Annals of Coloproctology

Guideline

Colorectal cancer

Colon cancer: the 2023 Korean clinical practice guidelines for diagnosis and treatment: Hyo Seon Ryu, Hyun Jung Kim, Woong Bae Ji, Byung Chang Kim, Ji Hun Kim, Sung Kyung Moon, Sung Il Kang, Han Deok Kwak, Eun Sun Kim, Chang Hyun Kim, Tae Hyung Kim, Gyoung Tae Noh, Byung-Soo Park, Hyeung-Min Park, Jeong Mo Bae, Jung Hoon Bae, Ni Eun Seo, Chang Hoon Song, Mi Sun Ahn, Jae Seon Eo, Young Chul Yoon, Joon-Kee Yoon, Kyung Ha Lee, Kyung Hee Lee, Kil-Yong Lee, Myung Su Lee, Sung Hak Lee, Jong Min Lee, Ji Eun Lee, Han Hee Lee, Myong Hoon Ihn, Je-Ho Jang, Sun Kyung Jeon, Kum Ju Chae, Jin-Ho Choi, Dae Hee Pyo, Gi Won Ha, Kyung Su Han, Young Ki Hong, Chang Won Hong, Jung-Myun Kwak, Korean Colon Cancer Multidisciplinary Committee; Ann Coloproctol. 2024;40(2):89-113. Published online April 30, 2024; DOI: https://doi.org/10.3393/ac.2024.00059.0008

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Colorectal cancer is the third most common cancer in Korea and the third leading cause of death from cancer. Treatment outcomes for colon cancer are steadily improving due to national health screening programs with advances in diagnostic methods, surgical techniques, and therapeutic agents.. The Korea Colon Cancer Multidisciplinary (KCCM) Committee intends to provide professionals who treat colon cancer with the most up-to-date, evidence-based practice guidelines to improve outcomes and help them make decisions that reflect their patients’ values and preferences. These guidelines have been established by consensus reached by the KCCM Guideline Committee based on a systematic literature review and evidence synthesis and by considering the national health insurance system in real clinical practice settings. Each recommendation is presented with a recommendation strength and level of evidence based on the consensus of the committee.

Citations

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2023 Korean Multidisciplinary Guidelines for Colon Cancer Management: Summary of Radiological Points
Nieun Seo, Hyo Seon Ryu, Myungsu Lee, Sun Kyung Jeon, Kum Ju Chae, Joon-Kee Yoon, Kyung Su Han, Ji Eun Lee, Jae Seon Eo, Young Chul Yoon, Sung Kyung Moon, Hyun Jung Kim, Jung-Myun Kwak
Korean Journal of Radiology.2024; 25(9): 769. CrossRef

Original Article

Anal canal coronal-sagittal ratio: a novel parameter for diagnosing pelvic floor injury in 2-dimensional transanal ultrasound: Hong Yoon Jeong, Keehoon Hyun, Jong Kyun Lee; Received February 8, 2022 Accepted May 21, 2022 Published online November 10, 2022; DOI: https://doi.org/10.3393/ac.2022.00129.0018 [Epub ahead of print]

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Abstract PDF: Purpose
Pelvic floor injury diagnosis using 3-dimensional (3D) pelvic floor ultrasound or magnetic resonance imaging is unfeasible in many clinics. We assessed the efficacy of a novel diagnostic parameter, the anal canal coronal-sagittal (CS) ratio, for pelvic floor injury on 2D transanal ultrasound.
Methods
This retrospective study analyzed the data of 126 female patients who underwent 3D pelvic floor ultrasound (including 2D transanal ultrasound) at a pelvic floor center between August and December 2020. The anal canal CS ratio on 2D transanal ultrasound and pelvic floor avulsion injury measurements were recorded for all patients.
Results
A cutoff anal canal CS ratio of 1.15 was obtained using receiver operating characteristic analysis (sensitivity, 0.820; specificity, 0.763; and area under the curve, 0.838). Patients were categorized into the anal canal CS ratio ≥1.15 and the anal canal CS ratio <1.15 groups. Bilateral pelvic floor avulsion was more common in the anal canal CS ratio ≥1.15 group (n=35, 56.5%), and the incidence of pelvic floor avulsion was significantly different between the 2 groups (P=0.001). Existing parameters of pelvic floor injury, including minimal levator hiatus (P=0.001), levator plate descent angle (P=0.001), and levator ani deficiency score (P=0.001), were statistically different between the 2 groups.
Conclusion
The anal canal CS ratio was an efficient novel parameter that indirectly detected pelvic floor injury in 2D transanal ultrasound. It is a potential alternative indicator for pelvic floor injury on the widely popular 2D transanal ultrasound.

Case Report

Benign bowel disease

Perioperative considerations for acute appendicitis in patients with COVID-19 infection: two case reports: In-Kyeong Kim, Seung-jin Kwag, Han-Gil Kim, Young-Tae Ju, Seung-Jun Lee, Tae-Jin Park, Sang-Ho Jeong, Eun-Jung Jung, Jin-Kwon Lee; Ann Coloproctol. 2023;39(6):521-525. Published online December 7, 2021; DOI: https://doi.org/10.3393/ac.2021.00647.0092

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Abstract PDF: We report considerations related with surgery through 2 cases of acute apendicitis with COVID-19 infection. In November and December 2020, two patients infected with COVID-19 developed acute apendicitis and underwent emergency surgery. In case 1, an 84-year-old woman was asymptomatic and diagnosed with acute apendicitis on the 20th day of infection. She was discharged after surgery without complication. In contrast, case 2 was a 69-year-old male patient with pneumonia treated with antibiotics, steroids and remdesivir. After surgery, he was hospitalized for a long duration due to persistent pneumonia and wound complications. We should perform appendectomy in well-established negative pressure operating rooms, personal protective equipment, and protocols. Since the physical examination and blood tests were limited, image examination like computed tomography scan should be considered if acute apendicitis is suspected. If the patient has pneumonia before surgery, it can get worse after surgery, and complications such as wound infections can occur.

Original Article

Malignant disease,Prognosis and adjuvant therapy,Colorectal cancer,Epidemiology & etiology

Characteristics and outcomes of colorectal cancer surgery by age in a tertiary center in Korea: a retrospective review: Tae-Hoon Lee, Jeong Min Choo, Jeong Sub Kim, Seon Hui Shin, Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim; Ann Coloproctol. 2022;38(3):244-252. Published online November 4, 2021; DOI: https://doi.org/10.3393/ac.2021.00619.0088

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Graphical Abstract Abstract PDF

Purpose
Colorectal cancer (CRC) occurs in all age groups, and the application of treatment may vary according to age. The study was designed to identify the characteristics of CRC by age.
Methods
A total of 4,326 patients undergoing primary resection for CRC from September 2006 to July 2019 were reviewed. Patient and tumor characteristics, operative and postoperative data, and oncologic outcome were compared
Results
Patients aged 60 to 69 years comprised the largest age group (29.7%), followed by those aged 50 to 59 and 70 to 79 (24.5% and 23.9%, respectively). Rectal cancer was common in all age groups, but right-sided colon cancer tended to be more frequent in older patients. In very elderly patients, there were significant numbers of emergency surgeries, and the frequencies of open surgery and permanent stoma were greater. In contrast, total abdominal colectomy or total proctocolectomy was performed frequently in patients in their teens and twenties. The elderly patients showed more advanced tumor stages and postoperative ileus. The incidence of adjuvant treatment was low in elderly patients, who also had shorter follow-up periods. Overall survival was reduced in older patients with stages 0 to 3 CRC (P<0.001), but disease-free survival did not differ by age (P=0.391).
Conclusion
CRC screening at an earlier age than is currently undertaken may be necessary in Korea. In addition, improved surgical and oncological outcomes can be achieved through active treatment of the growing number of elderly CRC patients.

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Review

Postoperative Bowel Function After Anal Sphincter-Preserving Rectal Cancer Surgery: Risks Factors, Diagnostic Modalities, and Management: Chris George Cura Pales, Sanghyun An, Jan Paolo Cruz, Kwangmin Kim, Youngwan Kim; Ann Coloproctol. 2019;35(4):160-166. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2019.08.10

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Abstract PDF

Low anterior resection syndrome (LARS) refers to a disturbance of bowel function that commonly manifests within 1 month after rectal cancer surgery. A low level of anastomosis and chemoradiotherapy have been consistently found to be risk factors for developing LARS. Thorough history taking and physical examination with adjunctive procedures are essential when evaluating patients with LARS. Anorectal manometry, fecoflowmetry, and validated questionnaires are important tools for assessing the quality of life of patients with LARS. Conservative management (medical, physiotherapy, transanal irrigation), invasive procedures (neuromodulation), and multimodal therapy are the mainstay of treatment for patients with LARS. A stoma could be considered when other treatment modalities have failed. An initial meticulous surgical procedure for rectal cancer, creation of a neorectal reservoir during anastomosis, and proper exercise of the anal sphincter muscle (Kegel’s maneuver) are essential to combat LARS. Pretreatment counseling is a crucial step for patients who have risk factors for developing LARS.

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Ming Jun Huang, Lin Ye, Ke Xin Yu, Jing Liu, Ka Li, Xiao Dong Wang, Ji Ping Li
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Eva Pape, Jennie Burch, Gabrielle H. van Ramshorst, Yves van Nieuwenhove, Claire Taylor
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Harald Rosen, Christian G. Sebesta, Christian Sebesta
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Excessive bowel volume loss during anus-preserving surgery for rectal cancer affects the bowel function after operation: A prospective observational cohort study (Bas-1611)
Fan Liu, Peng Guo, Quan Wang, Fujun Chen, Wenyong Wu, Xiangqian Su, Guiying Wang, Zhouman Yu, Jianlong Jiang, Feng Liang, Dechang Diao, Zhikang Chen, Yuanting Liu, Fanqiang Meng, Ning Ning, Yingjiang Ye
Heliyon.2023; 9(7): e17630. CrossRef
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Satish S.C. Rao, Nitin K. Ahuja, Adil E. Bharucha, Darren M. Brenner, William D. Chey, Jill K. Deutsch, David C. Kunkel, Baharak Moshiree, Leila Neshatian, Robert M. Reveille, Gregory S. Sayuk, Jordan M. Shapiro, Eric D. Shah, Kyle Staller, Steven D. Wexn
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Assessing the role of anastomotic level in low anterior resection (LAR) surgery among rectal cancer patients in the development of LAR syndrome: a systematic review study
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Dong-Ai Jin, Fang-Ping Gu, Tao-Li Meng, Xuan-Xuan Zhang
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Case Report

Anal Adenocarcinoma Can Masquerade as Chronic Anal Fistula in Asians: Faith Qi-Hui Leong, Dedrick Kok Hong Chan, Ker-Kan Tan; Ann Coloproctol. 2019;35(1):47-49. Published online December 3, 2018; DOI: https://doi.org/10.3393/ac.2018.03.15

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Abstract PDF

Purpose
Perianal adenocarcinoma arising from a chronic anorectal fistula is a rare condition for which the natural history and optimal management are not well established. For that reason, we conducted a retrospective analysis of 5 consecutive patients with a perianal adenocarcinoma arising from a chronic anorectal fistula managed at our institution from January 2014 to December 2015.
Methods
The patients were identified from a prospectively collected colorectal cancer database that included all patients managed for colorectal cancer at our institution.
Results
The median age at diagnosis was 64 years (range, 55–72 years). Magnetic resonance imaging (MRI) was the initial investigation for all patients and showed a hyperintense T2-weighted image. One patient underwent an abdominoperineal resection following neoadjuvant chemoradiotherapy and remained disease free during the 12-month follow-up. Three patients received neoadjuvant therapy with intent for surgery, but did not undergo surgery due to either worsening health or metastatic spread. One patient declined intervention. The median overall survival was 10.5 months (range, 2–19 months).
Conclusion
A high index of suspicion is required to make a clinical diagnosis of an anal adenocarcinoma arising from a chronic fistula. Histologic diagnosis must be achieved to confirm the diagnosis. Multimodal therapy with neoadjuvant chemoradiotherapy followed by abdominoperineal resection is the treatment of choice.

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Chronic fistula in ano associated with adenocarcinoma: a case report with a review of the literature
Nalini Kanta Ghosh, Ashok Kumar
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Shinji Yamamoto, Keiji Yonezawa, Naoki Fukata, Koji Takeshita, Makoto Kodama, Tetsuro Yamana, Shigeru Kiryu, Yukinori Okada
Medicine.2023; 102(14): e33281. CrossRef
Synchronous anal mucinous adenocarcinoma and anal tuberculosis presenting as chronic anal fistula: Challenging management
Sarah Benammi, Youness Bakali, Mouna Alaoui
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Non-mucinous adenocarcinomas and squamous cell carcinomas of the anal region masquerading as abscess or fistula: a retrospective analysis and systematic review of literature
Aysun Tekbaş, Henning Mothes, Utz Settmacher, Silke Schuele
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Vasilis Taliadoros, Henna Rafique, Shahnawaz Rasheed, Paris Tekkis, Christos Kontovounisios
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Adjuvant chemoradiotherapy does not improve outcomes in patients with fistula-associated anal adenocarcinoma undergoing abdominoperineal resection
Min Wang, Yu Xiang, Yunshan Wang, Jiayi Zhang, Haoran Zhao, Can Wang, Lichao Qiao, Bolin Yang
Frontiers in Oncology.2022;[Epub] CrossRef

Original Article

Unexpected Appendiceal Pathologies and Their Changes With the Expanding Use of Preoperative Imaging Studies: Hong Yeol Yoo, Jaewoo Choi, Jongjin Kim, Young Jun Chai, Rumi Shin, Hye Seong Ahn, Chang-Sup Lim, Hae Won Lee, Ki-Tae Hwang, In Mok Jung, Jung Kee Chung, Seung Chul Heo; Ann Coloproctol. 2017;33(3):99-105. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.99

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Abstract PDF

Purpose

The preoperative diagnosis of acute appendicitis is often challenging. Sometimes, pathologic results of the appendix embarrass or confuse surgeons. Therefore, more and more imaging studies are being performed to increase the accuracy of appendicitis diagnoses preoperatively. However, data on the effect of this increase in preoperative imaging studies on diagnostic accuracy are limited. We performed this study to explore unexpected appendiceal pathologies and to delineate the role of preoperative imaging studies in the diagnosis of acute appendicitis.

Methods

The medical records of 4,673 patients who underwent an appendectomy for assumed appendicitis between 1997 and 2012 were reviewed retrospectively. Pathological results and preoperative imaging studies were surveyed, and the frequencies of pathological results and preoperative imaging studies were investigated.

Results

The overall rate of pathology compatible with acute appendicitis was 84.4%. Unexpected pathological findings, such as normal histology, specific inflammations other than acute appendicitis, neoplastic lesions, and other pathologies, comprised 9.6%, 3.3%, 1.2%, and 1.5%, respectively. The rate of unexpected pathological results was significantly reduced because of the increase in preoperative imaging studies. The decrease in normal appendices contributed the most to the reduction while other unexpected pathologies did not change significantly despite the increased use of imaging studies. This decrease in normal appendices was significant in both male and female patients under the age of 60 years, but the differences in females were more prominent.

Conclusion

Unexpected appendiceal pathologies comprised 15.6% of the cases. Preoperative imaging studies reduced them by decreasing the negative appendectomy rate of patients with normal appendices.

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Hisham F. Bahmad, Abed Alhalim Aljamal, Juan Carlos Alvarez Moreno, Ali Salami, Philip Bao, Sarah Alghamdi, Robert J. Poppiti
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Caroline Maloney, Morris C. Edelman, Alexandra C. Bolognese, Aaron M. Lipskar, Barrie S. Rich
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Communication and management of incidental pathology in 1,214 consecutive appendicectomies; a cohort study
Ned Kinnear, Bridget Heijkoop, Eliza Bramwell, Alannah Frazzetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour, James Moore
International Journal of Surgery.2019; 72: 185. CrossRef
Unexpected Appendiceal Pathologies and Preoperative Imaging Studies on Patients With Acute Appendicitis
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Case Report

Primary Multiple Mesenteric Liposarcoma of the Transverse Mesocolon: Sandeep Sachidananda, Arunkumar Krishnan, Raja Ramesh, Sivaprakasam Kuppurao; Ann Coloproctol. 2013;29(3):123-125. Published online June 30, 2013; DOI: https://doi.org/10.3393/ac.2013.29.3.123

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Abstract PDF

Liposarcomas are common tumors arising in the retroperitoneum. However, a primary mesenteric liposarcoma is a rare entity and less than 50 cases have been reported so far. Further, a liposarcoma arising in the transverse mesocolon is very unusual, and cases of multiple primary tumors arising from the transverse mesocolon are extremely rare. We want to report a case of a multiple primary mesenteric liposarcoma arising from the transverse mesocolon in a 63-year-old female who was successfully treated by surgery. Because a primary mesenteric liposarcoma is a rare entity, it should be considered with the differential diagnosis of an abdominal mesenchymal tumor. It can be diagnosed preoperatively by using contrast enhanced computed tomography and magnetic resonance imaging. The treatment for such a liposarcoma is surgical resection with sufficient surgical margin; the role of adjuvant therapy has yet to be defined.

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Review

Right Colonic Diverticulitis: In Kyu Lee; J Korean Soc Coloproctol. 2010;26(4):241-245. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.241

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Abstract PDF

Although right colonic diverticultis (RCD) has been reported to be a rare disease in Western countries, RCD is a common diagnosis, with an incidence per 2.9-17 case of appendicitis, in Korea. Many Western studies have reported that it is difficult to differentiate the presenting symptoms of RCD from those of appendicitis before surgery because the signs and symptoms are similar. However, performing a computed tomography scan after the application of the diagnostic criteria for RCD has increased the preoperative RCD diagnostic rate. Treatment strategies have been difficult to define for this condition due to its low preoperative diagnosis rate. However, recent reports have shown that conservative medical treatment of uncomplicated RCD can be recommended and that such treatment is effective due to the benign and self-limited natural history of RCD. Therefore, in this review, we discuss the controversies surrounding RCD management.

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Original Articles

Adult Intussusception: Diagnosis and Treatment.: Yang, Jae Do , Lee, Min Ro , Kim, Jong Hun; J Korean Soc Coloproctol. 2007;23(6):416-419.; DOI: https://doi.org/10.3393/jksc.2007.23.6.416

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2 Citations

Abstract PDF

PURPOSE
Adult intussusception occurs infrequently and differs greatly from childhood intussusception in etiology. Proper diagnostic of and surgical therapeutic methods for adult intussusception remain controversial. The aim of this study was to determine useful diagnostic modalities and proper surgical interventions in adult intussusception.
METHODS
A retrospective analysis performed at Chonbuk National University Hospital identified 38 patients, aged 15 and older, with a diagnosis of intussusception from January 1991 to January 2007.
RESULTS
There were 19 males and 19 females. The median age of the group was 44 years with a range of 20 to 80 years. The mean follow-up period was 82 months. Abdominal pain was the most common presenting complaint (89%). There were 30 small bowel intussusceptions and 8 colonic intussusceptions. A pathologic cause was identified in 79% of the patients, with 5 of 30 (17%) small bowel and 4 of 8 (50%) large bowel lesions being malignant. A preoperative diagnosis was made accurately in 25 of 38 (66%) patients. The diagnostic rates of pre-operative radiological methods were 77%, 60%, 79%, and 100% for barium enema, ultrasonography, abdominal computerized tomography, and both ultrasonography and abdominal computerized tomography, respectively. Operative treatment consisted of manual reduction only in 6 small bowel (20%) and 1 large bowel intussusception (12%), bowel resection after manual reduction in 8 small bowel (27%) and 2 large bowel intussusceptions (24%), and resection alone in 16 small bowel (53%) and 5 large bowel intussusceptions (64%).
CONCLUSIONS
Both ultrasonography and abdominal computerized tomography are the most useful diagnostic modalities. Colonic intussusception should be treated with en-bloc resection without reduction due to the high incidence of malignancy. However, manual reduction only, bowel resection after reduction, and bowel resection alone can be chosen selectively in cases of small bowel intussusception.

Citations

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Adult intussusceptions: preoperative predictive factors for malignant lead point
Kil Hwan Kim, Hwan Namgung, Dong Guk Park
Annals of Surgical Treatment and Research.2014; 86(5): 244. CrossRef
A Case of Small Bowel Intussusception Caused by Jejunal Hamartoma Confused as Hepatitis A in an Adult
Joon Hur, Gu-Min Cho, Young Ook Eum, Ji Young Park, Mi Sung Kim, Byung Seong Ko, Hyang Mi Shin, Seung-Myoung Son
Yeungnam University Journal of Medicine.2012; 29(2): 110. CrossRef

Diverticulitis of the Right Colon: Tips for Preoperative Diagnosis and Treatment Strategy.: Lee, In Kyu , Kim, Su Hong , Lee, Yoon Suk , Kim, Hyung Jin , Lee, Sang Kuon , Kang, Won Kyung , Ahn, Chang Hyeok , Oh, Seong Taek , Jeon, Hae Myung , Kim, Jun Gi , Kim, Eung Kook , Chang, Suk Kyun; J Korean Soc Coloproctol. 2007;23(4):223-231.; DOI: https://doi.org/10.3393/jksc.2007.23.4.223

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31 Download
17 Citations

Abstract PDF

PURPOSE
The planned therapy of right colonic diverticulitis is very difficult because preoperative diagnosis is uncommon and the method of treatment is usually decided at the time of laparotomy. We retrospectively analyzed the clinical characteristics of right colonic diverticulitis, the clinical distinctions between preoperatively and postoperatively diagnosed patients, the recurrence rate, and the hospital stay by treatment modality.
METHODS
Among 104 patients who were treated for right colonic diverticulitis from January 1997 to May 2005, we enrolled 90 patients who had been diagnosed by the operation or a barium enema study (BE), and who had not been lost to follow-up. Patients were divided into three groups based on treatment modality: Group 1 (n=28), conservative management with intravenous antibiotics; Group 2 (n=46), aggressive resection; Group 3 (n=16), appendectomy with intravenous antibiotics.
RESULTS
Ultrasound and computed tomography (CT) detected 12 (22.6%) and 21 (87.5%) cases of right colonic diverticulitis, respectively. BE was applied to 45 patients, 28 (62.2%) of them with multiple diverticula. Right colonic diverticulitis was the preoperative diagnosis in 39 patients (43.3%). The length of hospital stay was significantly different between the groups (P<0.001): 4.9+/-3.1 days in Group 1, 7.5+/-3.7 days in Group 2, and 3.8+/-0.9 days in Group 3. Two patients (7.1%) in Group 1, 2 patients (4.3%) in Group 2, and 5 patients (31.3%) in Group 3 had recurrent diverticulitis during the follow-up period (P=0.007). The Kaplan-Meier estimated recurrence rates for Groups 1, 2, and 3 were statistically significantly different (P=0.0086).
CONCLUSIONS
To differentiate right colonic diverticulitis from appendicitis, focusing on the peculiar feature in contrast to appendicitis and appropriate utilization of CT are important. If diagnosed preoperatively, uncomplicated right colonic diverticulitis can be managed by conservative management with intravenous antibiotics. If diagnosed intraoperatively, aggressive resection is advocated as the most effective method for decreasing the recurrence rate.

Citations

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Right‐sided acute diverticulitis in a North African country: Presentation and management in one surgical center
Laila Jedidi, Aymen Mabrouk, Hela Ghali, Anis Ben Dhaou, Senda Ben Lahouel, Sami Daldoul, Houyem Said Latiri, Mounir Ben Moussa
World Journal of Surgery.2024; 48(6): 1509. CrossRef
Right-sided acute diverticulitis in the West: experience at a university hospital in Argentina
René M. Palacios Huatuco, Diana A. Pantoja Pachajoa, Julian E. Liaño, Héctor A. Picón Molina, Rafael Palencia, Alejandro M. Doniquian, Matías Parodi
Annals of Coloproctology.2023; 39(2): 123. CrossRef
Caecal diverticulitis can be misdiagnosed as acute appendicitis: a systematic review of the literature
Isabelle Uhe, Jeremy Meyer, Manuela Viviano, Surrennaidoo Naiken, Christian Toso, Frédéric Ris, Nicolas C. Buchs
Colorectal Disease.2021; 23(10): 2515. CrossRef
Laparoscopic diverticulectomy versus non-operative treatment for uncomplicated right colonic diverticulitis
Le Huy Luu, Nguyen Lam Vuong, Vo Thi Hong Yen, Do Thi Thu Phuong, Bui Khac Vu, Nguyen Viet Thanh, Nguyen Thien Khanh, Nguyen Van Hai
Surgical Endoscopy.2020; 34(5): 2019. CrossRef
Clinical differentiation of acute appendicitis and right colonic diverticulitis: A case-control study
Yosuke Sasaki, Fumiya Komatsu, Naoyasu Kashima, Takahiro Sato, Ikutaka Takemoto, Sho Kijima, Tadashi Maeda, Takamasa Ishii, Taito Miyazaki, Yoshiko Honda, Nagato Shimada, Yoshihisa Urita
World Journal of Clinical Cases.2019; 7(12): 1393. CrossRef
Right-sided acute diverticulitis: A single Western center experience
Francesco Monari, Maurizio Cervellera, Basilio Pirrera, Umberto D'Errico, Samuele Vaccari, Laura Alberici, Valeria Tonini
International Journal of Surgery.2017; 44: 128. CrossRef
Diagnosis and Management of Right Colonic Diverticular Disease: A Review
Francesco Ferrara, Jesús Bollo, Letizia V. Vanni, Eduardo M. Targarona
Cirugía Española (English Edition).2016; 94(10): 553. CrossRef
Diagnóstico y tratamiento de la enfermedad diverticular del colon derecho: revisión de conjunto
Francesco Ferrara, Jesús Bollo, Letizia V Vanni, Eduardo M Targarona
Cirugía Española.2016; 94(10): 553. CrossRef
Intraoperative diagnosis of solitary cecal diverticulum not requiring surgery: is appendectomy indicated?
Renol M. Koshy, Abdelrahman Abusabeib, Saif Al-Mudares, Mohamed Khairat, Adriana Toro, Isidoro Di Carlo
World Journal of Emergency Surgery.2016;[Epub] CrossRef
Risk factors for recurrence of right colonic uncomplicated diverticulitis after first attack
Hyoung-Chul Park, Byung Seup Kim, Kwanseop Lee, Min Jeong Kim, Bong Hwa Lee
International Journal of Colorectal Disease.2014; 29(10): 1217. CrossRef
Surgical management of colonic diverticular disease: Discrepancy between right- and left-sided diseases
Heung-Kwon Oh
World Journal of Gastroenterology.2014; 20(29): 10115. CrossRef
Is Conservative Treatment with Antibiotics the Correct Strategy for Management of Right Colonic Diverticulitis?: A Prospective Study
Tae Jung Kim, In Kyu Lee, Jong Kyung Park, Yoon Suk Lee, Youn Si, Hun Jung, Hyung Jin Kim, Sang Chul Lee, Dae Young Cheung, Lee D. Gorden, Seung Taek Oh
Journal of the Korean Society of Coloproctology.2011; 27(4): 188. CrossRef
Management of Right Colon Diverticulitis
Jong Ik Jang, Yang Soo Lim, Jong Woo Choi, Yoon Sik Lee
Journal of the Korean Society of Coloproctology.2010; 26(1): 22. CrossRef
Treatment of Right Colonic Diverticulitis: The Role of Nonoperative Treatment
Ma Ru Kim, Bong-Hyeon Kye, Hyung Jin Kim, Hyeon-Min Cho, Seong Taek Oh, Jun-Gi Kim
Journal of the Korean Society of Coloproctology.2010; 26(6): 402. CrossRef
Right Colonic Diverticulitis
In Kyu Lee
Journal of the Korean Society of Coloproctology.2010; 26(4): 241. CrossRef
A Case of Ascending Colon Diverticulitis with Perforation in a Child
Joon Woo Baek, Jae Young Shin, Jee Hyun Lee, So Young Jung, Ah Young Jung, Jeong Won Kim, Kon Hee Lee
Korean Journal of Pediatric Gastroenterology and Nutrition.2010; 13(2): 193. CrossRef
Laparoscopic and Open Surgery for Right Colonic Diverticulitis
In Kyu Lee, Yoon Suk Lee, Sung Jip Kim, D. Lee Gorden, Dae Youn Won, Hyeung Jin Kim, Hyeun Min Cho, Hae Myung Jeon, Jun-Gi Kim, Seong Taek Oh
The American Surgeon™.2010; 76(5): 486. CrossRef

Intussusception in Adults.: Yun, Sang On , Namgung, Hwan , Lee, Chang Hwan , Park, Dong Guk; J Korean Soc Coloproctol. 2004;20(4):199-204.

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Abstract PDF: PURPOSE
Intussusception in adults is uncommon and constitutes approximately 5% of all intussusceptions. An organic lesion is found to be the lead point in 75 to 90% of the cases, so surgical intervention is necessary in most cases. This study was designed to review our experience with adult intussusception and to determine an appropriate method for diagnosis and management.
METHODS
Thirteen (13) patients over 15 years of age were diagnosed as having on intussusception at our center between 1994 and 2003. We reviewed the medical records of these patients retrospectively.
RESULTS
The preoperative diagnosis had been made correctly in 85% of patients (11 cases) by combined use of abdominal ultrasonography and a CT scan. The types of intussusceptions wene jejuno-jejunal in two cases, ileo-ileal in four, ileo-colic in three, and colo-colic in four. Causative organic lesion was found in all patients; seven cases (54%) were due to benign tumors, and six (46%) were due to malignant tumors. Surgical intervention was carried out in all cases; 11 patients underwent a surgical resection without manual reduction, and 2 patients underwent a surgical resection after manual reduction.
CONCLUSIONS
Both abdominal ultrasonography and CT scan are effective and useful diagnostic tools in the diagnosis of adult intussusception. Since tumors, benign or malignant, are the most frequent cause of adult intussusception, surgical intervention is mandatory.

Review of the Pathology and Differential Diagnosis of Acute Appendicitis.: Kim, Jong Po , Son, Chang Mok; J Korean Soc Coloproctol. 2003;19(4):211-215.

1,209 View
33 Download

Abstract PDF: PURPOSE
Multiple methods are used to diagnose acute appendicitis. However, with the current practice, the negative laparotomy rate for acute appendicitis is from 15% up to 30%. This study was designed to evaluate various pathologies of the appendix and other intraabdominal organs of patients preoperatively diagnosed with acute appendicitis and to analyze clinically the difference between acute appendicitis and other intraabdominal inflammatory diseases.
METHODS
We reviewed the pathologic reports of 833 patients who underwent laparotomies for acute appendicitis from January 1997 to December 2001. We grouped these patients by pathology. Group I included patients with a negative appendectomy and no other intraabdominal pathology, group II included those with lesions within the appendix, and group III, those with intraabdominal lesions other than in the appendix. We also analyzed the age, sex distributions, the typical symptoms of appendicitis, the duration of symptoms, fever, and leukocytosis of 100 patients with typical appendicitis by random sampling to find the clinical differences that existed between pelvic inflammatory disease and cecal diverticular disease presented as appendicitis.
RESULTS
The diagnostic accuracy for acute appendicitis was 79.7%, and the negative appendectomy and negative laparotomy rates were 17.4% and 15.5%, respectively. The percents of patients in group I, II, and III were 10.4%, 82.6%, and 7.0%, respectively.
CONCLUSIONS
It is important to consider the possibility of various pathologies during diagnostic and operative procedures for an acute abdomen, especially one occurring in the right lower quadrant.

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