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Grimaldi J, Napoléon B, Masgnaux LJ, Leblanc S, Rivory J, Lépilliez V, Pioche M. Endoscopic submucosal dissection of a laterally spreading tumor totally invading a deep sigmoidal diverticulum using an adaptive traction strategy. Endoscopy 2023; 55:E898-E899. [PMID: 37442163 PMCID: PMC10344621 DOI: 10.1055/a-2114-0763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Affiliation(s)
- Jean Grimaldi
- Gastroenterology and Endoscopy Unit, Fleyriat Hospital, Bourg-en-Bresse, France
| | - Bertrand Napoléon
- Gastroenterology and Endoscopy Unit, Jean Mermoz Hospital, Lyon, France
| | - Louis-Jean Masgnaux
- Gastroenterology and Endoscopy Unit, Fleyriat Hospital, Bourg-en-Bresse, France
| | - Sarah Leblanc
- Gastroenterology and Endoscopy Unit, Jean Mermoz Hospital, Lyon, France
| | | | - Vincent Lépilliez
- Gastroenterology and Endoscopy Unit, Jean Mermoz Hospital, Lyon, France
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2
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Oura H, Hatayama Y, Nomura E, Sugiyama H, Murakami D, Arai M, Nishino T. Iatrogenic colorectal perforation caused by a clip. Endoscopy 2023; 55:E1091-E1092. [PMID: 37802116 PMCID: PMC10558279 DOI: 10.1055/a-2163-2290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Affiliation(s)
- Hirotaka Oura
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Yasuki Hatayama
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Erika Nomura
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Harutoshi Sugiyama
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Daisuke Murakami
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Makoto Arai
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Takayoshi Nishino
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
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3
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Miyake T, Yoshii S, Nakase H. Endoscopic full-thickness resection using an over-the-scope clip for colon cancer within a diverticulum. Dig Endosc 2023; 35:e30-e32. [PMID: 36511235 DOI: 10.1111/den.14475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/15/2022] [Indexed: 01/14/2023]
Affiliation(s)
- Takakazu Miyake
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Shinji Yoshii
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Hiroshi Nakase
- Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Hokkaido, Japan
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Ikezawa N, Toyonaga T, Tanaka S, Yoshizaki T, Takao T, Abe H, Sakaguchi H, Tsuda K, Urakami S, Nakai T, Harada T, Miura K, Yamasaki T, Kostalas S, Morita Y, Kodama Y. Feasibility and safety of endoscopic submucosal dissection for lesions in proximity to a colonic diverticulum. Clin Endosc 2022; 55:417-425. [PMID: 35545214 PMCID: PMC9178129 DOI: 10.5946/ce.2021.245] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/25/2021] [Accepted: 12/24/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND/AIMS Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicated because of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified. The aim of this study was to evaluate the feasibility and safety of D-ESD. METHODS D-ESD was defined as ESD for lesions within approximately 3 mm of a diverticulum. Twenty-six consecutive patients who underwent D-ESD were included. Two strategic approaches were used depending on whether submucosal dissection of the diverticulum-related part was required (strategy B) or not (strategy A). Treatment outcomes and adverse events associated with each strategy were analyzed. RESULTS The en bloc resection rate was 96.2%. The rates of R0 and curative resection in strategies A and B were 80.8%, 73.1%, 84.6%, and 70.6%, respectively. Two cases of intraoperative perforation and one case of delayed perforation occurred. The delayed perforation case required emergency surgery, but the other cases were managed conservatively. CONCLUSION D-ESD may be a feasible treatment option. However, it should be performed in a high-volume center by expert hands because it requires highly skilled endoscopic techniques.
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Affiliation(s)
- Nobuaki Ikezawa
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Takashi Toyonaga
- Department of Endoscopy, Kobe University Hospital, Kobe, Japan
- Department of Gastroenterology, Kishiwada Tokushukai Hospital, Kishiwada, Japan
| | - Shinwa Tanaka
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Tetsuya Yoshizaki
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Toshitatsu Takao
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Hirofumi Abe
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Hiroya Sakaguchi
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Kazunori Tsuda
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Satoshi Urakami
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Tatsuya Nakai
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Taku Harada
- Department of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - Kou Miura
- Department of Gastroenterology, Yoka Municipal Hospital, Yabu, Japan
| | - Takahisa Yamasaki
- Department of Gastroenterology, Yoka Municipal Hospital, Yabu, Japan
| | - Stuart Kostalas
- Department of Gastroenterology, Port Macquarie Base Hospital, Port Macquarie, Australia
| | - Yoshinori Morita
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Yuzo Kodama
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
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Muramoto T, Ohata K, Sakai E, Takayanagi S, Kimoto Y, Suzuki Y, Ishii R, Kanda K, Negishi R, Takita M, Minato Y, Tsuji Y, Chiba H, Matsuhashi N. Endoscopic submucosal dissection for colorectal neoplasms in proximity or extending to a diverticulum. Surg Endosc 2021; 35:3479-3487. [PMID: 32671524 DOI: 10.1007/s00464-020-07795-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/07/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS At specialized facilities, endoscopic submucosal dissection (ESD) has currently been performed even for difficult cases such as tumors extending to a diverticulum that previously required surgery. This study aims to classify the type of lesion according to the degree of infiltration to a diverticulum and assessed the safety and efficacy of ESD for each type of lesion. METHODS We retrospectively reviewed ESD for lesions at NTT Medical Center Tokyo between January 2014 and April 2019. Lesions were classified as follows: Type 1: lesions in contact with or within 3 mm of the edge of a diverticulum; Type 2: lesions that partially infiltrated into a diverticulum; and Type 3: lesions that infiltrated into and completely covered the diverticulum. Furthermore, ESD strategies were divided into A and B, which indicates that a lesion was resected separately from the diverticulum and along the entire diverticulum, respectively. The clinicopathological characteristics and clinical outcomes were analyzed according to the strategy. RESULTS A total of 47 lesions satisfied inclusion criteria (19 Type 1, 12 Type 2, and 16 Type 3 lesions). 19 Type 1 and 8 Type 2 lesions were resected using Strategy A, while 4 Type 2 and 16 Type 3 lesions were resected using Strategy B. En bloc resection was achieved in all cases. In Strategy A, the R0 resection rate was 96.3% and the curative resection rate was 88.9%. On the contrary, in Strategy B, the R0 resection rate was 95.0% and the curative resection rate was 90.0%. In Strategy B, one of the patients developed post-operative bleeding that required endoscopic hemostasis; another patient developed delayed perforation that required emergency surgery. CONCLUSIONS ESD for colorectal neoplasms in proximity or extending to a diverticulum is challenging, but this procedure can be a safe and effective therapeutic option.
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Affiliation(s)
- Takashi Muramoto
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Ken Ohata
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan.
| | - Eiji Sakai
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Syunya Takayanagi
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Yoshiaki Kimoto
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Yuichiro Suzuki
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Rindo Ishii
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Keisuke Kanda
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Ryoju Negishi
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Maiko Takita
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Yohei Minato
- Department of Gastrointestinal Endoscopy, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Yosuke Tsuji
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideyuki Chiba
- Department of Gastroenterology, Omori Red Cross Hospital, Tokyo, Japan
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Hawa F, Al Hillan A, Catanzaro AT, Tworek JA, Gunaratnam NT. Endoscopic Management of a Tubulovillous Adenoma Within a Diverticulum: Report of a Case and Review of Literature. Cureus 2020; 12:e8668. [PMID: 32699668 PMCID: PMC7370691 DOI: 10.7759/cureus.8668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/17/2020] [Indexed: 02/07/2023] Open
Abstract
Adenomas or adenocarcinomas located within a colonic diverticulum are considered a rare phenomenon that has been described in the literature. These lesions are technically difficult to manage endoscopically and usually require surgical intervention for removal. There is also an increased risk of perforation upon endoscopic resection owing to the lack of a muscular layer within the diverticulum. We report a case and include a literature review to evaluate different endoscopic techniques and propose the most effective for management of adenomas within a diverticulum. This technique is potentially comprised of employing a combined approach using a suction banding device, an over-the-scope clip (OTSC; Ovesco Endoscopy AG, Tübingen, Germany) , and hyperthemic snare to successfully remove the polyp, ensure tissue retrieval, and reduce risk of iatrogenic colonic perforation.
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Affiliation(s)
- Fadi Hawa
- Internal Medicine, St. Joseph Mercy Ann Arbor Hospital, Ann Arbor, USA
| | - Alsadiq Al Hillan
- Internal Medicine, Jersey Shore University Medical Center, Neptune City, USA
| | - Andrew T Catanzaro
- Gastroenterology and Hepatology, St. Joseph Mercy Ann Arbor Hospital, Ann Arbor, USA
| | - Joseph A Tworek
- Pathology, St. Joseph Mercy Ann Arbor Hospital, Ann Arbor, USA
| | - Naresh T Gunaratnam
- Gastroenterology and Hepatology, St. Joseph Mercy Ann Arbor Hospital, Ann Arbor, USA
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Kayano H, Ueda Y, Machida T, Hiraiwa S, Zakoji H, Tajiri T, Mukai M, Nomura E. Colon cancer arising from colonic diverticulum: A case report. World J Clin Cases 2019; 7:1643-1651. [PMID: 31367623 PMCID: PMC6658384 DOI: 10.12998/wjcc.v7.i13.1643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 04/28/2019] [Accepted: 05/01/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Colonic diverticulosis is a common disease, and the coexistence of colonic diverticulosis and colorectal cancer is often seen clinically. It is very rare that colon cancer arises from the mucosa of a colonic diverticulum. When colon cancer arises in a diverticulum and then tends to develop outside the wall, without developing within the lumen, the differential diagnosis from complicating lesions due to colonic diverticulitis is difficult.
CASE SUMMARY A 76-year-old man was admitted to a nearby clinic with a chief complaint of discomfort and urinary frequency. Since a vesicosigmoidal fistula was seen on abdominal computed tomography, he was referred to our hospital. Laparoscopic sigmoidectomy was performed because the various diagnostic findings were diagnosed as a vesicosigmoidal fistula with diverticulitis of the sigmoid colon. However, on histopathological examination, it was diagnosed as a vesicosigmoidal fistula due to colon cancer arising in the diverticulum. Laparoscopic partial resection of the bladder was performed because local recurrence was observed in the bladder wall one and a half years after surgery. It is currently one year after reoperation, but there has been no recurrence or metastasis.
CONCLUSION Colon cancer arising in a diverticulum of the colon should be considered when diverticulitis with complications is observed.
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Affiliation(s)
- Hajime Kayano
- Department of Gastroenterological and General Surgery, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
| | - Yusuhiko Ueda
- Department of Gastroenterological and General Surgery, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
| | - Takashi Machida
- Department of Gastroenterological and General Surgery, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
| | - Shinichiro Hiraiwa
- Departments of Pathology, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
| | - Hidenori Zakoji
- Departments of Urology, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
| | - Takuma Tajiri
- Departments of Pathology, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
| | - Masaya Mukai
- Department of Gastroenterological and General Surgery, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
| | - Eiji Nomura
- Department of Gastroenterological and General Surgery, Tokai University Hachioji Hospital, Tokyo, Hachioji 192-0032, Japan
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Jimenez-Garcia VA, Yamada M, Ikematsu H, Takamaru H, Abe S, Sakamoto T, Nakajima T, Matsuda T, Saito Y. Endoscopic submucosal dissection in management of colorectal tumors near or involving a diverticulum: a retrospective case series. Endosc Int Open 2019; 7:E664-E671. [PMID: 31061878 PMCID: PMC6499619 DOI: 10.1055/a-0848-8048] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 12/27/2018] [Indexed: 12/22/2022] Open
Abstract
Background and study aims Surgery is the standard treatment for colon tumors associated with diverticulum. U se of endoscopic submucosal dissection (ESD) to treat such tumors is controversial. The aim of this study was to assess the safety and feasibility of ESD in treating superficial colorectal tumors situated near or involving diverticulum. Patients and methods Consecutive patients from two referral centers who had colorectal tumors near or involving diverticulum treated by ESD were retrospectively studied. Clinicopathological characteristics and clinical outcomes were analyzed. Results Of the 12 patients studied, six had tumors near diverticulum and six had tumors involving diverticulum. The overall en-bloc R0 resection rate, median tumor size and procedure time were 67 %, 26.5 mm (range, 15 - 80 mm) and 110 minutes (range, 50 - 220 minutes), respectively. For tumors near diverticulum group, the en-bloc R0 resection rate was 100 % and no adverse events (AEs) or residual/recurrent tumors were observed. In contrast, for intradiverticular tumors group, the en-bloc R0 resection rate was low at 33 %, and one AE (perforation) was observed. The diverticula were ≥ 6 mm in diameter in the patients with incomplete resection. However, all but one diverticulum was unrecognized before ESD. Two residual tumors were detected at the 12-month surveillance and one required surgery. Conclusions This case series indicates that ESD is safe and feasible for treating colorectal tumors near a diverticulum and might be feasible for tumors involving a diverticulum smaller than 6 mm. Selection for smaller diverticulum size may contribute to higher en-bloc R0 resection rates.
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Affiliation(s)
| | - Masayoshi Yamada
- National Cancer Center Hospital, Endoscopy Division, Tokyo, Japan,Corresponding author Masayoshi Yamada, MD, PhD Endoscopy DivisionNational Cancer Center Hospital5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045Japan+81-3-3542-3815
| | - Hiroaki Ikematsu
- National Cancer Center Hospital East, Division of Endoscopy and Gastrointestinal Oncology, Kashiwa, Japan
| | | | - Seiichiro Abe
- National Cancer Center Hospital, Endoscopy Division, Tokyo, Japan
| | - Taku Sakamoto
- National Cancer Center Hospital, Endoscopy Division, Tokyo, Japan
| | - Takeshi Nakajima
- National Cancer Center Hospital, Endoscopy Division, Tokyo, Japan
| | - Takahisa Matsuda
- National Cancer Center Hospital, Endoscopy Division, Tokyo, Japan
| | - Yutaka Saito
- National Cancer Center Hospital, Endoscopy Division, Tokyo, Japan
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Kimura J, Lefor AK, Fukai S, Yoshikawa K, Sasamatsu S, Sakamoto T, Mizokami K, Kanzaki M, Kubota T, Saito A, Izumi H, Honjo K, Nagakari K, Fukunaga M. Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report. Surg Case Rep 2018; 4:47. [PMID: 29766314 PMCID: PMC5953913 DOI: 10.1186/s40792-018-0455-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/08/2018] [Indexed: 11/20/2022] Open
Abstract
Background There are few reports of metastases from colon cancer to an inguinal hernia sac, and few reports of colon cancer originating in diverticula. We report a patient with carcinoma of the sigmoid colon arising in two diverticula, who presented with peritoneal seeding to an inguinal hernia sac, and a review of the literature. Case presentation A 55-year-old male underwent open herniorrhaphy for a left inguinal hernia. At operation, a nodule in the inguinal hernia sac was resected and histologic examination revealed adenocarcinoma, which was suspected to be a metastasis from a distant primary lesion. Postoperative evaluation included colonoscopy and positron emission tomography which showed two suspected lesions in sigmoid diverticula. Laparoscopic subtotal colectomy was performed, and pathology revealed adenocarcinoma in two sigmoid diverticula. Conclusions If a nodule is found in an inguinal hernia sac, especially in older patients, peritoneal metastases should be considered. Resection of the nodule with histopathologic evaluation is essential. Colon cancer arising in a diverticulum should be considered as a possible site of the primary lesion.
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Affiliation(s)
- Jiro Kimura
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan.
| | - Alan Kawarai Lefor
- Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-City, Tochigi, 329-0498, Japan
| | - Shota Fukai
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Kentaro Yoshikawa
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Shingo Sasamatsu
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Takashi Sakamoto
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Ken Mizokami
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Masaki Kanzaki
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Tadao Kubota
- Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, 3-4-32, Todaijima, Urayasu, Chiba, 279-0001, Japan
| | - Akira Saito
- Department of Pathology, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Hiroshi Izumi
- Department of Pathology, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - Kunpei Honjo
- Department of Surgery, Juntendo Urayasu Hospital, Juntendo University, Chiba, Japan
| | - Kunihiko Nagakari
- Department of Surgery, Juntendo Urayasu Hospital, Juntendo University, Chiba, Japan
| | - Masaki Fukunaga
- Department of Surgery, Juntendo Urayasu Hospital, Juntendo University, Chiba, Japan
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Malignant Polyp in a Colonic Diverticulum: a Rare Cause of Diverticular Hemorrhage. J Gastrointest Cancer 2016; 43 Suppl 1:S104-7. [PMID: 21952946 DOI: 10.1007/s12029-011-9327-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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11
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Valli PV, Kaufmann M, Vrugt B, Bauerfeind P. Endoscopic resection of a diverticulum-arisen colonic adenoma using a full-thickness resection device. Gastroenterology 2014; 147:969-971. [PMID: 25093544 DOI: 10.1053/j.gastro.2014.07.053] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 06/05/2014] [Accepted: 07/23/2014] [Indexed: 12/13/2022]
Affiliation(s)
- Piero V Valli
- Clinic of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | | | - Bart Vrugt
- Institute of Pathology, University Hospital Zürich, Zürich, Switzerland
| | - Peter Bauerfeind
- Clinic of Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland.
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12
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Sigmoid colon cancer arising in a diverticulum of the colon with involvement of the urinary bladder: a case report and review of the literature. BMC Gastroenterol 2014; 14:90. [PMID: 24884743 PMCID: PMC4030041 DOI: 10.1186/1471-230x-14-90] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 05/07/2014] [Indexed: 12/24/2022] Open
Abstract
Background Colon cancer can arise from the mucosa in a colonic diverticulum. Although colon diverticulum is a common disease, few cases have been previously reported on colon cancer associated with a diverticulum. We report a rare case of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder, which presented characteristic radiographic images. Case presentation A 73-year-old man was admitted to our hospital for macroscopic hematuria. Computed tomography and magnetic resonance imaging revealed a sigmoid colon tumor that protruded into the urinary bladder lumen. The radiographs showed a tumor with a characteristic dumbbell-shaped appearance. Colonoscopy showed a type 1 cancer and multiple diverticula in the sigmoid colon. A diagnosis of sigmoid colon cancer with involvement of the urinary bladder was made based on the pathological findings of the biopsied specimens. We performed sigmoidectomy and total resection of the urinary bladder with colostomy and urinary tract diversion. Histopathological findings showed the presence of a colovesical fistula due to extramurally growing colon cancer. Around the colon cancer, the normal colon mucosa was depressed sharply with lack of the muscular layer, suggesting that the colon cancer was arising from a colon diverticulum. Conclusion The present case is the first report of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder. Due to an accurate preoperative radiological diagnosis, we were able to successfully perform a curative resection for sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder.
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Mori H, Tsushimi T, Kobara H, Nishiyama N, Fujihara S, Matsunaga T, Ayagi M, Yachida T, Masaki T. Endoscopic management of a rare granulation polyp in a colonic diverticulum. World J Gastroenterol 2013; 19:9481-9484. [PMID: 24409079 PMCID: PMC3882425 DOI: 10.3748/wjg.v19.i48.9481] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 10/01/2013] [Accepted: 10/14/2013] [Indexed: 02/06/2023] Open
Abstract
There are many case reports on colon diverticula that cause irritable bowel syndrome, constipation, bleeding, diverticulitis, stricture due to multiple recurrences of diverticulitis, and perforation. However, few articles have examined neoplasms that arise from a diverticulum, such as adenoma and adenocarcinoma, and there have been no reports of granulation polyps that arise from a colon diverticulum after recurrent diverticulitis. We observed a rare granulation polyp that arose from a diverticulum as a result of repeated episodes of local diverticulitis. Narrow band imaging magnified colonoscopy was very useful to diagnose the polyp as a granulation polyp because of the absence of a pit pattern on the surface of the polyp. We successfully resected the polyp using endoscopic mucosal resection. We inverted the diverticulum, and the resected stalk of the polyp was used to close the diverticulum with an over-the-scope clip. If a granulomatous polyp could arise from a diverticulum, differential diagnosis between a colon neoplasm and a granulomatous polyp would not only be difficult but also necessary for suitable endoscopic treatment.
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Donatelli G, Dhumane P, Dabo C, Perretta S, Dritsas S, Dallemagne B. A sessile (diminutive) polyp within a sigmoid diverticulum--EMR or observe? Indian J Gastroenterol 2012; 31:201-2. [PMID: 22766644 DOI: 10.1007/s12664-012-0195-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2011] [Accepted: 05/22/2012] [Indexed: 02/04/2023]
Abstract
Endoscopic mucosal resection (EMR) is a well-established technique for excision of colo-rectal polyps, which can be technically challenging when the polyp is inside a diverticulum, as colonic perforation may easily occur due to the lack of muscular coats. Here we report, to our knowledge, the first case of sessile (diminutive) polyp inside a diverticulum being successfully removed entirely by EMR.
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Affiliation(s)
- Gianfranco Donatelli
- IRCAD/EITS, Department of Gastrointestinal and Endocrinal Surgery, University of Strasbourg, Strasbourg, France.
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