Two Cases of Amebic Colitis Associated with Colon Perforation.

Colorectal cancer (CRC) is a disease with high incidence and mortality. Colonoscopy is a gold standard among tests used for CRC traceability. However, serious complications, such as colon perforation, may occur. Non-invasive diagnostic procedures are an unmet need. We aimed to identify a plasma microRNA (miRNA) signature for CRC detection. Plasma samples were obtained from subjects (n = 109) at different stages of colorectal carcinogenesis. The patients were stratified into a non-cancer (27 healthy volunteers, 17 patients with hyperplastic polyps, 24 with adenomas), and a cancer group (20 CRC and 21 metastatic CRC). miRNAs (381) were screened by TaqMan Low-Density Array. A classifier based on four differentially expressed miRNAs (miR-28-3p, let-7e-5p, miR-106a-5p, and miR-542-5p) was able to discriminate cancer versus non-cancer cases. The overexpression of these miRNAs was confirmed by RT-qPCR, and a cross-study validation step was implemented using eight data series retrieved from Gene Expression Omnibus (GEO). In addition, another external data validation using CRC surgical specimens from The Cancer Genome Atlas (TCGA) was carried out. The predictive model’s performance in the validation set was 76.5% accuracy, 59.4% sensitivity, and 86.8% specificity (area under the curve, AUC = 0.716). The employment of our model in the independent publicly available datasets confirmed a good discrimination performance in five of eight datasets (median AUC = 0.823). Applying this algorithm to the TCGA cohort, we found 99.5% accuracy, 99.7% sensitivity, and 90.9% specificity (AUC = 0.998) when the model was applied to solid colorectal tissues. Overall, we suggest a novel signature of four circulating miRNAs, i.e., miR-28-3p, let-7e-5p, miR-106a-5p, and miR-542-5p, as a predictive tool for the detection of CRC.

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The IL-33-ILC2 pathway protects from amebic colitis

Mucosal Immunology ◽

10.1038/s41385-021-00442-2 ◽

2021 ◽

Author(s):

Md Jashim Uddin ◽

Jhansi L. Leslie ◽

Stacey L. Burgess ◽

Noah Oakland ◽

Brandon Thompson ◽

...

Keyword(s):

Tissue Damage ◽

Cell Injury ◽

Defense Mechanism ◽

Protozoan Parasite ◽

Lymphoid Cells ◽

Amebic Colitis ◽

Host Defense Mechanism ◽

Important Host ◽

Murine Colon

AbstractEntamoeba histolytica is a pathogenic protozoan parasite that causes intestinal colitis, diarrhea, and in some cases, liver abscess. Through transcriptomics analysis, we observed that E. histolytica infection was associated with increased expression of IL-33 mRNA in both the human and murine colon. IL-33, the IL-1 family cytokine, is released after cell injury to alert the immune system of tissue damage. Treatment with recombinant IL-33 protected mice from amebic infection and intestinal tissue damage; moreover, blocking IL-33 signaling made mice more susceptible to amebiasis. IL-33 limited the recruitment of inflammatory immune cells and decreased the pro-inflammatory cytokine IL-6 in the cecum. Type 2 immune responses were upregulated by IL-33 treatment during amebic infection. Interestingly, administration of IL-33 protected RAG2–/– mice but not RAG2−/−γc−/− mice, demonstrating that IL-33-mediated protection required the presence of innate lymphoid cells (ILCs). IL-33 induced recruitment of ILC2 but not ILC1 and ILC3 in RAG2−/− mice. At baseline and after amebic infection, there was a significantly higher IL13+ILC2s in C57BL/J mice, which are naturally resistant to amebiasis, than CBA/J mice. Adoptive transfer of ILC2s to RAG2−/−γc−/− mice restored IL-33-mediated protection. These data reveal that the IL-33-ILC2 pathway is an important host defense mechanism against amebic colitis.

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Recurrent sigmoid volvulus: Cause of colon perforation, sepsis, and fetal death

Journal of Obstetrics and Gynaecology Research ◽

10.1111/jog.14764 ◽

2021 ◽

Author(s):

Deniz Simsek ◽

Gulten Ozgen

Keyword(s):

Fetal Death ◽

Sigmoid Volvulus ◽

Colon Perforation

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Colon perforation during colonoscopy: Surgicalversus conservative management

British Journal of Surgery ◽

10.1002/bjs.1800780509 ◽

1991 ◽

Vol 78 (5) ◽

pp. 542-544 ◽

Cited By ~ 99

Author(s):

C. Hall ◽

N. J. Dorricott ◽

I. A. Donovan ◽

J. P. Neoptolemos

Keyword(s):

Conservative Management ◽

Colon Perforation

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Spectrum of CT findings in amebic colitis

Japanese Journal of Radiology ◽

10.1007/s11604-021-01088-7 ◽

2021 ◽

Author(s):

Eliko Tanaka ◽

Yuki Tashiro ◽

Akio Kotake ◽

Nobuyuki Takeyama ◽

Takahiro Umemoto ◽

...

Keyword(s):

Amebic Colitis ◽

Ct Findings

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Radiology guided antegrade GASTROSTOMY deployment of mushroom (pull type) catheters with classical and modified methods in patients with oropharyngeal, laryngeal carcinoma, and anesthesia risk

British Journal of Radiology ◽

10.1259/bjr.20201130 ◽

2021 ◽

pp. 20201130

Author(s):

Süleyman Bakdık ◽

Muharrem Keskin ◽

Fatih Öncü ◽

Osman Koç

Keyword(s):

Success Rate ◽

Complication Rate ◽

Demographic Data ◽

Major Complication ◽

Good Alternative ◽

Transoral Approach ◽

Colon Perforation ◽

Minor Bleeding ◽

Technical Success Rate ◽

Wide Diameter

Objective: The aim of study is to evaluate the results of deployment of Percutaneous Radiological Gastrostomy (PRG), which is a good alternative to Surgical Gastrostomy (SG), with transoral approach in cases where Percutaneous Endoscopic Gastrostomy (PEG) is contraindicated, difficult or unsuccessful, in patients with high risk of American Society of Anesthesiologists with four scores. In addition, we aimed to demonstrate the advantages of mushroom pull type catheters over push type gastrostomy catheters. Methods: This retrospective study included a total of 40 patients (18 females and 22 males) aged 21–92 years who underwent PRG with the antegrade transoral approach. PRG was performed by retrograde passing through the esophagus or snaring the guidewire from the stomach and taking out of the anterior abdominal wall. Patients’ demographic data, indications for PRG, procedural outcomes and complications were screened and recorded. Results: PRG was performed in 39 of 40 patients included in the study. Technical success rate was 97.5%. Procedure-dependent major complications such as death, aspiration, colon perforation, and deep abscess were not observed. Aspiration occurred in the first patient during the first feeding on the day after the procedure. Major complication rate was 2.5%. The total minor complication rate was 17.5% in 7 patients; parastomal leakage in 2 patients (5%), skin rash and infection in 3 (7.5%) patients, minor bleeding in 2 (5%) patients with oropharynx cancer, minimal bleeding from the gastrostomy catheter 1 week after the procedure in 1 (2.5%) patient. None of the cases had buried buffer. Tube functionality was preserved in all patients without any damage. Conclusion: Mushroom tip (pull type) gastrostomy catheter is a safe treatment method for patients requiring prolonged feeding because of wide diameter, endurance, long staying opening duration, less excessive dilatation and parastomal leakage, and no need for gastropexy. Lower cost and easier access are advantageous for mushroom tip pull type catheters compared to push type gastrostomy catheters in our country. The less invasive PRG is an alternative option in patients who are difficult to administer PEG, are at high anesthesia risk and cannot be sedated. Advances in knowledge: This article is valuable in terms of its contribution to develop an alternative radiological method for the deployment of gastrostomy tubes in medical difficult patients. This method has shortened the duration of the procedure and increased the success rate in patients with difficulty in transition from the stomach to the esophagus or with difficulty in the upper gastrointestinal tract. Mushroom tip catheters can be placed successfully by radiological methods.

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Pneumoretroperitoneum and Pneumomediastinum Revealing a Left Colon Perforation

International Surgery ◽

10.9738/intsurg-d-14-00201.1 ◽

2015 ◽

Vol 100 (6) ◽

pp. 984-988 ◽

Cited By ~ 3

Author(s):

Giulia Montori ◽

Giacomo Di Giovanni ◽

Zeineb Mzoughi ◽

Cedric Angot ◽

Sophie Al Samman ◽

...

Keyword(s):

Computed Tomography ◽

Clinical Laboratory ◽

Left Thigh ◽

Left Colon ◽

Colon Perforation ◽

Emergency Laparotomy ◽

Computed Tomography Scan ◽

End Colostomy ◽

Retroperitoneal Perforation ◽

Tomography Scan

Left colon perforation usually occurs in complicated diverticulitis or cancer. The most frequent signs are intraperitoneal abscess or peritonitis. In cases of retroperitoneal colonic perforation, diagnosis may be difficult. A 59-year-old woman presented with left thigh pain and with abdominal discomfort associated with mild dyspnea. Computed tomography scan showed air bubbles and purulent collection in the retroperitoneum, with subcutaneous emphysema extending from the left thigh to the neck. Computed tomography scan also revealed portal vein gas and thrombosis with multiple liver abscesses. An emergency laparotomy revealed a perforation of the proximal left colon. No masses were found. A left colectomy was performed. The retroperitoneum was drained and washed extensively. A negative pressure wound therapy was applied. A second-look laparotomy was performed 48 hours later. The retroperitoneum was drained and an end colostomy was performed. Intensive Care Unit postoperative stay was 9 days, and the patient was discharged on the 32nd postoperative day. Pneumoretroperitoneum and pneumomediastinum are rare signs of colonic retroperitoneal perforation. The diagnosis may be delayed, especially in the absence of peritoneal irritation. Clinical, laboratory, and especially radiologic parameters might be useful. Surgical treatment must be prompt to improve prognosis.

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