In this slideshow, click through to learn about 5 different conditions affecting the colon. Each slide links to the full case report for more details.
Neoesophagus From Colonic Interposition
A 54-year-old man with a history of dysphagia and pacemaker placement for structural heart disease presented with left facial cellulitis and Streptococcus parasanguinis bacteremia. He required transesophageal echocardiography (TEE) for further assessment after a questionable vegetation had been seen on a 2-dimensional echocardiogram.
During TEE, the gastroenterology team was consulted after the cardiology team had difficulty advancing the endoscope beyond 30 cm on multiple attempts. Endoscopy was performed, the results of which revealed that the esophagus was surgically absent, and that the patient had a pharyngeal-colonic anastomosis (figure).
Hepatic Abscesses With Concomitant Colon Adenocarcinoma
A 58-year-old woman presented with 4 days of episodic fevers to 38.9°C, nausea with nonbilious and nonbloody vomitus, and pleuritic chest pain. Her symptoms had been preceded by 1 week of generalized malaise, right-sided abdominal pain, and abdominal bloating. No alleviating or aggravating factors were noted. She reported an associated nonproductive cough, anorexia, and drenching night sweats. She denied having any similar prior symptoms, weight loss, joint pain, history of malignancy, notable alterations in bowel patterns, and dietary changes. She had no history of injection drug use or recent abdominal surgery. Her medical, surgical, family, and social histories were noncontributory.
Colonic Intussusception Due to Mucinous Appendiceal Adenocarcinoma
A 51-year-old woman with a history of irritable bowel syndrome and hypothyroidism presented to the emergency department with worsening abdominal pain for a period of 24 hours. She stated that the abdominal pain had been gradually worsening and was sharp in nature.
Colonic Mantle Cell Lymphoma
An 80-year-old man underwent a colonoscopy as part of postoperative surveillance. His medical history was significant for colon resection 12 months previously for an invasive adenocarcinoma (stage I) arising from an existing tubular adenoma with high-grade dysplasia. Other pertinent medical history included mixed hyperlipidemia, atherosclerotic heart disease with unstable angina pectoris, gastroesophageal reflux disease, and morbid obesity (body mass index, 36.9 kg/m2).
Colonoscopic examination revealed multiple flat polypoid lesions ranging from 5 to 11 mm in the rectum (figure). A total of 6 mL of normal saline was injected underneath the lesions to raise them, and then snare polypectomy with fulguration was used to obtain a sample.
Angiosarcoma of the Small Intestine With Metastases to the Colon and Gallbladder
An 81-year-old man with a history of hypertension, type 2 diabetes mellitus, and Alzheimer disease presented with syncope. The patient denied having chest pain, dyspnea, palpitations, nausea, vomiting, hematochezia, melena, facial droop, slurred speech, or a history of seizure. He did not use aspirin or nonsteroidal anti-inflammatory drugs.
Slideshow: Cases Involving the Colon