Diabetes association of polyps and colon cancer

Aim The aim of the study was to retrospectively assess the relationship between the occurrence of polyps and colon cancer in patients with type 2 diabetes. Methods In 2014-2015, 976 colonoscopy was performed in patients. We compared the number of polyps with high-grade dysplasia and colorectal cancers in patients with and without diabetes. In addition, in the diabetic group, we documented the relationship between HbA1C and the occurrence of polyps high-grade dysplasia, and colon cancer. The data were statistically analyzed. Result 1) Patients with diabetes have a higher frequency of polyps with high-grade dysplasia/ carcinoma - (32/91 (35.16%) in comparison to patients without diabetes 136/885 (15.37%), p <0.001. 2) Patients with diabetes have a higher frequency of polyps with cancer - (9/91 (9.89%) as compared to patients without diabetes in patients 18/885 (2.03%), p <0.001. 3) Colorectal cancer occurred significantly more often in uncontrolled diabetes (p = 0.022) Conclusion The conducted study shows a significant association between type 2 diabetes and the incidence of colorectal adenomas. These findings may lead to the conclusion that diabetic patients are at a higher risk of developing colorectal cancer thus requiring more need for a controlled colonoscopy. Therefore it may be worth to consider a scheme for screening patients in the group mentioned above by performing colonoscopy.

Gastroenterocolic fistula in the patient after previous gastric resection and hepaticoenterostomy due to complicated ulcer disease - case report

The report presents the case of a patient treated surgically for perforated gastroenterocolic fistula with a concomitant abscess in abdominal integuments and symptoms of the digestive tract blockage. Many months before this surgery the patient had undergone gastric resection and hepaticoenterostomy (Roux-Y) due to inflammatory tumor causing pyrolostenosis and including the peripheral part of the common bile duct. After the surgery, the patient suffered from recurrent abdominal pain which resulted in many hospitalizations. After one of the episodes of complaints, the patient with symptoms of the digestive tract blockage was admitted again to our ward, prepared to the surgery and qualified for the surgical intervention. En bloc resection of the stomach, hepaticoenterostomy and partial resection of the transverse colon were performed. The continuity of the digestive tract was restored by gastroenterostomy with the isolated jejunal loop, anastomosis between the hepatic loop and side of the afferent loop and end-to-end anastomosis of the transverse colon. There were no postoperative complications. The authors point out circumstances affected on decision to postpone the surgery by the patient despite frequent recurrent complaints after primary surgery and numerous previous hospitalizations.