Colonoscopy-related colonic ischemia

Ischemic Sigmoid Colon Presenting As Hemoperitoneum From an Avulsed Mesocolon During Colonoscopy: A Case Report and Literature Review

Colonoscopy has proven efficacy for both screening and diagnostic purposes. Although the risk of complications during colonoscopy is low, it is not negligible. As such, we present the case of a 72-year-old male patient who presented with abdominal pain and positive peritoneal signs post-colonoscopy. He was found to have anemia and acute on chronic kidney disease. An abdominal CT scan found evidence of hemoperitoneum. Subsequently, he underwent a diagnostic laparoscopy converted into an open exploratory laparotomy to identify the source of bleeding, an avulsed mesocolon. A review of the literature regarding colonoscopy and associated complications is discussed, highlighting the importance of risk stratification to better treat patients and prognosticate outcomes.

The Evaluation and Management of Intestinal Ischemia

AbstractIntestinal ischemia can result from various pathologic conditions. The presentations of ischemia can range from acute to subacute and mild to severe. Diagnosis of this condition may pose challenges, particularly in the early, potentially salvageable, stages of disease. This review offers an evidence-based approach to understanding the diagnosis and management of inadequate intestinal perfusion.

Endoscopic Resection of Early Luminal Cancer

Gastrointestinal cancers can have severe consequences if diagnosed at a late stage but can be cured when detected and resected at an early stage. In recent years, the significance of endoscopic screening for gastrointestinal cancers has been established, leading to the identification of early-stage cancers and precancerous lesions. Consequently, endoscopic removal of gastrointestinal tumors has emerged as an effective means of cancer treatment and prevention. This article delves into the indications, techniques, and safety measures associated with endoscopic resection of early-stage luminal cancer within the gastrointestinal tract.

Colorectal Cancer-The Worst Enemy Is the One We Do Not Know

BACKGROUND

Colorectal cancer is one of the most common cancers in humans. It is the third most frequently diagnosed malignant neoplasm and is the second highest cause of cancer mortality in the world. Every year, more and more people die of colorectal cancer because the diagnosis is conducted too late. This shows how important a role screening tests and the awareness of the population about the symptoms play in this aspect. This article aimed to determine the knowledge of the Polish population about morbidity, symptoms, prevention, and subjective feelings about the level of availability of knowledge about colorectal cancer.

METHODS

In 2020, a study was conducted using an online questionnaire assessing the awareness of the Polish population about colorectal cancer. A self-authored questionnaire including questions about socio-demographic characteristics, and 18 questions related to substantive issues, was used. A research group was selected (n = 633). The substantive part of the questionnaire included questions examining the respondents' knowledge about morbidity, symptoms, prevention, and subjective feelings about the level of availability of knowledge about colorectal cancer.

RESULTS

The respondents' awareness level was influenced by demographic factors, such as gender: (p < 0.05) and age (p < 0.05) and social factors, such as: level of education (p < 0.05) or professional situation (p < 0.05). Compared to thematic articles from other countries, the research group was divided into smaller subgroups due to the abovementioned factors, due to which it was possible to stratify and analyze the significance of differences between them.

Advances in the diagnosis of non-occlusive mesenteric ischemia and challenges in intra-abdominal sepsis patients: a narrative review

Non-occlusive mesenteric ischemia (NOMI) is a type of acute mesenteric ischemia (AMI) with a high mortality rate mainly because of a delayed or misdiagnosis. Intra-abdominal sepsis is one of the risk factors for developing NOMI, and its presence makes early diagnosis much more difficult. An increase in routine abdominal surgeries carries a corresponding risk of abdominal infection, which is a complication that should not be overlooked. It is critical that physicians are aware of the possibility for intestinal necrosis in abdominal sepsis patients due to the poor survival rate of NOMI. This review aims to summarize advances in the diagnosis of NOMI, and focuses on the diagnostic challenges of mesenteric ischemia in patients with intra-abdominal sepsis.

Colonoscopy induced ischemic colitis: An endoscopic and histological assay

Colonoscopy is a safe and effective diagnostic modality for various ileo-colonic diseases. Though the procedure itself is a rare cause of ischaemic colitis. Fewer than 30 cases of ischaemic colitis caused by colonoscopy procedure have been reported in the literature to date. The colon is susceptible to ischemia due to its minor blood flow compared to other organs in the abdomen. The etiology of colon ischemia after colonoscopy is multifactorial. Endoscopists must be aware of this condition and its risk factors for risk minimization, early diagnosis and proper treatment.

Case report: Early detection of mesenteric ischemia by intravital microscopy in a patient with septic shock

Gut ischemia is a frequent but underdiagnosed complication, especially in critically ill intensive care patients, and represents a special diagnostic challenge that can only be solved in an interdisciplinary manner. We report a case of a 54-year-old woman with acute mesenteric ischemia (AMI) as a cause of septic shock diagnosed by intravital microscopy (IVM) 2 days before visible necrotic changes in a multimodality approach. We show that intravital microscopy can be a serious alternative for the early diagnosis of mesenteric ischemia in the hands of the skilled. We use this case to discuss the value and clinical perspective of IVM in the intensive care setting.