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Colitis Cystica Profunda


Presentation

  • The patient presented with intestinal obstruction due to a polypoid mass in the descending colon, which was diagnosed as colitis cystica profunda after the patient underwent colectomy.[ncbi.nlm.nih.gov]
  • We present a case of colitis cystica profunda misdiagnosed as adenocarcinoma based on their similar clinical picture and histological features.[ncbi.nlm.nih.gov]
  • Colitis cystica profunda is a rare, benign, non-neoplastic condition which usually presents as a mass in the rectum associated with bloody, mucoid diarrhea.[ncbi.nlm.nih.gov]
  • The patient presented as anal bleeding and a protruding mass at the descending colon; the mass was polypoid and was made up of papillary epithelial hyperplasia with downward herniation of glands into the submucosa.[ncbi.nlm.nih.gov]
  • Several types of clinical presentation have been recognized, the most common being a solitary lesion in the rectum. The cause is generally ascribed to the reparative process associated with chronic mucosal inflammation.[ncbi.nlm.nih.gov]
Tachypnea
  • At physical examination, he was dehydrated with severe abdominal pain, tachycardia and tachypnea, abdominal distention, without bowel sounds, "wood abdomen" with clearly acute abdomen signs, and anuria for 48 h.[translsurg.com]
Diarrhea
  • Colitis cystica profunda is a rare, benign, non-neoplastic condition which usually presents as a mass in the rectum associated with bloody, mucoid diarrhea.[ncbi.nlm.nih.gov]
  • A 39-year-old woman with inflammatory bowel disease was admitted to the hospital because of cramping abdominal pain and diarrhea. Ultrasound of the abdomen revealed thickening of the wall of the descending colon.[ncbi.nlm.nih.gov]
  • ., a 36-year-old white male, was first admitted in 1964 with complaints of diarrhea and occasional passage of bloody stools.[pubs.rsna.org]
  • A young man was debilitated by chronic mucus diarrhea and had diffuse cystic involvement of the distal colon. His symptoms were relieved by an end sigmoid colostomy, and he regained good health.[jamanetwork.com]
Abdominal Tenderness
  • The patient is well-nourished; his physical examination is essentially unremarkable with normal auscultation and absence of abdominal tenderness or peritoneal signs. Stool for occult blood was not done at the time.[oatext.com]
  • Clinical examination revealed a malnourished woman in severe distress due to diffuse abdominal tenderness. Signs of colonic obstruction were apparent. Digital rectal examination was indicative for rectal bleeding.[wjso.biomedcentral.com]
Left Lower Quadrant Pain
  • Persistent left lower quadrant pain was his only presentation. Intervention: The patient underwent a colonoscopy that demonstrated two sigmoid polyp-like lesions that were removed.[oatext.com]
Gagging
  • […] profunda - A Very Rare Benign Entity of the Lower GI-tract 1 Abteilung für Allgemein- und Viszeralchirurgie, Herz-Jesu-Krankenhaus Fulda 2 Internistische, Gastroenterologische und Diabetologische Praxis, Fulda 3 Institut für Pathologie, Klinikum Fulda gAG[thieme-connect.com]
Irritability
  • Its etiology has been attributed to several conditions, such as chronic irritation and congenital weakness of the musculature, but has not been established and remains a pathological enigma.[pubs.rsna.org]
  • Apart from diarrhea-predominant irritable bowel syndrome she had no significant past medical problem and no family history of bowel pathology.[ncbi.nlm.nih.gov]
Neglect
  • Furthermore, the brevity of discus sion of anatomy, physiology, and pathology and the neglect of details of medical therapy of numerous colorectal diseases must be attributed to the fact that this volume is directed primarily toward the practicing surgeon[books.google.de]
Encephalopathy
  • Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized[nejm.org]

Workup

  • Provides all the necessary tools to make a comprehensive diagnostic workup including data from ancillary techniques and molecular findings whenever appropriate.[books.google.com]
Nephrolithiasis
  • The patient was also found to have incidental 7 mm cholelithiasis per abdominal US and a 4 mm right non-obstructive nephrolithiasis per CT scan.[oatext.com]
Colitis
  • […] cysts diagnostic of colitis cystica profunda.[ncbi.nlm.nih.gov]
  • Colitis cystica profunda is a rare intestinal lesion.[ncbi.nlm.nih.gov]
  • Colitis cystica profunda is a rare nonneoplastic disease defined by the presence of intramural cysts that contain mucus, usually situated in the rectosigmoid area, which can mimic various malignant lesions and polyps.[ncbi.nlm.nih.gov]
  • Localized colitis cystica profunda developed in a fibrotic radiation-induced colonic stricture 17 years after pelvic radiation for squamous carcinoma of cervix.[ncbi.nlm.nih.gov]
  • We have reported a case of colitis cystica profunda, an uncommon, benign disease of the colon presumably due to chronic inflammation, characterized by submucosal mucus-filled cysts.[ncbi.nlm.nih.gov]

Treatment

  • This case demonstrates the successful treatment of a young female patient with colitis cystica profunda causing rectal prolapse, after primary treatment with a Delorme procedure had failed.[ncbi.nlm.nih.gov]
  • The type of treatment varies from surgical, medical, and endoscopic to no treatment at all.[ncbi.nlm.nih.gov]
  • Diagnosis requires a high degree of suspicion and adequate biopsies, and treatment is by simple excision.[ncbi.nlm.nih.gov]
  • Colorectal cancer is an infrequent sequel to radiotherapy, which may occur many years after treatment of the primary tumor. Prolonged follow-up of these patients is essential.[ncbi.nlm.nih.gov]
  • After 14 months of treatment he developed localized colitis cystica profunda mimicing a stenosating cancer of the rectum. The process developed over a short period.[ncbi.nlm.nih.gov]

Prognosis

  • With the correct pathological diagnosis, a better treatment with excellent prognosis could have resulted.[translsurg.com]
  • With the correct pathological diagnosis, a better treatment with excellent prognosis could have resulted. [ FULL TEXT ] [ PDF ]* Article Access Statistics Viewed 1408 Printed 95 Emailed 0 PDF Downloaded 137 Comments [Add][translsurg.com]
  • The prognosis in patients with complete excisions is excellent, with a free recurrence rate of 80% [12]. This case described the typical features of the colitis cystic profunda on CT and MRI examinations.[ncbi.nlm.nih.gov]
  • […] be aware of this clinical and pathologic entity so that it is not mistaken for a mucinous adenocarcinoma, carcinoid tumour, pancreatic heterotopia, inverted or pseudo-invasion of the adenomatous polyp of the anorectum for the reasons of therapy and prognosis[ncbi.nlm.nih.gov]

Etiology

  • Colitis cystica profunda (CCP) is a rare benign condition with a controversial etiology. We report a case of CCP in a patient with a history of anal masturbation, supporting an acquired traumatic etiology.[ncbi.nlm.nih.gov]
  • We reviewed the literature and compared the clinical features, etiology, and macroscopic findings. The pathogenesis of the lesion may be related to repeated ulceration and regeneration, while chronic colonic ischemia may also play a role.[ncbi.nlm.nih.gov]
  • Its diagnosis has to be confirmed histologically, and its etiology remains unclear.[ncbi.nlm.nih.gov]
  • Its etiology still remains not fully elucidated, and several mechanisms such as congenital, post-traumatic, and infectious have been implicated in the development of this rare entity.[ncbi.nlm.nih.gov]
  • Clinical pattern, etiology and diagnosis are described with reference to a personal case and 84 cases in the literature. It is emphasized that cancer must be ruled out (i.e rectal amputation is unnecessary in cystic colitis.[unboundmedicine.com]

Epidemiology

  • Definition / general Reactive mucosal change characterized by submucosal mucin filled cysts lined by benign epithelium Terminology Also called colitis cystica polyposa or hamartomatous inverted polyp when presents as polypoid lesion Epidemiology Uncommon[pathologyoutlines.com]
  • ., 2001: Collection of genomic DNA from adults in epidemiological studies by buccal cytobrush and mouthwash Kikuchi, S.; Satoh, K.; Nagata, T.; Kawagashira, N.; Doi, K.; Kishimoto, N.; Yazaki, J.; Ishikawa, M.; Yamada, H.; Ooka, H.; Hotta, I.; Kojima,[eurekamag.com]
  • Epidemiology and Demographics The condition is thought to be uncommon. It usually occurs in young adults, but children can be affected too. [1] Causes The essential cause of SRUS is thought to be related to too much straining during defecation.[wikidoc.org]
Sex distribution
Age distribution

Pathophysiology

  • […] polyposa or hamartomatous inverted polyp when presents as polypoid lesion Epidemiology Uncommon; male predilection Sites Can occur anywhere in GI tract, including stomach ("gastritis cystica profunda") and small intestine ("enteritis cystica profunda") Pathophysiology[pathologyoutlines.com]
  • Anorectal physiology studies may help to elucidate the underlying pathophysiology such as solitary rectal ulcer. However, only in 54% of localized CCP cases were found to suffer from rectal prolapse [ 1, 8 ].[wjso.biomedcentral.com]

Prevention

  • Awareness of the entity on the part of surgeons and pathologists will prevent needless radical surgery. Full Text Download PDF Full Text Cite This Citation Ballas M, Nunez L, Miller EM. Localized Colitis Cystica Profunda.[jamanetwork.com]
  • It is important to establish the correct diagnosis for this condition in order to prevent added investigations, worsening morbidity and higher care cost.[oatext.com]
  • In summary, knowledge of colitis cystica profunda and its correct diagnosis are indispensable to differentiate this benign entity from malignancy and prevent unnecessary radical surgical procedures.[elsevier.es]
  • ., 2000: Collaborative multidisciplinary workshop report: clinical antimicrobial trials for primary and secondary prevention of atherosclerotic cardiovascular disease Kawashima, H.; Watanabe, N.; Hirose, M.; Sun, X.; Atarashi, K.; Kimura, T.; Shikata,[eurekamag.com]

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