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- A unique surgical approach to the management of life-threatening, obscure lower gastrointestinal bleeding
- Nelson Chen, Tessa Daly, Neil Strugnell, Russell Hodgson, David Bird
- Ann Coloproctol. 2024;40(5):515-518. Published online October 17, 2024
- DOI: https://doi.org/10.3393/ac.2024.00101.0014
- 3,663 View
- 76 Download
- 1 Web of Science
- 1 Citations
Original Article
Malignant disease,Rectal cancer,Complication,Biomarker & risk factor
- Cross-sectional area of psoas muscle as a predictive marker of anastomotic failure in male rectal cancer patients: Japanese single institutional retrospective observational study
- Yusuke Mizuuchi, Yoshitaka Tanabe, Masafumi Sada, Koji Tamura, Kinuko Nagayoshi, Shuntaro Nagai, Yusuke Watanabe, Sadafumi Tamiya, Kohei Nakata, Kenoki Ohuchida, Toru Nakano, Masafumi Nakamura
- Ann Coloproctol. 2022;38(5):353-361. Published online April 12, 2022
- DOI: https://doi.org/10.3393/ac.2022.00122.0017
- 7,807 View
- 179 Download
- 8 Web of Science
- 9 Citations
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Graphical Abstract
Abstract
PDF
Supplementary Material - Purpose
Preoperative sarcopenia worsens postoperative outcomes in various cancer types including colorectal cancer. However, we often experienced postoperative anastomotic leakage in muscular male patients such as Judo players, especially in rectal cancer surgery with lower anastomosis. It is controversial whether the whole skeletal muscle mass impacts the potential for anastomotic failure in male rectal cancer patients. Thus, the purpose of this study was to clarify whether skeletal muscle mass impacts anastomotic leakage in rectal cancer in men.
Methods
We reviewed the medical charts of male patients suffering from rectal cancer who underwent colo-procto anastomosis below the peritoneal reflection without a protective diverting stoma. We measured the psoas muscle area and calculated the psoas muscle index.
Results
One hundred ninety-seven male rectal cancer patients were enrolled in this study. The psoas muscle index was significantly higher in patients with anastomotic leakage (P<0.001). Receiver operating characteristic curve determined the optimal cut-off value of the psoas muscle index for predicting anastomotic leakage as 812.67 cm2/m2 (sensitivity of 60% and specificity of 74.3%). Multivariate analysis revealed that high psoas muscle index (risk ratio [RR], 3.933; P<0.001; 95% confidence interval [CI], 1.917–8.070) and super low anastomosis (RR, 2.792; P=0.015; 95% CI, 1.221–6.384) were independent predictive factors of anastomotic leakage.
Conclusion
This study showed that male rectal cancer patients with a large psoas muscle mass who underwent lower anastomosis had a higher rate of postoperative anastomotic leakage. -
Citations
Citations to this article as recorded by
- Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef - Unraveling the role of computed tomography derived body composition metrics on anastomotic leakages rates in rectal cancer surgery: A protocol for a systematic review and meta-analysis
Mark Broekman, Charlotte M. S. Genders, Ritchie T. J. Geitenbeek, Klaas Havenga, Schelto Kruijff, Joost M. Klaase, Alain R. Viddeleer, Esther C. J. Consten, Ozlem Boybeyi-Turer
PLOS ONE.2024; 19(7): e0307606. CrossRef - Association of computed tomography‐derived body composition and complications after colorectal cancer surgery: A systematic review and meta‐analysis
Claire P.M. van Helsdingen, Job G.A. van Wijlick, Ralph de Vries, Nicole D. Bouvy, Mariska M.G. Leeflang, Robert Hemke, Joep P.M. Derikx
Journal of Cachexia, Sarcopenia and Muscle.2024; 15(6): 2234. CrossRef - Prognostic Value of Artificial Intelligence-Driven, Computed Tomography-Based, Volumetric Assessment of the Volume and Density of Muscle in Patients With Colon Cancer
Minsung Kim, Sang Min Lee, Il Tae Son, Taeyong Park, Bo Young Oh
Korean Journal of Radiology.2023; 24(9): 849. CrossRef - Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer
Su Hyeong Park, Hye Seung Woo, In Kyung Hong, Eun Jung Park
Cancers.2023; 15(20): 5098. CrossRef - Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef - Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef - Can the cross-sectional area of the psoas muscle be a predictor of anastomotic failure in male rectal cancer patients?
Myong Hoon Ihn
Annals of Coloproctology.2022; 38(5): 333. CrossRef - Psoas Muscle Index – Could It Be an Indicator of Postoperative Complications in Colorectal Cancer? Case Presentation and Review of the Literature
Georgiana Alexandra Scurtu, Zsolt Zoltán Fülöp, Botond Kiss, Patricia Simu, Diana Burlacu, Tivadar Bara
Journal of Interdisciplinary Medicine.2022; 7(4): 100. CrossRef
- Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Case Report
- Hematochezia due to Angiodysplasia of the Appendix
- Je-Min Choi, Seung-Hun Lee, Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek
- Ann Coloproctol. 2016;32(3):117-119. Published online June 30, 2016
- DOI: https://doi.org/10.3393/ac.2016.32.3.117
- 6,165 View
- 50 Download
- 7 Web of Science
- 12 Citations
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Abstract
PDF
Common causes of lower gastrointestinal bleeding include diverticular disease, vascular disease, inflammatory bowel disease, neoplasms, and hemorrhoids. Lower gastrointestinal bleeding of appendiceal origin is extremely rare. We report a case of lower gastrointestinal bleeding due to angiodysplasia of the appendix. A 72-year-old man presented with hematochezia. Colonoscopy showed active bleeding from the orifice of the appendix. We performed a laparoscopic appendectomy. Microscopically, dilated veins were found at the submucosal layer of the appendix. The patient was discharged uneventfully. Although lower gastrointestinal bleeding of appendiceal origin is very rare, clinicians should consider it during differential diagnosis.
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Citations
Citations to this article as recorded by- Dieulafoy's Disease Causing Appendiceal Hemorrhage: A Case Report
Ruitao Liu, Yang Yan, Guibing Chen
Cureus.2025;[Epub] CrossRef - Appendiceal bleeding caused by vascular malformation: A case report
Qin Ma, Jin-Jie Du
World Journal of Clinical Cases.2024; 12(14): 2457. CrossRef - Appendiceal bleeding, a rare yet important cause of lower gastrointestinal bleed
Ayman Tabcheh, Johny Salem, Karim Zodeh, Ammar Ghazale
European Journal of Case Reports in Internal Medicine.2024;[Epub] CrossRef - A rare case of appendiceal haemorrhage causing life-threatening haematochezia
Howard H Y Tang, Daming Pan, Andrew Fitzdowse, Aaron Ow, Stephen Chan, Jason S C Tan
Journal of Surgical Case Reports.2024;[Epub] CrossRef - Beyond the Usual Suspects: Appendiceal Bleeding as the Surprising Cause of Lower Gastrointestinal (GI) Bleeding
Asher Siddiqui, Nowera Zafar, Mahdi Hakiminezhad, Zohaib Jamal, Imran Alam, Zeeshan Khawaja
Cureus.2024;[Epub] CrossRef - WITHDRAWN: Appendiceal bleeding caused by vascular malformation: A case report and literature review
Qin Ma, Jinjie Du
International Journal of Surgery Case Reports.2023; : 108903. CrossRef - Clinical features, treatments and prognosis of appendiceal bleeding: a case series study
Xiao-cun Xing, Jin-lin Yang, Xue Xiao
BMC Gastroenterology.2023;[Epub] CrossRef - Angiodysplasia of the appendix: a diagnostic challenge and the importance of colonoscopy
Obiajulu Johnson, Naomi Mackenzie, Jamil Choudhury, Sanjay Furtado
BMJ Case Reports.2023; 16(12): e255498. CrossRef - Appendiceal bleeding: A case report
Sheng-Yue Zhou, Mao-Dong Guo, Xiao-Hua Ye
World Journal of Clinical Cases.2022; 10(18): 6314. CrossRef - Appendiceal bleeding in an elderly male: a case report and a review of the literature
Yuto Maeda, Seiya Saito, Mayuko Ohuchi, Yuka Tamaoki, Jiro Nasu, Hideo Baba
Surgical Case Reports.2021;[Epub] CrossRef - Acute Eosinophilic Appendicitis: A Rare Cause of Lower Gastrointestinal Hemorrhage
So Ra Ahn, Joo Hyun Lee
The Korean Journal of Gastroenterology.2021; 78(2): 134. CrossRef - Appendix bleeding with painless bloody diarrhea: A case report and literature review
Wanqun Chen, Hong Qiu, Xiaojun Yang, Jinwei Zhang
Open Medicine.2019; 14(1): 735. CrossRef
- Dieulafoy's Disease Causing Appendiceal Hemorrhage: A Case Report
Original Articles
- The Safety and Efficacy of Mesenteric Embolization in the Management of Acute Lower Gastrointestinal Hemorrhage
- Ker-Kan Tan, David Hugh Strong, Timothy Shore, Mohammmad Rafei Ahmad, Richard Waugh, Christopher John Young
- Ann Coloproctol. 2013;29(5):205-208. Published online October 31, 2013
- DOI: https://doi.org/10.3393/ac.2013.29.5.205
- 6,510 View
- 42 Download
- 18 Citations
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Abstract
PDF
Purpose Mesenteric embolization is an integral part in the management of acute lower gastrointestinal (GI) bleeding. The aim of this study was to highlight our experience after adopting mesenteric embolization in the management of acute lower GI hemorrhage.
Methods A retrospective review of all cases of mesenteric embolization for acute lower GI bleeding from October 2007 to August 2012 was performed.
Results Twenty-seven patients with a median age of 73 years (range, 31 to 86 years) formed the study group. More than half (n = 16, 59.3%) of the patients were on either antiplatelet and/or anticoagulant therapy. The underlying etiology included diverticular disease (n = 9), neoplasms (n = 5) and postprocedural complications (n = 6). The colon was the most common bleeding site and was seen in 21 patients (left, 10; right, 11). The median hemoglobin prior to the embolization was 8.6 g/dL (6.1 to 12.6 g/dL). A 100% technical success rate with immediate cessation of hemorrhage at the end of the session was achieved. There were three clinical failures (11.1%) in our series. Two patients re-bled, and both underwent a successful repeat embolization. The only patient who developed an infarcted bowel following embolization underwent an emergency operation and died one week later. There were no factors that predicted clinical failure.
Conclusion Mesenteric embolization for acute lower GI bleeding can be safely performed and is associated with a high clinical success rate in most patients. A repeat embolization can be considered in selected cases, but postembolization ischemia is associated with bad outcomes.
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Citations
Citations to this article as recorded by- Lower Gastrointestinal Bleeding (Nonvariceal): Concepts and Technique
Uday Kumar Marri, Jagadeesh R. Singh, Partha Pal, Shreeyash Modak
Digestive Disease Interventions.2025; 09(04): 230. CrossRef - Imaging and interventions in vascular malformations of the gastrointestinal tract
Divij Agarwal, Sanchita Gupta, Hemanga K Bhattacharjee, Chandan J Das
Abdominal Radiology.2025; 50(9): 4023. CrossRef - Efficacy and safety of transcatheter arterial embolization for lower gastrointestinal bleeding: a systematic review and meta-analysis of 58 clinical trials
Qiulian Sun, Jiefei Cheng, XueLei Zhang, Xiangzhong Huang, Ling Tang, Jingjing Li, Dongqing Ren, Xinjian Xu, Delei Cheng
European Journal of Medical Research.2025;[Epub] CrossRef - Twenty years of embolization for acute lower gastrointestinal bleeding: a meta-analysis of rebleeding and ischaemia rates
Qian Yu, Brian Funaki, Osman Ahmed
British Journal of Radiology.2024; 97(1157): 920. CrossRef - Arteriovenous Malformation of the Jejunum, Causing Massive Gastrointestinal Bleeding, Treated With Intraoperative Enteroscopy Guidance: A Case Report
Sajan Shrestha, Susan Pradhan, Ajay KC, Sujan Shrestha, Prasan Kansakar
Cureus.2023;[Epub] CrossRef - Management of Synchronous Colorectal Cancer Metastases
Traci L. Hedrick, Victor M. Zaydfudim
Surgical Oncology Clinics of North America.2022; 31(2): 265. CrossRef - Management of acute lower gastrointestinal bleeding by pharmaco-induced vasospasm embolization therapy
Ming-Feng Li, Huei-Lung Liang, Chia-Ling Chiang, Yih-Huie Lin
Journal of the Chinese Medical Association.2022; 85(2): 233. CrossRef - Safety Profile of Particle Embolization for Treatment of Acute Lower Gastrointestinal Bleeding
Elisabeth Seyferth, Rui Dai, James Ronald, Jonathan G. Martin, Alan A. Sag, Nicholas Befera, Waleska M. Pabon-Ramos, Paul V. Suhocki, Tony P. Smith, Charles Y. Kim
Journal of Vascular and Interventional Radiology.2022; 33(3): 286. CrossRef - Superselective transcatheter arterial embolization for acute small bowel bleeding: clinical outcomes and prognostic factors for ischemic complications
Yong Seek Kim, Joon Ho Kwon, Kichang Han, Man-Deuk Kim, Junhyung Lee, Gyoung Min Kim, Jong Yun Won
Acta Radiologica.2021; 62(5): 574. CrossRef - Surgical approach for right‐sided colonic diverticular bleeding: A single‐center review of 43 consecutive cases
Hitoshi Kameyama, Toshiyuki Yamazaki, Akira Iwaya, Hiroaki Uehara, Shiori Utsumi, Motoharu Hirai, Masaru Komatsu, Akira Kubota, Tomohiro Katada, Kazuaki Kobayashi, Daisuke Sato, Naoyuki Yokoyama, Shirou Kuwabara, Tetsuya Otani
Asian Journal of Endoscopic Surgery.2021; 14(4): 717. CrossRef - The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery
Andrew S. Miller, Kathryn Boyce, Benjamin Box, Matthew D. Clarke, Sarah E. Duff, Niamh M. Foley, Richard J. Guy, Lisa H. Massey, George Ramsay, Dominic A. J. Slade, James A. Stephenson, Phil J. Tozer, Danette Wright
Colorectal Disease.2021; 23(2): 476. CrossRef - ACR Appropriateness Criteria® Radiologic Management of Lower Gastrointestinal Tract Bleeding: 2021 Update
Karunakaravel Karuppasamy, Baljendra S. Kapoor, Nicholas Fidelman, Hani Abujudeh, Twyla B. Bartel, Drew M. Caplin, Brooks D. Cash, Steven J. Citron, Khashayar Farsad, Aakash H. Gajjar, Marcelo S. Guimaraes, Amit Gupta, Mikhail Higgins, Daniele Marin, Para
Journal of the American College of Radiology.2021; 18(5): S139. CrossRef - Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology
Kathryn Oakland, Georgina Chadwick, James E East, Richard Guy, Adam Humphries, Vipul Jairath, Simon McPherson, Magdalena Metzner, A John Morris, Mike F Murphy, Tony Tham, Raman Uberoi, Andrew McCulloch Veitch, James Wheeler, Cuthbert Regan, Jonathan Hoare
Gut.2019; 68(5): 776. CrossRef - Making decisions using radiology in lower GI hemorrhage
Assad Zahid, Christopher John Young
International Journal of Surgery.2016; 31: 100. CrossRef - Transcatheter Arterial Embolization for Gastrointestinal Bleeding Secondary to Gastrointestinal Lymphoma
Lin Zheng, Ji Hoon Shin, Kichang Han, Jiaywei Tsauo, Hyun-Ki Yoon, Gi-Young Ko, Jong-Soo Shin, Kyu-Bo Sung
CardioVascular and Interventional Radiology.2016; 39(11): 1564. CrossRef - Study protocol: first nationwide comparative audit of acute lower gastrointestinal bleeding in the UK
Kathryn Oakland, Richard Guy, Raman Uberoi, Frances Seeney, Gary Collins, John Grant-Casey, Neil Mortensen, Mike Murphy, Vipul Jairath
BMJ Open.2016; 6(8): e011752. CrossRef - Diverticular Disease: Changing Epidemiology and Management
Roshan Razik, Geoffrey C. Nguyen
Drugs & Aging.2015; 32(5): 349. CrossRef - Mesenteric Embolization: Is It Safe in Patients With Acute Lower Gastrointestinal Hemorrhage?
Dong Won Lee, Seon Hahn Kim
Annals of Coloproctology.2013; 29(5): 181. CrossRef
- Lower Gastrointestinal Bleeding (Nonvariceal): Concepts and Technique
- Abdominal Computed Tomography in Patients with Right Lower Quadrant Pain.
- Won, Chang Sik , Roh, Hye Rin , Park, Seung Bae , Kim, Yang Hei , Chae, Gi Bong
- J Korean Soc Coloproctol. 2008;24(6):417-421.
- DOI: https://doi.org/10.3393/jksc.2008.24.6.417
- 2,167 View
- 7 Download
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Abstract
PDF
- PURPOSE
This study was performed to evaluate the usefulness of abdominal computed tomography (CT) for patients with right lower quadrant (RLQ) pain.
METHODS
Between January 2006 and July 2008, 191 consecutive patients with RLQ pain underwent abdominal CT (CT group). Forty-two patients who had undergone abdominal ultrasound (US group) and 52 patients without abdominal CT or abdominal ultrasound for RLQ pain (clinical Dx group) underwent emergent operations. Using the Alvarado scoring system, we scored all patients. The abdominal CT was performed in the abdominal and pelvic area with contrast.
RESULTS
One hundred twenty-one (63.4%) of the 191 patients in the CT group were preoperatively diagnosed as having acute appendicitis and underwent surgery. There were three cases of negative appendectomy (1.6%). In the US group and the clinical Dx group, the negative appendectomy rates were 4.8% and 3.8%, respectively. The sensitivity of the abdominal CT was 96.7%. In the CT group, in addition to acute appendicitis, colitis, nonspecific enteritis, diverticulitis, urinary stone, ovary, uterine, and diseases were indentified.
CONCLUSIONS
In this study, abdominal CT scans in patients with RLQ pain were useful for the diagnosis acute appendicitis and for the differential diagnosis of other diseases presenting with RLQ pain. The false positive rate was significantly lower in the CT group than in the other groups.
Case Reports
- Benign Solitary Cecal Ulcer Accompanied by Massive Lower Gastrointestinal Tract Hemorrhage.
- Park, Jong Ik , Park, Sang Su , Kang, Sung Gu , Shin, Dong Gue , Yoon, Jin , Kim, Il Myung
- J Korean Soc Coloproctol. 2006;22(6):424-427.
- 1,301 View
- 7 Download
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Abstract
PDF
- A benign cecal ulcer is an uncommon lesion. The etiology remains unknown, and there are no pathognomonic lesions or symptoms. Lower gastrointestinal tract hemorrhage secondary to benign cecal ulcer is the most common complication. Herein, the case of a 24-year-old man with a benign cecal ulcer presenting with a massive lower gastrointestinal tract hemorrhage requiring transfusion until a exploratory laparotomy and right hemicolectomy, is reported with a review of the literature. Surgical intervention is warranted if malignancy is suspected or if the patient has signs of uncontrollable hemorrhage, perforation, or peritonitis.
- A Case of Adult Duplication Cyst Presenting with Lower Gastrointestinal Bleeding.
- Park, Min Su , Lee, Kil Yeon , Lee, Suk Hwan , Kim, Youn Wha
- J Korean Soc Coloproctol. 2006;22(4):271-275.
- 1,224 View
- 4 Download
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Abstract
PDF
- Congenital cystic duplications of the alimentary tract are rare, but can occur anywhere along the GI tract. Ileal duplication cysts account for the majority of diagnosed cases. Symptoms generally develop during infancy or childhood, with diverse presentations. Common manifestations include abdominal pain, an abdominal mass, vomiting, occasional intussusception, perforation, bleeding, and obstructive symptoms. In this report, we present the case of a 20-year-old man with an ileal duplication cyst with obscure lower gastrointestinal bleeding. The patient underwent cyst excision with a primary end to end anastomosis. The patient was discharged on the postoperative 7th day without any complications.
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