BİR EĞİTİM ARAŞTIRMA HASTANESİNDE ALT GASTROİNTESTİNAL SİSTEM BULGULARININ DEĞERLENDİRİLMESİ

2021 ◽  
Vol 8 (16) ◽  
pp. 16-20
Author(s):  
Nursel ÜSTÜNDAĞ ÖCAL ◽  
Sevda YAMAN ◽  
Serdar YANIK
Keyword(s):  
Hyperplastic Polyp ◽  
Occult Blood ◽  
Outpatient Clinics ◽  
Central Anatolia ◽  
Bowel Habit ◽  
Tubular Adenoma ◽  
Hyperplastic Polyps ◽  
Tubulovillous Adenoma ◽  
Important Place ◽  
The Mean

Patients with complaints about colorectal region refer to general surgery, gastroenterology and other outpatient clinics with an increasing frequency. Rectal bleeding, abdominal pain, unexplained anemia, changes in bowel habit, occult blood positivity in stool can be a sign of serious colon disease. In this study, patients under the age of 65 who underwent AGIS endoscopy in the endoscopy unit of the Research and Application Hospital in Central Anatolia Region between 2015 and 2018 were examined. The data were reviewed retrospectively. 214 patients under the age of 65 were included in the study. Colitis in 37 (17.29%), hyperplastic polyp in 38 (17.76%), tubular adenoma in 86 (40.19%), tubular adenoma in 40 (18.69%), Adenocarcinoma was detected in 13 (6.7%) of results. Tubular adenoma, tubulovillose adenoma and adenocarcinomas were more common at the age of fifties, with colitis and hyperplastic polyps detected in the mean age of forties. Adenocarcinomas were found to be more common in female sex, unlike other results. Lower gis endoscopy has an important place in the diagnosis and treatment of colorectal cancer. In our study, in which the results of AGIS endoscopy were examined, tubular adenoma was high in individuals under 65 years of age. Keywords: Tubulovillous Adenoma, Colitis, Hyperplastic Polyp

scholarly journals Focal Intramucosal Adenocarcinoma Occurring in Gastric Hyperplastic Polyps Treated with Endoscopic Mucosal Resection

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Jéssica Alférez-Andía ◽  
Harold Benites-Goñi ◽  
Fernando Palacios-Salas
Keyword(s):  
Hyperplastic Polyp ◽  
Magnifying Endoscopy ◽  
Gastric Body ◽  
Tubular Adenocarcinoma ◽  
Tubular Adenoma ◽  
High Grade ◽  
Hyperplastic Polyps ◽  
Color Enhancement ◽  
Intramucosal Adenocarcinoma ◽  
Well Differentiated

Hyperplastic polyps are the most frequent benign epithelial gastric polyps. Although they are considered nonneoplastic, some cases have been reported with focal adenocarcinoma. We present the case of a 59-year-old woman with a sessile lesion of 15 mm on the distal gastric body associated with an extensive atrophic gastritis. Magnifying endoscopy with Fuji Intelligent Color Enhancement (FICE) revealed an irregular microsurface pattern at the apex, suggesting malignancy. A mucosectomy was performed. The histopathology revealed that the base corresponded to a hyperplastic polyp, where a tubular adenoma with high-grade dysplasia was established, with focal well-differentiated intramucosal tubular adenocarcinoma.

scholarly journals Adenomatous Polyps in Adolescent Girl and Boy: A Report of Two Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Laleh Vahedi Larijani ◽  
Maryam Ghasemi ◽  
Hassan Karami
Keyword(s):  
Pediatric Patients ◽  
Colonic Polyps ◽  
Definitive Diagnosis ◽  
Adenomatous Polyps ◽  
Common Symptom ◽  
Tubular Adenoma ◽  
Tubulovillous Adenoma ◽  
Benign Adenoma ◽  
Juvenile Type ◽  
Rectal Hemorrhage

A polyp is defined as a mass of the mucosal surface that protrudes into the lumen of the gastrointestinal tract. Neoplastic epithelial polyps are classified histologically as either benign adenoma or malignant carcinoma. The colonic polyps that most commonly present in children occur sporadically and individually and are of the juvenile type; they are most frequently associated with painless rectal hemorrhage (which is the most common symptom). Adenomatous polyps are similar to other nontumoral polyps, and it is very rare for children to have symptoms other than rectal bleeding. This report describes two rare cases of polyps in pediatric patients. An 11-year-old girl presented with tubulovillous adenoma and a 13-year-old boy with tubular adenoma; both patients complained of rectal hemorrhage as well as anemia and abdominal pain. Epithelial adenoma is a tumor that is rarely found in adults or children. Colonoscopic perforation and biopsy are mandatory for establishing a definitive diagnosis and avoiding medical mismanagement.

scholarly journals Pseudotumor cerebri in childhood and adolescence: data from a specialized service

2018 ◽  
Vol 76 (11) ◽  
pp. 751-755 ◽  
Author(s):  
Gabriela G. M. Balbi ◽  
Sandro L. Matas ◽  
Claudio A. Len ◽  
Melissa M. Fraga ◽  
Iggor O. Sousa ◽  
...  
Keyword(s):  
Rheumatic Disease ◽  
Disease Onset ◽  
Pseudotumor Cerebri ◽  
Tertiary Hospital ◽  
Outpatient Clinics ◽  
Childhood And Adolescence ◽  
Common Symptom ◽  
Medical Reports ◽  
Specialized Service ◽  
The Mean

ABSTRACT Objective: To report cases of children and adolescents diagnosed with pseudotumor cerebri associated or not with rheumatic disease. Methods: This was a retrospective study based on medical reports of 29 patients, up to 18 years of age and diagnosed with pseudotumor cerebri, followed up in the Pediatric Rheumatology and Neurology outpatient clinics of a tertiary hospital, until December 2016. Results: Among the 29 patients diagnosed with pseudotumor cerebri, 51.7% were girls and the mean age at the disease onset was 12.3 years. In 18 patients (62%) where an etiology was found, four were associated with a rheumatic disease. The most common symptom was headache (69%) and acetazolamide was the most used medication (69%). Two patients developed blindness and 10 are still being followed up. Conclusion: Although rare, pseudotumor cerebri should be considered in children with headaches, especially in patients with rheumatic disease.

scholarly journals Letrozole versus Clomiphene Citrate in Patients with Anovulatory Infertility

2009 ◽  
Vol 1 (1) ◽  
pp. 19-23
Author(s):  
PG Paul ◽  
Dhiraj Gada ◽  
Mandakini Parihar ◽  
Shravanti Bhowmik
Keyword(s):  
Outcome Measure ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Comparative Trial ◽  
Outpatient Clinics ◽  
Parallel Group ◽  
The Mean ◽  
Infertility Patients ◽  
Anovulatory Infertility ◽  
Micronized Progesterone

ABSTRACT Objective To compare the effectiveness of letrozole and clomiphene citrate (CC) in patients with anovulatory infertility. Design Open, prospective, randomized, parallel group, multicentric, comparative trial. Setting Outpatient clinics of infertility centers in India. Patient(s) Fifty-five patients with anovulatory infertility were recruited. Twenty-seven patients (59 cycles) were given letrozole and twenty-eight patients (68 cycles) were given CC. Both drugs were given orally on days 3-7 of menstrual cycle. Intervention(s) Letrozole, CC, ovulation induction, vaginal micronized progesterone, IUI. Main outcome measure(s) Occurrence of ovulation, endometrial thickness and pregnancy rates. Result(s) Ovulation occurred in 77.9 % (46/59) of letrozole cycles and in 80.9 % (55/68) of CC cycles. The mean endometrial thickness on the day of human chorionic gonadotropin administration was 9 mm in letrozole group and 8.76 mm in the CC group. Pregnancy rate per cycle was 11.9 % (7/59) in the letrozole group and 8.8 % (6/68) in the CC group. Conclusion(s) Letrozole and CC have comparable effectiveness in anovulatory infertility patients. Letrozole may be an acceptable alternative to CC as an ovulation-inducing drug.

A case of osseous metaplasia in a gastric hyperplastic polyp: An unexpected finding in a common polyp

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S69-S70
Author(s):  
Y Zhang ◽  
Y Nakanishi
Keyword(s):  
Bone Formation ◽  
Hyperplastic Polyp ◽  
Case Reports ◽  
Osseous Metaplasia ◽  
Heterotopic Bone ◽  
Heterotopic Bone Formation ◽  
Hyperplastic Polyps ◽  
History Of ◽  
Acute And Chronic Inflammation ◽  
Gastric Hyperplastic Polyp

Abstract Introduction/Objective Foveolar hyperplastic polyp is a common gastric polyp characterized by foveolar hyperplasia with erosion, acute and chronic inflammation, granulation tissue formation, and smooth muscle strands extending from the muscularis mucosae. Although foveolar hyperplastic polyps may rarely contain foci of dysplasia or invasive carcinoma, osseous metaplasia/heterotopic bone formation in foveolar hyperplastic polyps of the stomach is extremely rare with a few case reports. Methods/Case Report A 63-year-old female with a history of hypertension, sick sinus syndrome, and Hashimoto’s thyroiditis was referred to our facility for evaluation of a mass in segment eight of the liver. The liver biopsy showed a moderately differentiated adenocarcinoma, most consistent with intrahepatic cholangiocarcinoma. A screening gastrointestinal endoscopy revealed a 7-mm sessile polyp in the antrum. The polyp was removed with a cold snare. No other abnormalities were identified in the stomach. Sections of the polyp showed fragments of antral-type gastric mucosa with foveolar hyperplasia, erosion, acute and chronic inflammation, and focal granulation tissue formation. In addition, multiple foci of woven bone formation without bone marrow surrounding dilated gastric foveolae were identified. No Helicobacter infection, intestinal metaplasia, dysplasia or malignancy was identified histologically. Osseous metaplasia/heterotopic bone formation is a well-known finding reported in various neoplastic and non- neoplastic conditions. However, osseous metaplasia in foveolar hyperplastic polyps of the stomach is extremely rare. There have been only four previous case reports published in English language. Our current case shows clinicopathologic features similar to those of the previous case reports including the findings of small-sized polyp found incidentally in middle-aged patients with no clinical history of hypercalcemia or any other abnormalities causing heterotopic bone formation. Results (if a Case Study enter NA) N/A Conclusion Although the pathogenesis of osseous metaplasia in a gastric hyperplastic polyp remains unknown, the finding of osseous metaplasia in a gastric hyperplastic polyp is very intriguing.

scholarly journals Correlation between Clinical Symptoms of Various Colorectal Diseases and Colonoscopic Findings

2019 ◽  
Vol 17 (1) ◽  
pp. 16-19
Author(s):  
Roman Kidwai ◽  
Anup Sharma
Keyword(s):  
Diagnostic Accuracy ◽  
Clinical Symptoms ◽  
Colorectal Polyps ◽  
Bowel Habit ◽  
Female Ratio ◽  
Medical College ◽  
Inflammatory Conditions ◽  
The Mean ◽  
Colorectal Diseases ◽  
Male To Female

Background: About 30% of patients presenting to surgical outpatient department has lower gastrointestinal (LGI) symptoms. Colonoscopy is a low risk and at the same time investigation of choice in these patients which allows visualization of the entire colon and the terminal portion of ileum. This study was done to find out the diagnostic accuracy of colonoscopy in relation to the clinical symptoms of the disease.  Methods: This was a prospective, hospital based study from February 2014 to March 2019 carried out at Nepalgunj Medical College and Teaching Hospital. The colonoscopy diagnosis was compared with the clinical symptoms and further confirmed with histological examination.  Results: 341 patients underwent colonoscopy. There were 234 (68.62%) males and 107 (31.37%) females with the male to female ratio of 2.18: 1. The age ranged from 16 to 81 with the mean age of 59.63±10.37. The most common presenting symptom was per rectal bleeding (40.34%) the after were alteration in bowel habit (17.30%), constipation (12.90%), hematochezia (11.43%). The least common indication for colonoscopy was unexplained anemia. Haemorrhoids were the most common findings consisting 32.55%. In 19.94% it was normal. Majority had various inflammatory conditions, among them 10.85% had proctocolitis, 2.34% were suspected to have ulcerative colitis. There were 17(4.98%) patients with colonic and 13(3.18%)with rectal carcinoma. 10.55% had colorectal polyps. Out of 111 patients suspected to have hemorrhoids clinically 102 had same findings on colonoscopy. Similarly 34 patients presenting with chronic diarrhea with bleeding and 59 with alteration in bowel habit where inflammatory conditions were suspected had similar findings on colonoscopy in 29 and 34 patients respectively. Similarly the suspicion of malignancy on clinical basis was also correlated on colonoscopy. The inflammatory conditions diagnosed on colonoscopy were confirmed in 85.04 % by histology. Similarly malignancy and the presence of polyps diagnosed on colonoscopy were confirmed by histology in 97.05% and in 97.22% cases respectively. Conclusion: Colonoscopy is a safe and effective investigation to diagnose various colorectal conditions. There was a correlation between the clinical symptoms and the colonoscopicdiagnosis especially in conditions like inflammatory and neoplastic colorectal diseases. When combined with histology the diagnostic accuracy can be near 100% in conditions like inflammatory and benign or malignant diseases.

Incidental Finding of Colorectal Cancer in Screening Colonoscopy and Its Cost Effectiveness

2009 ◽  
Vol 75 (8) ◽  
pp. 699-704 ◽  
Author(s):  
Chichi Berhane ◽  
David Denning
Keyword(s):  
Colorectal Cancer ◽  
Cost Effectiveness ◽  
Villous Adenoma ◽  
Colorectal Neoplasm ◽  
Incidental Finding ◽  
Screening Colonoscopy ◽  
Tubular Adenoma ◽  
Hyperplastic Polyps ◽  
Asymptomatic Patients ◽  
Involvement Rate

The objective of this study is to measure the risk of colorectal cancer and adenoma with screening colonoscopy and its cost effectiveness. We reviewed the procedure and pathology results of approximately 11,000 asymptomatic patients age 50 to 90 that underwent screening colonoscopy Among those 11,808 screening colonoscopies performed, advance neoplasm (adenocarcinoma) was detected in 272 (2.3%) patients; age 50 to 90, with mean age of 64-years-old. Fourteen per cent had hyperplastic polyps, 15 per cent had tubular adenoma, and 8.6 per cent villous adenoma. Adenoma with high grade dysplasia was found in 6.6 per cent, and 5.5 per cent had nonadenomatous lesions. Sixty-five of 272 (24%) neoplasms were found proximally Forty-five of 207 distal neoplasms were found through sigmoidoscopy, nine of 45 (20%) had proximal involvement. Rate of complication during colonoscopy was 0.06 per cent and no patients died. All patients underwent complete colonoscopy, 99.8 per cent were men. Rate of adenocarcinoma from 2000 to 2006 was (24/470, 29/520, 33/891,37/961,46/2889,49/2977, and 54/3100). Screening colonoscopy can detect advanced colorectal neoplasm in asymptomatic adults. The more screening colonoscopy was preformed the earlier the neoplasm was discovered and with better prognosis. Twenty per cent of the patients with distal neoplasms found on sigmoidoscopy had proximal lesions when complete colonoscopies were performed. These findings warrant refinement of the screening recommendations for colorectal cancer.

scholarly journals Automated imaging cytometry reveals dysplastic indices of colonic serrated adenomas

2020 ◽  
pp. FSO459
Author(s):  
Nicholas S Samel ◽  
Qin Huang ◽  
Hiroshi Mashimo
Keyword(s):  
Dna Content ◽  
Chromosome Instability ◽  
Neoplastic Progression ◽  
Hyperplastic Polyps ◽  
Dna Index ◽  
Tissue Sections ◽  
Automated Imaging ◽  
Imaging Cytometry ◽  
The Mean ◽  
Serrated Adenomas

Aim: Left-sided colonic serrated adenomas (L-SAs) were evaluated for aneuploidy using automated imaging cytometry to quantify DNA content and compared with normal colonic tissues (NCT), tubular adenomas (TA), left-sided hyperplastic polyps (L-HP) and adenocarcinomas. Materials & methods: We used standard paraffin-embedded Feulgen-stained tissue sections. Results: The mean DNA index (DI) of NCT was 0.95, L-HP was 1.08, TA was 1.22, L-SA was 1.11 and adenocarcinomas was 1.46. DI of L-SA was statistically higher than that of NCT, but not statistically different from L-HP. Conclusion: This study demonstrates that DIs correlate with the described neoplastic progression of L-SA, TA and L-SA compared with NCT and suggests that L-SA may be involved in a chromosome instability pathway of neoplastic progression.

scholarly journals Automated Classification of Colorectal Neoplasms in White-Light Colonoscopy Images via Deep Learning

2020 ◽  
Vol 9 (5) ◽  
pp. 1593 ◽  
Author(s):  
Young Joo Yang ◽  
Bum-Joo Cho ◽  
Myung-Je Lee ◽  
Ju Han Kim ◽  
Hyun Lim ◽  
...  
Keyword(s):  
Deep Learning ◽  
Colorectal Neoplasms ◽  
White Light ◽  
External Validation ◽  
Validation Dataset ◽  
Tubular Adenoma ◽  
Colonoscopic Examination ◽  
Test Dataset ◽  
The Mean

Background: Classification of colorectal neoplasms during colonoscopic examination is important to avoid unnecessary endoscopic biopsy or resection. This study aimed to develop and validate deep learning models that automatically classify colorectal lesions histologically on white-light colonoscopy images. Methods: White-light colonoscopy images of colorectal lesions exhibiting pathological results were collected and classified into seven categories: stages T1-4 colorectal cancer (CRC), high-grade dysplasia (HGD), tubular adenoma (TA), and non-neoplasms. The images were then re-classified into four categories including advanced CRC, early CRC/HGD, TA, and non-neoplasms. Two convolutional neural network models were trained, and the performances were evaluated in an internal test dataset and an external validation dataset. Results: In total, 3828 images were collected from 1339 patients. The mean accuracies of ResNet-152 model for the seven-category and four-category classification were 60.2% and 67.3% in the internal test dataset, and 74.7% and 79.2% in the external validation dataset, respectively, including 240 images. In the external validation, ResNet-152 outperformed two endoscopists for four-category classification, and showed a higher mean area under the curve (AUC) for detecting TA+ lesions (0.818) compared to the worst-performing endoscopist. The mean AUC for detecting HGD+ lesions reached 0.876 by Inception-ResNet-v2. Conclusions: A deep learning model presented promising performance in classifying colorectal lesions on white-light colonoscopy images; this model could help endoscopists build optimal treatment strategies.

scholarly journals Gastric Hyperplastic Polyp Associated with Proliferation of Xanthoma Cells Observed by Magnification Narrow-Band Imaging Endoscopy

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Shoji Hirasaki ◽  
Motoharu Kubo ◽  
Atsushi Inoue
Keyword(s):  
Digestive Tract ◽  
Endoscopic Mucosal Resection ◽  
Narrow Band ◽  
Hyperplastic Polyp ◽  
Narrow Band Imaging ◽  
Endoscopic Examination ◽  
Hyperplastic Polyps ◽  
Pedunculated Polyp ◽  
Greater Curvature ◽  
Gastric Hyperplastic Polyp

A case of gastric hyperplastic polyp with proliferation of xanthoma cells is reported. The patient was a 69-year-old man who visited our hospital for further evaluation of gastric polyps. Endoscopic examination of the upper digestive tract revealed multiple hyperplastic polyps in the gastric antrum. There was a pedunculated polyp with whitish yellow granules, 7 mm in diameter, arising from the greater curvature of the antrum. Magnification narrow-band imaging endoscopy (GIF-H260Z, Olympus) revealed long microcapillaries in the polyp but did not reveal disappearance of the mucosal microstructure or irregular branched capillaries. Endoscopic mucosal resection (EMR) was performed. Histological examination of the specimen revealed the lengthened gastric foveolae in the superficial portion and tight sheet of foamy histiocytes in the lamina propria. Diagnosis of gastric hyperplastic polyp with proliferation of xanthoma cells was made. There was no evidence of malignancy. It is necessary to know that a gastric hyperplastic polyp may associate with gastric xanthoma, although such association is very rare.

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