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Villous Adenoma of the Colon

Colon Adenoma Villous


Presentation

  • A case of severe fluid and electrolyte depletion resulting from a massive villous adenoma of the rectosigmoid colon is presented. The syndrome is discussed, and the often insidious presentation and life-threatening aspects are emphasized.[ncbi.nlm.nih.gov]
  • The case is presented of a villous adenoma of the colon associated with profuse, watery diarrhoea of such severity as to cause dehydration and electrolyte depletion.[ncbi.nlm.nih.gov]
  • Summary A case of severe fluid and electrolyte depletion resulting from a massive villous adenoma of the rectosigmoid colon is presented. The syndrome is discussed, and the often insidious presentation and life-threatening aspects are emphasized.[link.springer.com]
  • Home Videos Educational VIdeo Español Korean YTN Radio Stomach Balloon Reviews Fee Schedule FAQs Directions Contact Us Colon: Villous Adenoma with Diarrhea Details Written by Los Angeles Colonoscopy A 66 year old male presenting with 3 year history of[laendo.net]
  • Overlying mild mucosal irregularity present with narrowing of the distal segment of the colon. No stricture or obstruction is seen.[radiologydefinition.com]
Collapse
  • A RARE, but curable, cause of circulatory collapse in people of middle and late age has recently been managed successfully in a small community hospital.[nejm.org]
Laboratory Technician
  • Wallace Jones for advice and criticism in the management of this patient and in the preparation of this manuscript and to the laboratory technicians at Symmes Hospital for co-operation.[nejm.org]
Diarrhea
  • diarrhea, up to 8 times per day.[laendo.net]
  • Furthermore, the etiology of the diarrhea is often difficult to establish by the usual technics.[nejm.org]
  • When they do occur, however, they may include abnormal bleeding, cramps, abdominal pain, constipation, or diarrhea.[microscopyu.com]
  • , pain, rectal bleeding, or melena • Lesion closer to rectum: More likely to have diarrhea, electrolyte loss (hypokalemia and hyponatremia) TERMINOLOGY Synonyms Definitions • Adenomatous polyp that contains predominantly villous (“shaggy” surface) elements[radiologykey.com]
  • These can also lead to secretory diarrhea with large volume liquid stools with few formed elements. They are commonly described as secreting large amounts of mucus, resulting in hypokalaemia in patients.[en.wikipedia.org]
Rectal Mass
  • Physical examination may demonstrate: Bright red blood on digital rectal examination Rectal mass Laboratory Findings There are no specific laboratory findings associated with villous adenoma.[wikidoc.org]
  • Digital rectal examination is important in order to feel for a rectal mass, its location and relationship to the anal sphincters, its fixity to adjacent structures and to feel for any enlarged extrarectal nodule.[surgwiki.com]

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]
Polyps
  • Intraluminal polyps are more easily detected than those that are sessile (along with the colon wall). Evolution of polyps into colon cancer does occur; the larger the polyp, the greater the chance the histology will show a malignant change.[radiologydefinition.com]
  • Polyps in the rectum are occasionally palpable by rectal examination, but more often require examination via endoscopy to be discovered.[microscopyu.com]
  • The villous component of nine colonic polyps (three pure villous adenoma and six mixed adenomatous and villous adenomas) was studied by light and electron microscopy. Normal colonic mucosa was used for control.[ncbi.nlm.nih.gov]
  • Adenomatous tubulo-villous polyp, pedunculated (colon) .[pathologyatlas.ro]
  • The report from the gastroenterologist says that he had two sessile polyps in the sigmoid colon, which were removed and sent for histology. The polyps were 1.5 cm and 2 cm in size.[usmleforum.com]

Treatment

  • […] adults, commonly in rectum or rectosigmoid Less frequent than tubular adenoma ( eMedicine ) May invade directly into colon wall since no stalk is present to serve as buffer zone Higher risk of malignancy than tubular adenoma; 40% risk if sessile and 4 cm Treatment[pathologyoutlines.com]
  • Treatment is required only for uncontrollable bleeding or intussusception. Inflammatory polyps and pseudopolyps occur in chronic ulcerative colitis and in Crohn disease of the colon.[merckmanuals.com]
  • References: [2] [8] [9] [10] [11] [12] [13] [14] [15] Diagnostics Treatment Treatment depends on the etiology and nature of the polyp or polyps. References: [1] [2][amboss.com]
  • Exploratory colonoscopy and cautery snare is the most common approach to the diagnosis and treatment of villous adenoma.[wikidoc.org]
  • All 4 are effective in catching cancers in the early stages, when treatment is most beneficial.[huronregional.org]

Prognosis

  • If left untreated, patients with villous adenoma may progress to develop colorectal cancer . [3] Complications Common complications of villous adenoma include: Bleeding Obstruction Bowel torsion Prognosis The prognosis of villous adenoma is generally[wikidoc.org]
  • ., lips (perioral lentigines), buccal mucosa, palms, and soles) Enteroscopy : 20 polyps , primarily in the jejunum Prognosis The lifetime risk of colorectal cancer is 40% .[amboss.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]
  • Based on the fact that the ascending colon resection showed cancer at regional stage (a positive lymph node), that tumor has a worse prognosis and should be sequence 01. Turn to the colon histology coding rules in your preferred format.[training.seer.cancer.gov]

Etiology

  • Furthermore, the etiology of the diarrhea is often difficult to establish by the usual technics.[nejm.org]
  • References: [2] [8] [9] [10] [11] [12] [13] [14] [15] Diagnostics Treatment Treatment depends on the etiology and nature of the polyp or polyps. References: [1] [2][amboss.com]
  • (Etiology) Currently, the exact cause and mechanism of formation of Villous Adenoma of Vagina is unknown It is believed to arise from embryological remnants (displaced tissue) during fetal growth and development The kind of tissue that can be abnormally[dovemed.com]

Epidemiology

  • Epidemiology References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. Etiology Classification The majority of colon carcinomas develop from adenomas ( adenoma‑carcinoma sequence).[amboss.com]
  • Methods for pooled analyses of epidemiologic studies. Epidemiology , 4 : 295 -302, 1993 . Terry M. B., Gammon M. D., Ng-Mak D., Thompson W. D. Re: “p53 protein overexpression in relation to risk factors for breast cancer.” Am. J.[cebp.aacrjournals.org]
  • Methods Statistics Trigonometry Medical & Nursing Anatomy Anesthesiology Audiology Bacteriology Biochemistry Bioethics Biomedical Science Cardiology Cardiovascular Childbirth Chiropractic Dentistry Dermatology Diagnostic Imaging Drugs Endocrinology Epidemiology[brainscape.com]
  • Differentiating Villous Adenoma from Other Diseases Villous adenoma must be differentiated from other diseases that cause abnormal growth of tissue projecting from a mucous membrane such as: Colorectal cancer Inflammatory fibroid polyp Epidemiology and[wikidoc.org]
  • 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]
Sex distribution
Age distribution

Pathophysiology

  • Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126.[medlineplus.gov]
  • Historical Perspective Villous adenoma was first discovered by Helwig in 1946. [2] Classification Villous adenoma may be classified into 3 subtypes according to appearance: [3] Tubular Tubulovillous Villous (most common) Pathophysiology Pathogenesis The[wikidoc.org]
  • 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]

Prevention

  • Are Colon Polyps Preventable? There is no definitive, fail-proof method of preventing colon polyps from forming. Avoiding the risk factors one can control, such as tobacco use or poor diet may help to prevent polyps from forming.[sanfranciscocolonoscopy.com]
  • Cautery snare in conjunction with exploratory colonoscopy is the most common approach to both the diagnosis and treatment of villous adenoma. [3] Prevention Primary Prevention Effective measures for the primary prevention of villous adenoma include periodic[wikidoc.org]
  • Prevention of Colon Polyps There is no guaranteed way to prevent polyps from forming. However, the risk of developing polyps can be lowered by taking a few small steps.[gipractice.com]
  • Printer-friendly Colon Polyps and Cancer Prevention PDF[arizonadigestivehealth.com]
  • Nonsteroidal anti-inflammatory drugs, eicosanoids, and colorectal cancer prevention. Gastroenterol Clin North Am . 1996 Dec. 25(4):773-91. [Medline] . Farnell MB, Sakorafas GH, Sarr MG, et al.[emedicine.medscape.com]

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