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Zhang W, Zhang R, Yang R, Sun Y, Zhang Q, Feng X, Cui C, Liu W. A thermally reversible injectable adhesive for intestinal tissue repair and anti-postoperative adhesion. Biomater Sci 2024; 12:3141-3153. [PMID: 38687002 DOI: 10.1039/d4bm00164h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Abstract
Intestine damage is an acute abdominal disease that usually requires emergency sealing. However, traditional surgical suture not only causes secondary damage to the injured tissue, but also results in adhesion with other tissues in the abdominal cavity. To this end, a thermally reversible injectable gelatin-based hydrogel adhesive (GTPC) is constructed by introducing transglutaminase (TGase) and proanthocyanidins (PCs) into a gelatin system. By reducing the catalytic activity of TGase, the density of covalent and hydrogen bond crosslinking in the hydrogel can be regulated to tune the sol-gel transition temperature of gelatin-based hydrogels above the physiological temperature (42 °C) without introducing any synthetic small molecules. The GTPC hydrogel exhibits good tissue adhesion, antioxidant, and antibacterial properties, which can effectively seal damaged intestinal tissues and regulate the microenvironment of the damaged site, promoting tissue repair and regeneration. Intriguingly, temperature-induced hydrogen bond disruption and reformation confer the hydrogel with asymmetric adhesion properties, preventing tissue adhesion when applied in vivo. Animal experiment outcomes reveal that the GTPC hydrogel can seal the damaged intestinal tissue firmly, accelerate tissue healing, and efficiently prevent postoperative adhesion.
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Affiliation(s)
- Wenmo Zhang
- School of Material Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin 300350, China.
| | - Runze Zhang
- NHC Key Laboratory of Critical Care Medicine, Department of Neurosurgery, Binhai Hospital of Tianjin Medical University General Hospital, Tianjin 300480, China
| | - Rong Yang
- School of Material Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin 300350, China.
| | - Yage Sun
- School of Material Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin 300350, China.
| | - Qian Zhang
- School of Material Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin 300350, China.
| | - Xuequan Feng
- Tianjin First Center Hospital, Tianjin 300192, China.
| | - Chunyan Cui
- School of Material Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin 300350, China.
- State Key Laboratory of Molecular Engineering of Polymers (Fudan University), China
| | - Wenguang Liu
- School of Material Science and Engineering, Tianjin Key Laboratory of Composite and Functional Materials, Tianjin University, Tianjin 300350, China.
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2
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Ziani H, Nasri S, Kamaoui I, Skiker I. An unusual case of diastatic perforation of the transverse colon: Case report and literature review. Radiol Case Rep 2024; 19:2434-2437. [PMID: 38585400 PMCID: PMC10997867 DOI: 10.1016/j.radcr.2024.02.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/24/2024] [Accepted: 02/28/2024] [Indexed: 04/09/2024] Open
Abstract
Diastatic perforation corresponds to a bursting of the cecal wall caused by excessive distension resulting from a remote obstruction of the low large bowel. This perforation could be explained by Laplace's physical law, and by the particular vascular anatomy of the cecal wall. We report the case of a 75-year-old man admitted for peritonitis with an abdominal CT scan highly suggestive of a diastatic perforation of the cecum complicating colonic distension upstream of a stenosing tumor of the rectosigmoid junction. To our surprise, surgical exploration revealed the defect to be in the transverse colon and not in the cecum. Diastatic perforation of the transverse colon is exceptional, and would require other pathophysiological explanations than those for classical cecal perforation.
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Affiliation(s)
- Hamid Ziani
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
| | - Siham Nasri
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
| | - Imane Kamaoui
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
| | - Imane Skiker
- Department of Radiology, Mohammed VI University Hospital, Faculty of Medicine, University Mohammed First, Oujda, Morocco
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3
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Hughes H, Jajodia A, Soyer P, Mellnick V, Patlas MN. Bowel Emergencies in Patients With Cancer. Can Assoc Radiol J 2024:8465371241252035. [PMID: 38721789 DOI: 10.1177/08465371241252035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Cancer is the second most common cause of death worldwide. Bowel emergencies in patients with cancer are becoming increasingly more prevalent due to advances in cancer therapy and longer overall patient survival. When these patients present acutely, they are often frail and may have pre-existing co-morbidities. This article discusses the imaging features of bowel emergencies commonly encountered in oncological patients in clinical practice. These include chemotherapy related colitis, neutropenia enterocolitis and typhlitis, toxic megacolon, bowel perforation, malignant bowel obstruction and gastrointestinal haemorrhage. The radiologist plays a key role in identifying these oncological emergencies and guiding further management.
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Affiliation(s)
- Hannah Hughes
- Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland
| | - Ankush Jajodia
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Philippe Soyer
- Department of Radiology, Hôpital Cochin, Assistance Publique-Hopitaux de Paris, Paris, France
- Faculté de Médecine, Université Paris Cité, Paris, France
| | - Vincent Mellnick
- Department of Radiology, Mallinckrodt Institute of Radiology, St Louis, MO, USA
| | - Michael N Patlas
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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4
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Milne M, Sims C, Anderson DR, Johannemann A, Leverenz D, Criscione-Schreiber L, Ardalan K. A Rare Manifestation of a Rare Disease: The Importance of Thinking Outside the Box in a Patient With Complex Dermatomyositis. Arthritis Care Res (Hoboken) 2022; 74:1943-1949. [PMID: 35507472 DOI: 10.1002/acr.24905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/03/2022] [Accepted: 04/28/2022] [Indexed: 02/05/2023]
Affiliation(s)
- Megan Milne
- Duke University School of Medicine, Durham, North Carolina
| | - Catherine Sims
- Duke University School of Medicine, Durham, North Carolina
| | | | | | - David Leverenz
- Duke University School of Medicine, Durham, North Carolina
| | | | - Kaveh Ardalan
- Duke University School of Medicine, Durham, North Carolina
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5
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Sahli H, Mandour JE, Tessi RTY, Jerguigue H, Latib R, Omor Y. An unusual cause of peritonitis: Perforation of a gastric carcinoma. Radiol Case Rep 2022; 17:740-743. [PMID: 35003472 PMCID: PMC8717435 DOI: 10.1016/j.radcr.2021.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 02/05/2023] Open
Abstract
Gastric carcinoma perforation is an uncommon consequence that is often missed during the preoperative stage. Perforation may occur at any stage of cancer, but it is more common in late stages. It can also happen early in the illness. Because of the spilled stomach contents, it produces an acute abdominal syndrome. The goal of treatment should be to strike a balance between the emergency situation of peritonitis and oncological surgical techniques. A case of stomach cancer perforation with typical imaging findings is presented.
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Affiliation(s)
- Hind Sahli
- Radiology Department, National Institute of Oncology "Sidi Mohammed Ben Abdellah", Ibn Sina Hospital, Mohamed V University, Rabat-Morocco
| | - Jihane El Mandour
- Radiology Department, National Institute of Oncology "Sidi Mohammed Ben Abdellah", Ibn Sina Hospital, Mohamed V University, Rabat-Morocco
| | - Romeo Thierry Yehouenou Tessi
- Radiology Department, National Institute of Oncology "Sidi Mohammed Ben Abdellah", Ibn Sina Hospital, Mohamed V University, Rabat-Morocco
| | - Hounayda Jerguigue
- Radiology Department, National Institute of Oncology "Sidi Mohammed Ben Abdellah", Ibn Sina Hospital, Mohamed V University, Rabat-Morocco
| | - Rachida Latib
- Radiology Department, National Institute of Oncology "Sidi Mohammed Ben Abdellah", Ibn Sina Hospital, Mohamed V University, Rabat-Morocco
| | - Youssef Omor
- Radiology Department, National Institute of Oncology "Sidi Mohammed Ben Abdellah", Ibn Sina Hospital, Mohamed V University, Rabat-Morocco
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Sunnapwar A, Ojili V, Katre R, Shah H, Nagar A. Multimodality imaging of adult gastric emergencies: A pictorial review. Indian J Radiol Imaging 2021; 27:13-22. [PMID: 28515579 PMCID: PMC5385768 DOI: 10.4103/0971-3026.202957] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Acute gastric emergencies require urgent surgical or nonsurgical intervention because they are associated with high morbidity and mortality. Imaging plays an important role in diagnosis since the clinical symptoms are often nonspecific and radiologist may be the first one to suggest a diagnosis as the imaging findings are often characteristic. The purpose of this article is to provide a comprehensive review of multimodality imaging (plain radiograph, fluoroscopy, and computed tomography) of various life threatening gastric emergencies.
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Affiliation(s)
- Abhijit Sunnapwar
- Department of Body Imaging, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Vijayanadh Ojili
- Department of Body Imaging, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Rashmi Katre
- Department of Body Imaging, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Hardik Shah
- Department of Body Imaging, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Arpit Nagar
- Department of Body Imaging, Ohio State University Wexner Medical Center, Ohio, USA
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McGinty K. Acute Abdomen in the Oncology Patient. Semin Roentgenol 2020; 55:400-416. [PMID: 33220786 DOI: 10.1053/j.ro.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Katrina McGinty
- Department of Radiology, UNC School of Medicine, Chapel Hill, NC.
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8
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Leturia Etxeberria M, Biurrun Mancisidor MC, Ugarte Nuño A, Arenaza Choperena G, Mendoza Alonso M, Esnaola Albizu M, Serdio Mier A, Gredilla Sáenz M, Gomez Usabiaga V. Imaging Assessment of Ectopic Gas Collections. Radiographics 2020; 40:1318-1338. [DOI: 10.1148/rg.2020200028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Maria Leturia Etxeberria
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
| | - Maria Carmen Biurrun Mancisidor
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
| | - Ane Ugarte Nuño
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
| | - Gorka Arenaza Choperena
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
| | - Miguel Mendoza Alonso
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
| | - Maite Esnaola Albizu
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
| | - Alberto Serdio Mier
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
| | - María Gredilla Sáenz
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
| | - Virginia Gomez Usabiaga
- From the Department of Radiology, Donostia University Hospital, Paseo Dr. Beguiristain 109, 20014 Donostia–San Sebastián, Gipuzkoa, Spain
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9
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Dormagen JB, Verma N, Fink KR. Imaging in Oncologic Emergencies. Semin Roentgenol 2020; 55:95-114. [PMID: 32438984 DOI: 10.1053/j.ro.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Nupur Verma
- Department of Radiology, University of Florida, Gainesville, FL
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Tau N, Cohen I, Barash Y, Klang E. Free abdominal gas on computed tomography in the emergency department: aetiologies and association between amount of free gas and mortality. Ann R Coll Surg Engl 2020; 102:581-589. [PMID: 32233866 DOI: 10.1308/rcsann.2020.0057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Free abdominal gas is an important finding with major clinical implications. However, data on the aetiologies and prognosis of patients with free gas are scarce. Our primary aim was to describe the sources of free abdominal gas on emergency department (ED) computed tomography (CT). The secondary aim was to evaluate the association between the amount of free gas and all-cause mortality. METHODS All patients who underwent CT in the ED between February 2012 and February 2019 with free abdominal gas were included in the study. A scoring system was used to assess the amount of free gas: small - gas bubbles; medium - any gas pocket ≤2cm in diameter; large - any gas pocket >2cm. Data were collected from laboratory and clinical assessment regarding the source of free gas and all-cause mortality. RESULTS A total of 372 patients had free abdominal gas. Colonic diverticulitis was the most common aetiology among those with a small or medium amount of free gas (81/250 [32.4%] and 12/71 [16.9%] respectively). For patients with a large amount of gas, peptic disease was the most common aetiology (11/51 [21.6%]). Three-quarters of the patients (280/372, 75.2%) had the source of free gas identified during ED admission. Ninety-day mortality rates were 7.2%, 9.9% and 21.6% for patients with small, medium and large amounts of gas respectively (p=0.007). CONCLUSIONS Colonic diverticulitis was the most common source of free abdominal gas and peptic disease was the most common cause of a large amount of free gas. Mortality rates correlated with the amount of gas and were significantly higher in patients with a large amount.
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Affiliation(s)
- N Tau
- Sheba Medical Center, Ramat Gan, , Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - I Cohen
- Sheba Medical Center, Ramat Gan, , Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Y Barash
- Sheba Medical Center, Ramat Gan, , Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - E Klang
- Sheba Medical Center, Ramat Gan, , Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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12
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Lee NK, Kim S, Hong SB, Lee SJ, Kim TU, Ryu H, Lee JW, Kim JY, Suh HB. CT diagnosis of non-traumatic gastrointestinal perforation: an emphasis on the causes. Jpn J Radiol 2019; 38:101-111. [PMID: 31848888 DOI: 10.1007/s11604-019-00910-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
Gastrointestinal tract (GI) perforations can occur due to various causes such as trauma, iatrogenic factor, infectious condition, peptic ulcer, inflammatory disease, or a neoplasm. Because GI perforations represent an emergency and life-threatening condition, prompt diagnosis and surgical treatment are required in most cases. However, according to the underlying causes of GI perforations, additional treatment strategies may be needed. Adjuvant chemotherapy or immunotherapy may be required in various GI neoplasms such as adenocarcinoma, lymphoma or gastrointestinal stromal tumor. Inflammatory bowel disease is a chronic disease repeating cycle of intermittent, thus appropriate medical treatment and periodic follow-up are also required. Moreover, vascular intervention may have a role in some cases of mesenteric ischemia associated with mesenteric artery occlusion. Recently, computed tomography (CT) has been the first choice for patients with suspected GI perforations, because CT plays an important role in the accurate assessment of the perforation site, the pathology causing the perforation and the ensuing complications. This review will illustrate characteristic CT findings that differentiate underlying pathologies causing GI perforations to help clinicians decision-making regarding an optimal treatment plan.
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Affiliation(s)
- Nam Kyung Lee
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, and Pusan National University School of Medicine, 179, Gudeok-ro, Seo-gu, Busan, 49241, Korea.
| | - Suk Kim
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, and Pusan National University School of Medicine, 179, Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Seung Baek Hong
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, and Pusan National University School of Medicine, 179, Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - So Jeong Lee
- Department of Pathology, Pusan National University Hospital, and Pusan National University School of Medicine, Busan, Korea
| | - Tae Un Kim
- Department of Radiology, Pusan National University Yangsan Hospital, and Pusan National University School of Medicine, Gyeongsangnam-do, Korea
| | - Hwaseong Ryu
- Department of Radiology, Pusan National University Yangsan Hospital, and Pusan National University School of Medicine, Gyeongsangnam-do, Korea
| | - Ji Won Lee
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, and Pusan National University School of Medicine, 179, Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Jin You Kim
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, and Pusan National University School of Medicine, 179, Gudeok-ro, Seo-gu, Busan, 49241, Korea
| | - Hie Bum Suh
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, and Pusan National University School of Medicine, 179, Gudeok-ro, Seo-gu, Busan, 49241, Korea
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13
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Brikman S, Chertok E, Dori G. Perforation of small intestine due to metastatic lung carcinoma. BMJ Case Rep 2018; 2018:bcr-2018-225708. [PMID: 30206057 DOI: 10.1136/bcr-2018-225708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Shay Brikman
- Internal Medicine E, Emek Medical Center, Afula, Israel
| | - Elena Chertok
- Internal Medicine E, Emek Medical Center, Afula, Israel
| | - Guy Dori
- Internal Medicine E, Emek Medical Center, Afula, Israel
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14
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Gong XH, Zhuang ZG, Zhu J, Feng Q, Xu JR, Qian LJ. Differentiation of cancerous and inflammatory colorectal perforations using multi-detector computed tomography. Abdom Radiol (NY) 2017; 42:2233-2242. [PMID: 28401282 DOI: 10.1007/s00261-017-1134-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To determine reliable CT features to distinguish cancerous from inflammatory colorectal perforations. MATERIALS AND METHODS A total of 43 patients with surgically and pathologically confirmed colorectal perforation caused by either colorectal cancer (n =27) or an inflammatory conditions (n = 16) were identified. Two radiologists independently assessed the contrast-enhanced CT features for locations of perforation, mural configurations, soft-tissue alterations, lymphadenopathy, and metastases. Intergroup comparisons for univariate analysis were performed using Fisher's exact test or chi-square test for categorical data and Mann-Whitney test for numeric data. Stepwise logistic regression analysis was conducted with features that were found significant under the univariate analysis. Interobserver agreement was assessed using intraclass correlation coefficient (ICC) and kappa test. RESULTS Maximal mural thickness >1.39 cm (sensitivity, 100%; specificity, 68.75%), luminal mass or shoulder formation (sensitivity, 88.89%; specificity, 68.75%), absence of diverticula (sensitivity, 96.30%; specificity, 50.00%), irregular mural thickening (sensitivity, 92.59%; specificity, 81.25%), lymphadenopathy (sensitivity, 40.74%; specificity, 93.75%), and metastases (sensitivity, 25.93%; specificity, 100%) were significantly frequent in cancerous perforations. The maximal mural thickness (P = 0.0493, odds ratio = 439.83) and irregular mural thickening (P = 0.0343, odds ratio = 4.69) were identified as the highly distinguished identifiers. CONCLUSIONS The CT manifestations of cancerous and inflammatory colorectal perforations overlap. Definitive diagnosis is not always possible with imaging alone. The maximal mural thickness >1.39 cm and irregular configuration of the thickened bowel wall were the two highly statistically significant CT features that may help order the difference between the two entities.
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Affiliation(s)
- Xu Hua Gong
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Rd. Pudong, Shanghai, 200127, People's Republic of China
| | - Zhi Guo Zhuang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Rd. Pudong, Shanghai, 200127, People's Republic of China
| | - Jiong Zhu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Rd. Pudong, Shanghai, 200127, People's Republic of China
| | - Qi Feng
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Rd. Pudong, Shanghai, 200127, People's Republic of China
| | - Jian Rong Xu
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Rd. Pudong, Shanghai, 200127, People's Republic of China
| | - Li Jun Qian
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Rd. Pudong, Shanghai, 200127, People's Republic of China.
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Abstract
Anorectal disorders are a common cause of presentation to the emergency department (ED). While the most frequently encountered anorectal conditions, such as hemorrhoids and anal fissures, are relatively benign and do not require imaging for diagnosis or management, there are multiple potentially life threatening anorectal conditions for which imaging is an important component of evaluation, diagnosis, and management. Although computed tomography (CT) is the most commonly used imaging modality for evaluation of anorectal pathology in the ED, magnetic resonance imaging (MRI) has an increasingly important role in the detection, characterization and management of specific anorectal conditions. This pictorial essay will review the imaging anatomy of the anorectum, summarize imaging protocols, and discuss the clinical presentation, imaging appearance, and differential diagnosis of anorectal conditions that may present to the emergency department, including infectious, inflammatory, malignant and vascular conditions.
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16
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Filippone A, Cianci R, Delli Pizzi A, Esposito G, Pulsone P, Tavoletta A, Timpani M, Cotroneo AR. CT findings in acute peritonitis: a pattern-based approach. Diagn Interv Radiol 2016; 21:435-40. [PMID: 26359872 DOI: 10.5152/dir.2015.15066] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Many inflammatory and infectious entities may acutely affect the peritoneum causing a thickening of its layers. Unfortunately, several acute peritoneal diseases can have overlapping features, both clinically and at imaging. Therefore, the awareness of the clinical context, although useful, may be sometimes insufficient to identify the underlying cause. This article provides a specific computed tomography-based approach including morphologic characteristics of peritoneal thickening (e.g., smooth, irregular, or nodular) and ancillary findings to narrow the differential diagnosis of acute peritonitis.
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Affiliation(s)
- Antonella Filippone
- Department of Neuroscience and Imaging, G. d'Annunzio University, SS. Annunziata Hospital, Chieti, Italy.
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17
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Lee SA, Poh A. Unsuspected colorectal carcinoma on routine abdominopelvic computed tomography. Singapore Med J 2016; 56:248-56; quiz 257. [PMID: 26034316 DOI: 10.11622/smedj.2015072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Colorectal carcinoma is a common lethal disease with signs and symptoms that may be nonspecific. Computed tomography (CT) of the abdomen and pelvis with or without contrast is frequently performed for various general abdominal complaints, but unlike CT colonography, the large bowel may not be optimally prepared for evaluation. As such, careful and diligent assessment of the non-prepared colon in all CT images of the abdomen and pelvis is important, as it ensures that incidental colorectal malignancy is not missed, especially in older patients. This article gives an overview of multidetector CT imaging signs and subtle clues to aid in the diagnosis of colorectal carcinoma, as well as their pitfalls.
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Affiliation(s)
- Su Ann Lee
- Department of Radiology, Changi General Hospital, Singapore
| | - Angeline Poh
- Department of Radiology, Changi General Hospital, Singapore
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18
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Kim SW, Kim HC, Yang DM, Won KY. Gastrointestinal stromal tumours (GISTs) with a thousand faces: atypical manifestations and causes of misdiagnosis on imaging. Clin Radiol 2015; 71:e130-42. [PMID: 26646370 DOI: 10.1016/j.crad.2015.10.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/21/2015] [Accepted: 10/20/2015] [Indexed: 11/28/2022]
Abstract
Gastrointestinal stromal tumours (GISTs) can lead to emergency situations, such as gastrointestinal bleeding, intestinal obstruction, and tumoural rupture with haemoperitoneum or peritonitis. In addition, if a GIST grows exophytically to a large size, it is often misdiagnosed as a tumour arising from adjacent organs. Sometimes, the atypical appearance of GISTs on imaging causes diagnostic confusion. In this article, we illustrate a variety of GISTs with atypical presentations and also discuss the important diagnostic clues for differentiating GISTs from other lesions.
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Affiliation(s)
- S W Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, South Korea.
| | - H C Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - D M Yang
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - K Y Won
- Department of Pathology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, South Korea
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Guniganti P, Bradenham CH, Raptis C, Menias CO, Mellnick VM. CT of Gastric Emergencies. Radiographics 2015; 35:1909-21. [DOI: 10.1148/rg.2015150062] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Guo T, Yu Y, Yip GWC, Baeg GH, Thike AA, Lim TKH, Tan PH, Matsumoto K, Bay BH. Y-box binding protein 1 is correlated with lymph node metastasis in intestinal-type gastric cancer. Histopathology 2014; 66:491-9. [PMID: 25270600 DOI: 10.1111/his.12570] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Accepted: 09/26/2014] [Indexed: 02/06/2023]
Abstract
AIMS Y-box binding protein-1 (YB-1) is known to modulate gene transcription and protein translation, as well as cellular response to drug treatment. The aim of this study is to correlate YB-1 protein expression levels with clinicopathological parameters in intestinal-type gastric cancer tissue samples (as categorized by the Lauren classification) and substantiate the findings with in vitro experimentation. METHODS AND RESULTS Paraffin-embedded samples from 167 patients with intestinal-type gastric cancer were used for the construction of tissue microarrays (TMAs). TMA slides were immunostained and YB-1 immunoreactivity score was based on the weighted average intensity score. Univariate analysis revealed that YB-1 immunohistochemical expression was correlated significantly with lymph node status (P = 0.054, borderline significance) and perforation (P = 0.043). YB-1 expression was also found to be an independent predictor of lymph node spread by multivariate analysis. Furthermore, siRNA-mediated YB-1 gene knockdown in MKN7 gastric cancer cells (which is known to originate from an intestinal-type gastric cancer tissue) inhibited cell migration (P = 0.0002) and invasion in vitro (P = 0.0129) significantly. CONCLUSION YB-1 expression is associated with lymph node spread in intestinal-type gastric cancer and is a potential prognostic biomarker in this subtype of gastric cancer.
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Affiliation(s)
- TianTian Guo
- Department of Anatomy, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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