ◽

Feasible Option

Background: Colonic atresia (CA) is a rare cause of congenital intestinal obstruction. The management of CA is challenging because of its rarity. Case Presentation: We present a case of right-sided CA in a term male baby weighing 3006 gm, without any other comorbidity. Type 1 atresia was seen at ascending colon and upon decompression, a reasonable caliber was achieved for a primary anastomosis following distal Cheatle slit and proximal tapering. Postoperative recovery was uneventful. Conclusion: Primary anastomosis is a feasible option in right-sided CA when no major comorbidity is present and a normal distal colon with reasonable caliber is certain.

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Prevalence of Depression among Type-II Diabetic Patients Attending the Diabetic Clinic at Arar National Guard Primary Health Care Center, Saudi Arabia

Psychiatry Journal ◽

10.1155/2020/9174818 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Norah Muqbil Alhunayni ◽

Amal Elwan Mohamed ◽

Sabry Mohamed Hammad

Keyword(s):

Health Care ◽

Primary Health Care ◽

National Guard ◽

Care Center ◽

Poor Compliance ◽

Primary Health Care Center ◽

Diabetic Patients ◽

Type Ii ◽

Health Care Center ◽

Primary Health

Background. Depression is a common comorbidity in type-II diabetic patients, which if undiagnosed leads to poor clinical outcomes. Objectives. To determine the prevalence and risk factors of depression among type-II diabetic patients attending the National Guard Diabetic Clinic in Arar city. Subjects and methods. This cross-sectional study included every third type-II diabetic patient attending the National Guard Primary Health Care Center between the 1st of January and 31st of March 2019. Participants were interviewed using the Patient Health Questionnaire 9 (PHQ-9). Patients who scored ≥5 were considered to have depression. Chi-square test (χ2) was used to compare differences between categorical variables. P≤0.05 was considered statistically significant. Results. Of the total 422 diabetic patients approached for this study, 397 provided complete responses (94% response rate). Of these, 37% had depression: 23% mild, 9% moderate, and 5% severe. Diabetic patients with low education, poor income, and long duration of diabetes mellitus were found to be at higher risk of depression. Poor compliance with physical activities, diet regimen, family history of DM, and the presence of complications was also significantly associated with depression. On logistic regression analysis, low family income, duration of DM, poor compliance to physical activity, and presence of complications as neuropathy or libido were the main predictors of depression in diabetic patients. Conclusion. More than one-third of type-II diabetic patients had depression. Regular screening of type-II diabetic patients for depression is a necessity, as it can affect the clinical outcome.

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Infantile SVT in Consequence of a Congenital Antithrombin Deficiency

Blood ◽

10.1182/blood.v118.21.5260.5260 ◽

2011 ◽

Vol 118 (21) ◽

pp. 5260-5260

Author(s):

Susan Halimeh ◽

Stephan Dreher ◽

Thorsten Rosenbaum ◽

Martin Rekus ◽

Hannelore Rott ◽

...

Keyword(s):

Conflicts Of Interest ◽

Care Center ◽

Residual Activity ◽

Hereditary Disease ◽

Type I ◽

Antithrombin Deficiency ◽

Health Care Center ◽

Function Loss ◽

Different Types ◽

Deficiency Type

Abstract Abstract 5260 The liver-made antithrombin is a natural coagulation inhibitor in human blood. Exceptionally it takes effect in inhibiting the coagulation-supporting factors IIa (thrombin) and Xa. A congenital antithrombin deficiency leads to thrombosis and has to be heterozygous, because homozygous ATIII deficiencies are incompatible with life. Unfortunately it's dominant inherited. In 1965 a congenital ATIII deficiency was first detected as a hereditary disease. There are two different types, type I describes a less produced ATIII deficiency, type II is a function loss of ATIII. Special testing can define more subclasses. In cases of congenital ATIII deficiency, vascular blockage (thrombosis) appears, especially in leg veins. Released clots can cause pulmonal embolism, rarely are other arteries affected. Although this disease is hereditary, it appears mostly between ages of 15 'til 30. Clinical trials showed that 80% of affected patient have a thrombosis or embolism until the age of 40. Has there be no kind of illness appeared until there, it's very improbable to get one becaus eof ATIII deficiency. Every hundredth below the age of 70, who comes to a health care center has a ATIII deficiency. In total population it's a freqzuency of 1:2000 until 1:5000. Mostly there's a deficiency nown in familary history why they are investigated. The residual activity is between 40 – 60%. Conclusion: Most cases of thrombosis are treated with heparine. Heparin binds to ATIII, so ATIII can be much more effective and inhibits thrombin and Xa much more intense. For the future we have to make sure that antithrombin deficiencies especially in childhood have to be treated with phenprocumone. Disclosures: No relevant conflicts of interest to declare.

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Colonic Atresia: Association with Other Anomalies

Journal of Neonatal Surgery ◽

10.21699/jns.v5i4.422 ◽

2016 ◽

Vol 5 (4) ◽

pp. 47 ◽

Cited By ~ 15

Author(s):

Khaled M. El-Asmar ◽

Mohammed Abdel-Latif ◽

Abdel-Hamid A. El-Kassaby ◽

Mohamed H. Soliman ◽

Mosad M. El-Behery

Keyword(s):

Hirschsprung's Disease ◽

Hirschsprung’S Disease ◽

Primary Anastomosis ◽

Intestinal Atresia ◽

Good Prognosis ◽

Type I ◽

Colonic Atresia ◽

Type Iv ◽

Low Incidence ◽

Bowel Atresia

Background: Colonic atresia (CA) is a rare form of congenital intestinal atresia. Although CA may be isolated, it is more commonly reported in literature in association with other congenital anomalies.Materials and Methods: This study is a review of prospectively collected data of all the patients with colonic atresia presented to our center (Ain Shams University) during 2008 to 2016.Results: Twelve patients were enrolled in this study. The atresia was of type I in one case, type II in four cases, type IIIa in six cases, type IV in one case. These cases accounted for 4.9 % of intestinal atresias managed in our center during the same period. Five cases were isolated CA, while the other seven cases had associated abdominal congenital anomalies (exomphalos, Hirschsprung’s disease, imperforate anus, closing gastroschisis, colonic duplication, and multiple small bowel atresia in two cases). The management in ten cases was by staged procedure with creation of a temporary stoma initially, while primary anastomosis was established in two cases. We had two cases with delayed presentations, one missed diagnosis, and three mortalities in this series.Conclusions: The low incidence of CA may result in delay in the diagnosis and management. Hirschsprung’s disease should be excluded in every case of colonic atresia. Early diagnosis and proper surgical management is essential for good prognosis.

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Glenoid Rim Lesions Associated with Recurrent Anterior Dislocation of the Shoulder

The American Journal of Sports Medicine ◽

10.1177/03635465980260012301 ◽

1998 ◽

Vol 26 (1) ◽

pp. 41-45 ◽

Cited By ~ 365

Author(s):

Louis U. Bigliani ◽

Peter M. Newton ◽

Scott P. Steinmann ◽

Patrick M. Connor ◽

Stephen J. McIlveen

Keyword(s):

Anterior Dislocation ◽

Type I ◽

Type Ii ◽

Recurrent Instability ◽

Fracture Fragment ◽

Type Iiia ◽

Type Iiib ◽

Anterior Glenoid ◽

Bony Fragment ◽

The One

Twenty-five shoulders with recurrent instability and associated anterior glenoid rim lesions were reviewed to 1) develop a classification system of the lesions, 2) evaluate radiographic techniques in detecting the lesions, and 3) analyze the outcome of surgery. Lesions were classified into three types: Type I, a displaced avulsion fracture with attached capsule; Type II, a medially displaced fragment malunited to the glenoid rim; and Type III, erosion of the glenoid rim with less than 25% (Type IIIA) or greater than 25% (Type IIIB) deficiency. Lesions were detected by plain radiographs (19 shoulders) or supplemental CT-arthrograms (12 shoulders) or both. In 16 Type I fractures, both the bony fragment and capsule were reattached to the glenoid rim. In five Type II and three Type IIIA lesions, only the capsule was repaired to the remaining glenoid rim. In the one Type IIIB lesion, a coracoid transfer was performed. At an average followup of 30 months, 22 shoulders (88%) had satisfactory results without recurrent instability, whereas three shoulders (12%) had postoperative redislocations. The majority of recurrent anterior dislocations with associated glenoid rim lesions can be treated by suturing the fracture fragment or capsule or both to the glenoid rim and addressing associated capsular laxity.

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Colonic Atresia: A Case Report

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v12i1.39982 ◽

2016 ◽

Vol 12 (1) ◽

pp. 116-119

Author(s):

Meherun Nessa ◽

Shams ud Din Elias Khan ◽

Md Shakhawat Hossain

Keyword(s):

Case Report ◽

Armed Forces ◽

Middle Part ◽

Type I ◽

Ascending Colon ◽

Medical College ◽

Colonic Atresia ◽

Descending Colon ◽

Female Baby ◽

Distal Intestinal Obstruction

Atresia of the colon is among the rare types of all gastrointestinal atresias. Descending colon is the rarest site of all the colonic atresias. A case report of 3 days old female baby was presented with the features of distal intestinal obstruction. At laparotomy type I atresia of the middle part of asending colon, with proximal dilatation of caecum and ilum. Microcolon was noticed in ascending colon, transverse colon, descending colon and sigmoid colon when newborn underwent exploration. Primary ileostomy and distal mucus stoma of ascending colon was done. After four weeks, closure of ostomy was done. Journal of Armed Forces Medical College Bangladesh Vol.12(1) 2016: 116-119

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Evaluation of the outcomes of right paralumbar fossa colostomy for type II colonic atresia in calves: a report of 24 cases

Medycyna Weterynaryjna ◽

10.21521/mw.6213 ◽

2019 ◽

Vol 75 (02) ◽

pp. 6213-2019

Author(s):

MUHARREM EROL ◽

HANIFI EROL ◽

SEMIH ALTAN ◽

NURI YAVRU

Keyword(s):

Abdominal Cavity ◽

Clinical Findings ◽

Radiographic Examination ◽

Type Ii ◽

Ascending Colon ◽

Postoperative Course ◽

Colonic Atresia ◽

Vertical Incision ◽

Descending Colon ◽

The Right

The aim of the present study was to evaluate the effectiveness of right fossa paralumbar colostomy on the survival rate of calves with atresia coli maintained under Anatolian farming conditions. The clinical diagnosis was confirmed by clinical findings, pain and contrast radiographic examination. In clinical and indirect radiographic examination, rectum and descending colon were seen as more constricted than usual. In surgery, the abdominal cavity was opened through a vertical incision from the right paralumbar fossa. The blind end of the ascending colon was fixed to the abdominal wall in order to create a stoma. The postoperative course of the calves was obtained from the owners of the calves during a period of four months. It was learned that only one calf survived and the others died because of diarrhea within the four month period. In conclusion, this study demonstrated that although right fossa paralumbar colostomy was successfully performed for type-II atresia coli, severe functional impairment and fluid imbalance due to the loss of an important fluid resorption resulted in the death of most calves that were kept under Anatolian farming conditions.

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Primary interlocking nailing for open fractures of tibial shaft: a clinical study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193660 ◽

2019 ◽

Vol 5 (5) ◽

pp. 811

Author(s):

Talluri V. G. Krishna

Keyword(s):

Intramedullary Nailing ◽

Open Fractures ◽

Type I ◽

Type Ii ◽

Tibial Shaft ◽

Non Union ◽

Interlocking Nailing ◽

Type Iiia ◽

Open Injury ◽

Closed Intramedullary Nailing

Background: The excellent method for treating fractures of the tibial shaft was the closed intramedullary nailing technique. But because of limited references related to the results, incidence of infection, non-union of open injury. Hence, it was decided to analyse open tibial fractures treatment by primary interlocking nailing.Methods: 50 Patients with open fractures of the tibial shaft which were treated with primary interlocking nail were studied in the period of 14 months.Results: In present study 18 (36%) type I, 22 (44%) type II and 10 (20%) type IIIA Gustilo open fractures were treated. The average duration of time between injury and nailing was 3.5 hours (range was 1.5 hours to 4 hours). After reaming, 40 (80%) fractures were fixed, without reaming, 10 (20%) of fractures were fixed. The average time to union was 27 weeks for type I fractures, 30 weeks for type II fractures and 33 weeks for type IIIA fractures. There was 1 non-union. There were 4 deep infections.Conclusions: The best mode of therapy was primary interlocking intramedullary nailing for open fractures.

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