James P. Muldoon

Colitis cystica profunda: Report of two cases

SummaryColitis cystica profunda is a benign lesion that may be single or multiple and involves the rectum or the colon, or both. It may be confused with a mucus-producing adenocarcinoma and, as such, it may be treated erroneously by a radical surgical procedure. Two cases are presented.

Colitis cystica profunda in an adenoma (adenomatous polyp)

SummaryReference is made to cases in which a frozen-section diagnosis of adenocarcinoma of the colon or doubt has led to a segmental resection for a benign condition (colitis cystica profunda). A case of colitis cystica profunda in an adenoma which was diagnosed and treated as a benign lesion at celiotomy is presented. It is proposed that adenomas may play a role in the pathogenesis of colitis cystica profunda. Fecal irritation of the head of a polyp high in the colon may have the same effect that fecal irritation has in the lower sigmoid colon and rectum.

Juvenile polyps of the colon and rectum.

All polypoid lesions at the Ferguson Clinic for the past 22 years were checked by our pathology department. Of these, 174 were found to be juvenile polyps and were studied in detail.SummaryAll polypoid lesions at the Ferguson Clinic for the past 22 years were checked by our pathology department. Of these, 174 were found to be juvenile polyps and were studied in detail.All polypoid lesions at the Ferguson Clinic for the past 22 years were checked by our pathology department. Of these, 174 were found to be juvenile polyps and were studied in detail.

Perineal herniation-A late complication of adominoperineal resection of the rectum: Report of a case

SummaryHerniation of small bowel through a posterior wound may be a late complication of an abdominoperineal resection of the rectum. Surgical correction of herniation of small bowel in an old posterior wound has been described.

Is long-term follow up of rectal polyps justifiable?

Summary and ConclusionsThe records of 200 patients with adenomatous polyps of the rectum, followed 3 to 15 years, were reviewed. Rectal adenomas were most prevalent in patients between the ages of 45 to 65 years. Men predominated over women (ratio, 1.6 : 1.0). The recurrence rate of adenomatous polyps of the rectum was 31 per cent.Follow-up colon x-ray studies revealed a recurrence of single or multiple colonic lesions in 23 patients (11.5%).Until thepolyp-cancer issue has been clarified, yearly sigmoidoscopy and x-ray examination of the colon should be continued in patients who have rectal polyps.

A transrectal approach to the high-lying lesion in the rectosigmoid

SummaryWe have presented a double-scope technic for complete removal under direct vision and control of mobile, high-lying, benign lesions of the rectosigmoid colon, especially those above the peritoneal reflection.

Hirschsprung’s disease

Summary and ConclusionsTrue Hirschsprung’s disease, occurring in the adult, is not reported frequently in medical literature. The patient presented herewith illustrates the essential features of Hirschsprung’s disease, namely, unrelenting constipation since birth, massive dilatation of the sigmoid flexure with a distal narrowed segment, and a rectal muscle biopsy showing no ganglion cells. Rectal muscle biopsy is conclusive in making the diagnosis of Hirschsprung’s disease. By microscopic examination of the muscle of the bowel wall, the extent of the disease in the colon can be determined.

The rectosigmoidal area

ConclusionsDigital and sigmoidoscopic examination and x-ray of the colon and rectum after administration of a barium enema are necessary for thorough evaluation.The danger of missing lesions in the twilight zone situated between the upper limit of the area that can be well seen by sigmoidoscopy and the area that can be visualized efficiently by roentgenography is reemphasized.The value of the Chassard-Lapine projection for solution of this problem is stressed.Repeated roentgenologic studies with attention focused on a local area and progress examinations are often necessary to establish a diagnosis.

TRAUMATIC PERFORATION OF THE RECTUM AND THE RETROPERITONEAL SPACE.

SummaryInvolvement of the retroperitoneal space in traumatic perforation of the rectum has been discussed. The anatomic limits of the retroperitoneal space are outlined.Transverse colostomy should be contemplated in all perforating wounds of the rectum. Extraperitoneal drainage of retroperitoneal abscess is stressed.