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Rectal Adenoma

Adenoma of the Rectum


Presentation

  • We report the case of a 75-year-old woman, presenting to the emergency department with acute renal failure and electrolyte imbalance, reporting an history of recurrent episodes of dehydration and chronic diarrhea.[ncbi.nlm.nih.gov]
  • The cases are presented and the advantages and limitations of the method are discussed.[ncbi.nlm.nih.gov]
  • We present a case of a patient with a lower rectal adenoma extending above the dentate line, which underwent combined ESD and transanal minimally invasive surgery (TAMIS) to achieve accurate excision and prevent complications.[ncbi.nlm.nih.gov]
  • : 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]
  • 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]
Rectal Bleeding
  • Case Report A 58-year-old woman without previous major diseases starts suffering from evacuatory straining, occasional rectal bleeding and mass sensation 1 year prior to attending to a local ambulatory center.[omicsonline.org]
  • 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]
  • bleeding [ 1 ].[bmcsurg.biomedcentral.com]
  • Adenomas typically cause few symptoms; however, painless rectal bleeding is the most common symptom. There is no known way to prevent polyps, but they are easily removed by colonoscopy, which eliminates the risk of cancer in most cases.[ameripath.com]
Chronic Diarrhea
  • We report the case of a 75-year-old woman, presenting to the emergency department with acute renal failure and electrolyte imbalance, reporting an history of recurrent episodes of dehydration and chronic diarrhea.[ncbi.nlm.nih.gov]
  • It has been suggested that the triad of prerenal failure, electrolyte disorder and chronic diarrhea should always prompt a complete colonoscopy [ 4 ].[bmcsurg.biomedcentral.com]
  • Diarrhea and Acute Renal Failure.[imedpub.com]
Photosensitivity
  • Adverse events were reported by direct questioning of all patients; skin photosensitivity, changes in biochemical tests of liver function, blood pressure and heart rate, and the occurrence of GI symptoms (nausea, vomiting) were recorded for 5 patients[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]

Treatment

  • A prompt diagnosis plays an important role in the treatment of McKittrick-Wheelock syndrome.[ncbi.nlm.nih.gov]
  • Abstract There is no consensus about the best technique to use for the surgical treatment for large rectal adenomas. The advent of laparoscopic surgery has led to the development of several new methods for the treatment of gastrointestinal tumors.[ncbi.nlm.nih.gov]
  • The role of TAMIS in the treatment of rectal adenoma is to be defined through comparative studies.[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]
  • Therefore, the less-invasive transsacral approach, rather than the transabdominal approach, was chosen for treatment. The lesion was successfully resected, without disturbing the pouch.[ncbi.nlm.nih.gov]

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]
  • We present this case to underline the necessity of maintaining an high clinical suspicion for this syndrome in patients with an history of unexplained chronic diarrhea, especially given that the condition has a good prognosis when diagnosed and treated[bmcsurg.biomedcentral.com]
  • PROGNOSIS AFTER TREATMENT Once a colorectal polyp is completely removed, it rarely comes back. However, at least 30% of patients will develop new polyps after removal.[fascrs.org]

Etiology

  • It gives updated in formation on etiology - whether genetic or environmental, pathology, clinical features and treatments. It also gives information on screening, prevention and chemoprevention, where available.[books.google.ro]
  • 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]
  • (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]
  • Declarations Acknowledgements The authors would like to thank Kai-Tai Zhang, Department of Etiology and Carcinogenesis of Peking Union Medical College as the help of array CGH experiment.[bmcmedgenomics.biomedcentral.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]
  • .) — 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]
  • […] 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]
  • Total colorectal adenoma 4538 10,130 Colorectal cancer Murtaugh (2004) [ 6 ] 1997–2002 952 1205 Journal of nutrition Two times Murtaugh (2005) [ 7 ] 1991–2002 2298 2749 Journal of nutrition Butler (2003) [ 8 ] 1996–2000 620 1038 American Journal of Epidemiology[mdpi.com]
  • Epidemiology of polyps in the rectum and colon. Recovery and evaluation of unresected polyps 2 years after detection. Scand J Gastroenterol. 1986; 21 853-862 15 Winawer S J, Zauber A G, Ho M N et al.[thieme-connect.com]
Sex distribution
Age distribution

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]
  • 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]
  • 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]

Prevention

  • 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]
  • 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]
  • He had multiple cardiac co-morbidities that prevented curative surgical resection. The endoscopic assessment was performed to exclude foci of cancer.[bli.eu]
  • "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]
  • It also gives information on screening, prevention and chemoprevention, where available.[books.google.ro]

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