Screening for Colorectal Cancer In the United States, colorectal cancer (CRC) is the second most commonly diagnosed cancer in males and females. The age-adjusted incidence rate during the period 2006-2010 was 52.2 per 100,000 men and 39.3 per 100,000 women…
Introduction Malignant polyps of the large intestine can be divided into polypoid cancers, which are largely cancerous lesions with a polypoid shape, and polyps that are mostly benign but have a focus of cancer. Polypoid cancers are generally unsuited to…
Introduction Acute colonic pseudo-obstruction, also known as Ogilvie syndrome, is a nonmechanical, functional obstruction of the large intestine. It has become a well-known clinical entity, but in many regards it is poorly understand and difficult to manage. In 1948 a…
Introduction In this chapter, we review the presentation, diagnostic strategy, and treatment algorithms for colonic volvulus. Colonic volvulus is the torsion of a mobile loop of bowel with an elongated mesentery and a narrow pedicle. The twisting of the bowel…
Introduction A large bowel obstruction results from a narrowing of the colorectal lumen that restricts passage of gas and stool. It is a relatively common surgical emergency. Because the condition may be the result of many combinations of causes, locations,…
Introduction Lower gastrointestinal hemorrhage refers to blood loss originating distal to the ligament of Treitz that is symptomatic and necessitates hospital admission. It is a serious and potentially life-threatening situation. Although rectal hemorrhage can be seen in any age group,…
Introduction Surgical management of patients presenting with complications of diverticular disease can be elective, semi-elective, or an emergency, depending on the severity of the disease and patient comorbidities. A laparoscopic sigmoid resection is the preferred procedure in the elective setting,…
Introduction Colonic diverticula are false diverticula—that is, pockets composed of mucosa and submucosa that have herniated through weaknesses in the colon wall at the points where intramural vasa recta penetrate the inner circular muscle of the bowel ( Fig. 48-1,…
Introduction An unusual outbreak of Kaposi sarcoma (KS) and Pneumocystis carinii pneumonia among young homosexual men was first reported by the Centers for Disease Control and Prevention (CDC) in 1981. By the end of 1982, the term acquired immune deficiency…
Introduction Clostridium difficile was originally described as a component of the normal intestinal flora of newborn infants by Hall and O’Toole in 1935, who also demonstrated that this organism produced a toxin extremely lethal to mice. However, the “ C.…