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2.1
Rectal Adenoma
Rectum Adenoma

Presentation

This form of presentation of rectal villous adenomas may require surgical treatment for removal. [ncbi.nlm.nih.gov]

We present a case of an 87 year old man presented to the emergency department because of an incarcerated rectal prolapse totally carpeted by a giant villous rectal adenoma. [tropicalgastro.com]

Case presentation: In this case we describe a 28-year-old female patient suffering from 6 months of secretory diarrhea, presented to our emergency department with severe dehydration, acute renal failure, hyponatremia and hypokalemia. [imedpub.com]

Carcinoma present at or within 1 mm of the surgical margin Usually recognized by cautery Measure from the superficial edge of the cautery where tissue is still recognizable High grade carcinoma (see Grading at left), even if only focal in the lesion [surgpathcriteria.stanford.edu]

Entire Body System

  • Hypoxemia

    In the sixth postoperative day, presented respiratory distress and hypoxemia that required mechanical ventilation and progressed to death in the second postoperative week due to severe pneumonia. [ncbi.nlm.nih.gov]

Gastrointestinal

  • Rectal Bleeding

    bleeding correlates with size and may be seen in as many as 67% • Imaging • Rate of detection of polyps less than 1 cm is higher with air contrast • Rate of detection of polyps 1cm or greater is about equal with single vs. double contrast • From 1/4 [learningradiology.com]

    Eight months later, she attends to the emergency department of the Hospital Universitario de Caracas with abdominal pain, growth of the rectal mass, rectal bleeding, and proctalgia so she is evaluated by the gastroenterology department and later referred [omicsonline.org]

    This is the case of an octogenarian man with a several year history of hemorrhoids and intermittent rectal bleeding, more recently complaining of continuous hematochezia. [wjgnet.com]

    They also may be involved in abnormal secretory activity associated with diarrhea and electrolyte imbalance, rectal bleeding or obstruction [2,3]. Association between giant villous adenomas (carpet-like lesion) and rectal prolapse is uncommon [4,5]. [tropicalgastro.com]

Musculoskeletal

  • Narrow Pelvis

    However, anterior resection of the rectum by abdominal approach may, on some occasions, raise doubts as to the resection margin and be difficult to be performed in obese patients with a narrow pelvis and in voluminous low rectal tumors. [ncbi.nlm.nih.gov]

Workup

Adenomatous Polyposis Peutz-Jeghers Syndrome Other Problems to be Considered: Adenocarcinoma Tubular adenoma Cowden disease Granular cell tumor Hyperplastic polyp Inflammatory polyps Juvenile polyps Lymphoid polyps Mucosal prolapse Solitary rectal ulcer Workup [suprepkit.com]

You may be referred to an enterostomal therapist (a health care professional, often a nurse, trained to help people with their colostomies) as part of your initial workup. [healthywomen.org]

Treatment

A prompt diagnosis plays an important role in the treatment of McKittrick-Wheelock syndrome. [ncbi.nlm.nih.gov]

As a result the harmony and open communication between these specialties facilitated by a multidisciplinary team approach are crucial in providing the best care to patients and ensuring successful treatment. [books.google.es]

Conclusions A prompt diagnosis plays an important role in the treatment of McKittrick-Wheelock syndrome. [bmcsurg.biomedcentral.com]

Prognosis

The prognosis of IIIA approaches that of IIB etc. This is not yet in widespread use). The advent of the newer chemotherapy agents has made a significant impact on rectal cancer prognosis. [myvmc.com]

These have a worse prognosis than non-mucinous carsinomas. Photomicrograph of a primary mucinous adenocarcinoma. Click to enlarge. [oncolex.org]

What is the prognosis of rectal polyps? People with a history of polyps have an increased risk of developing polyps again in their lifetime and should have regular exams by a physician specially trained to treat diseases of the colon and rectum. [annapoliscolon.com]

Villous adenomas have a worse prognosis and warrant closer follow-up. One needs only to remember the criteria for tubular adenomas and villous adenomas, as tubulovillous adenomas are what is left over. [librepathology.org]

Stage for stage, right-sided colonic cancers tend to have a better prognosis than left-sided cancers. Prognosis Tumour stage is the main determinant ( Table 28, “Prognosis in colorectal cancer” ) of prognosis. [surgwiki.com]

Etiology

(Etiology) Tubular Adenoma of the Colon is caused by genetic mutations that results in dysplasia Dysplasia is the phenomena of disordered growth of the epithelial lining of the colon. Genetic mutations lead to cell growths at abnormally high rates. [dovemed.com]

Using gene-environment interaction analyses to clarify the role of well-done meat and heterocyclic amine exposure in the etiology of colorectal polyps. Am. J. Clin. [mdpi.com]

Google Scholar Pre-publication history The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1755-8794/5/52/prepub Download references Acknowledgements The authors would like to thank Kai-Tai Zhang, Department of Etiology [bmcmedgenomics.biomedcentral.com]

McKittrick-Wheelock syndrome: a rare etiology of acute renal failure associated to well-differentiated adenocarcinoma (G1) arising within a villous adenoma. Rom J Morphol Embryol. 2011;52(3 Suppl):1153–1156. [PubMed] [Google Scholar] 28. [ncbi.nlm.nih.gov]

Hyperplastic polyposis Little is known about the etiology, natural history, and incidence of this rare condition, which is characterized by multiple and/or large hyperplastic polyps of the colon. [spandidos-publications.com]

Epidemiology

Experimental evidence has supported the hypothesis that dietary fibre may protect against the development of CRC, although epidemiologic data have been inconclusive. [cochrane.org]

[…] colon polyp with at least low grade dysplasia Precursor to invasive adenocarcinoma Essential features Dysplastic nuclei (elongated and hyperchromatic pseudostratification) < 25% villous component ICD coding K63.5 : colon polyp D12.6 : adenomatous polyp Epidemiology [pathologyoutlines.com]

Epidemiology of colorectal polyps. Tech Coloproctol. 2004;8(2):S243–S247. [PubMed] [Google Scholar] 3. Wilhelm D., Von Delius S., Weber L. Combined laparoscopic–endoscopic resections of colorectal polyps: 10-year experience and follow-up. [ncbi.nlm.nih.gov]

Clinical, autopsical, and epidemiological studies provide evidence of adenoma-to-carcinoma progression. The mean age of adenoma diagnosis is 10 years earlier than with carcinoma, and progression to carcinoma takes a minimum of 4 years. [emedicine.medscape.com]

— all in Norway; the Department of Epidemiology, Harvard School of Public Health, Boston (M.L., M.K., Ø.H., H.-O.A., M.B.); and the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (H.-O.A.). [nejm.org]

Pathophysiology

[…] undergoing colonoscopy are found to have at least one adenoma ( N Engl J Med 2006;355:2551 ) Men more commonly affected than women ( Gastrointest Endosc 2011;74:135 ) Sites Found more commonly in the left colon and rectum compared with other polyps Pathophysiology [pathologyoutlines.com]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126. [medlineplus.gov]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, and Management. 6th ed. Philadelphia: WB Saunders; 1997. 467-71. Mandel JS, Bond JH, Church TR, et al. [emedicine.medscape.com]

Sleisinger & Fordtran's Gastrointestinal and liver disease; pathophysiology, diagnosis, management. 6th ed. Philadelphia: Saunders, 1998. 11. Launoy G, Smith TC, Duffy SW, Bouvier V. [aafp.org]

Pathophysiology: Adenomas are believed to have an abnormal process of cell proliferation and apoptosis. The proliferative component is not confined to the crypt base and accumulates onto the surface and infolds downward. [suprepkit.com]

Prevention

Colorectal cancer prevention: is an ounce of prevention worth a pound of cure? Semin Oncol. 2005 Feb;32(1):24-34. Review. 6. Dietary calcium supplementation for preventing colorectal cancer and adenomatous polyps. [passeportsante.net]

Combined ESD and TAMIS is effective in patients with benign and early neoplastic lesions of the anorectum extending above the dentate line with concomitant hemorrhoids and can prevent complications. [ncbi.nlm.nih.gov]

He had multiple cardiac co-morbidities that prevented curative surgical resection. The endoscopic assessment was performed to exclude foci of cancer. [bli.eu]

Prevention If you have a history of polyps in your colon, you’re more likely to get colon cancer. Screening is your best way to prevent that. Doctors generally recommend getting your first colonoscopy at age 50. [webmd.com]

"Screening for Colorectal Cancer" in Guide to Clinical Preventative Services, 2nd Edition, Report of the U.S. Preventative Services Task Force, U.S. [labtestsonline.it]

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