Colorectal cancer poses a serious threat to the health and well-being of individuals, especially those at high risk or over the age of 50. Gone undetected, colorectal cancer is often fatal, however, preventive screening greatly reduces the number of people who may develop this disease. The Centers for Disease Control and Prevention developed the Colorectal Cancer Screening Demonstration Program in 2005 to assess the feasibility of a national colorectal cancer screening program serving low-income and un- or underinsured populations. Qualitative case study data from the Colorectal Cancer Screening Demonstration Program evaluation were analyzed in order to examine the start-up experiences of two of the programs involved. Results from this multiple case study document program models and describe facilitators, challenges, and participant perception of the expected impact on screening behavior. Further research on program implementation is needed to understand how program models perform and impact behavior once screening begins.

This study was aimed at investigating adverse and beneficial long-term effects of jejunoileal bypass (JIB) sugery in obese patients. The JIB was the first widly used surgical procedure for treatment of morbid obesity. The weight loss was remarkable, but the procedure was declared not appropiate for obesity surgery in the late 1970's. Serious late adverse effects such as liver cirrhosis and malignancies, have been postulated. Unexpectedly few studies have adressed these problems. In the long-term follow-up of 87 uniformly operated patients, several persisting beneficial effects were found. The mean Body Mass Index was 41.5 kg/m2 at the time of operation and 29.7 kg/m2 sixteen years after the operation. Diabetes type II and hyperlipidemia, common in an obese population, was not found in this group. Reversals were performed in 3% of the patients in contrast to 20-30% in many earlier studies. Revisions performed in 8% of the patients due to excessive weight loss could have contributed to the good long-term outcome. Percutaneous liver biopsies from 44 patients taken 14-20 (mean 17) years after JIB revealed normal or fatty liver, a lower degree of histological abnormalities than in 11 biopsies taken at the time of operations 1-14 (mean 6) years postoperatively. Liver cirrhosis seen early in one patient could not be found in the late biopsies. Reduced activity of the fibrinolytic system has been shown to be a new cardiovacular risk factor. In 45 patients studied 14-20 years after JIB, the levels of both plasminogen activator inhibitor type 1 (PAI-1) and tissue plasminogen activator (tPA) were significantly lower than in a control group of 10 morbidly obese patients ( PAI-1: 8.4 vs 32 U/mL, tPA: 7.2 vs 12 pg/L). Bile acids are regarded as cofactors in the carcinogenesis in the colon and experimentally an increased frequency of malignant tumors has been demonstated after JIB in carcinogen-induced rats. In 30 of the operated patients, colonoscopy with biopsy was performed 11-17 yeras after the operation. No evidence for malignant transformation was found as reflected by an abscense of polyp formation, histologic dysplasia or aneuploidia in flow cytometric DNA analysis. Eight hundred and thirty patients from 10 hospitals subjected to JIB were compared to 1660 controls with respect to malignant diagnosis over a 20 years period. No significantly increased risk for colorectal carcinoma could be demonstrated. However the overall risk for malignant disease was increased in the operated patients. The frequency of endometrial carcinoma was significantly elevated up to five years after the operation but was normal after that time. In conclusion the postulated progress of serious adverse effects of JIB such as liver cirrhosis and malignant disease has not been possible to demonstrate. Several beneficial effects such as weight loss and reduction of cardiovascular risk factors have been found a long time after the operation. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1995, härtill 5 uppsatser.</p> / digitalisering@umu

Over 80% of colorectal cancers (CRCs) are sporadic/randomly arising tumors. Interval CRCs represent a subset of sporadic tumors that develop within 6-36 months after a negative colonoscopy. Interval CRCs are suggested to exhibit altered biological properties that contribute to rapid growth and proliferation. We hypothesize that chromosomal instability (CIN), or aberrant chromosome numbers, contributes to the etiology of Interval CRCs. We have assembled a Manitoban cohort of Interval and sporadic (control) CRC tumor samples, and established a fluorescence in situ hybridization approach to characterize CIN by enumerating specific chromosomes. The results of this study indicate that 75% of Interval CRCs exhibit a CIN phenotype, making CIN the most prevalent contributor to genomic instability in Interval CRCs. Only once we grasp a better understanding of the tumorigenic pathways through which Interval CRCs develop, can we tailor screening strategies and treatment options to specifically identify and combat this subset of sporadic CRC.

About half of million deaths caused by colorectal cancer (CRC) has been reported worldwide every year. Programmes for early diagnosis of CRC has reduced mortality due to this disease, as the cancer is diagnosed in earlier stages which can be treated more successfully. Programme for early CRC diagnosis in Lithuania has been based on the faeces occult blood test (FOBT). If positive FOBT result is obtained, patients should be referred for colonoscopy (CS) examination. Based on the data from the National Health Fund, during the first three years CS examination was carried out for a little bit more than half of the patients participating in the programme and presenting with positive FOBT result. Aiming to improve accuracy of CRC diagnostics we have suggested alternative CS examination – computed tomography colonography (CTC). The aim of our study was to establish diagnostic value of CTC examination in the identification of neoplastic alterations in the patients with positive FOBT result and to specify factors having influence on the examination quality. CTC examinations were carried out and their results were compared with the findings of CS. We discovered that CTC is of high diagnostic value for detection of lesions sized ≥ 6 mm and of very high diagnostic value for detection of large ( ≥ 10 mm) polyps in a colon. We found out that the length of colon had no influence on how patients tolerated this examination and on patients well-being during CTC procedure, and colon cleaning... [to full text] / Pasaulyje kasmet nuo storosios žarnos vėžio (SŽV) miršta apie pusė milijono žmonių. SŽV ankstyvosios diagnostikos programos sumažina mirtingumą nuo šios ligos, nes vėžys tada yra aptinkamas anksčiau ir galima jį lengviau išgydyti. Lietuvoje SŽV ankstyvosios diagnostikos programa yra paremta slapto kraujo išmatose nustatymo testu (FOBT). Po teigiamo FOBT atsakymo pacientai yra nukreipiami kolonoskopijai (KS). Valstybinės ligonių kasos duomenimis per pirmuosius trejus metus iš pacientų, dalyvavusių programoje, kuriems nustatytas teigiamas FOBT, iš jų tik kiek daugiau nei pusei pacientų atlikta KS. Norint dažniau diagnozuoti SŽV, pasiūlėme alternatyvų KS tyrimą - kompiuterinės tomografijos kolonografiją (KTK). Taikydami KTK ir lygindami jos rezultatus su KS, norėjome išsiaiškinti KTK tyrimo diagnostinę vertę nustatant neoplastinius pakitimus pacientams su teigiamu FOBT bei nustatyti tyrimo kokybei darančius įtaką faktorius. Nustatėme, kad KTK pasižymi didele diagnostine verte nustatant ≥6 mm dydžio pakitimus bei labai didele diagnostine verte nustatant didelius (≥10 mm) polipus, storojoje žarnoje. Nustatėme, kad storosios žarnos ilgis neturi įtakos KTK tyrimo tolerancijai ir paciento savijautai KTK metu, o žarnos išsivalymo kokybė prieš KTK tyrimą nepriklauso nuo anatominių storosios žarnos savybių – tokių, kaip ilgis. Išsiaiškinome, kad KTK tyrimas yra jautrus nustatant storosios žarnos neoplastines adenomas ir vėžį, bet nesiekia KS tyrimo jautrumo, todėl KTK taikyti... [toliau žr. visą tekstą]

Darbo tikslas: ištirti pacientų, dalyvaujančių profilaktinėje storosios žarnos vėžio patikroje, pasitenkinimą endoskopiniu tyrimu. Tyrimo uždaviniai: 1. Įvertinti profilaktinėje storosios žarnos vėžio patikroje dalyvaujančių pacientų informuotumą apie atliekamą tyrimą. 2. Nustatyti veiksnius, lemiančius pacientų, dalyvaujančių profilaktinėje storosios žarnos vėžio patikroje, žarnyno paruošimo kokybę. 3. Įvertinti veiksnius, lemiančius pacientų pasitenkinimą endoskopinio tyrimo metu. Tyrimo kontingentas ir metodai. 2013 metų kovo – gruodžio mėnesiais atlikta anoniminė anketinė apklausa. Tyrime dalyvavo (42,4 proc. vyrų ir 57,6 proc. moterų) pacientai, kurie tyrimo laikotarpiu buvo siųsti į Lietuvos Sveikatos Mokslų universiteto ligoninės Kauno klinikų Endoskopijų skyrių atlikti endoskopinio storosios žarnos tyrimo (n=177, atsako dažnis - 93,1 proc.). Tyrimui naudota autorės sukurta anketa, remiantis analizuota Lietuvos ir užsienio šalių moksline literatūra. / Research aim: to research patients satifaction during screening colonoscopy procedure. The research goals: 1. To evaluate patients, participating in colon cancer prevention screening programme, awareness of the administered colonoscopy procedure. 2. To determine factors, influencing patients, participating in colon cancer prevention screening programme, quality of bowel preparation. 3. To evaluate factors, determining the patients satisfaction during colonoscopy procedure. Research contingent and methods. During March to December 2013 an anonymous questionnaire was conducted of 177 participants (response rate – 93,1%), i.e. patients (42,4% men, 57,6 % women) administered to perform colonoscopy to Endoscopy department in hospital of Lithuanian University of Health Sciences Kaunas Clinics. A questionnaire, made by the author , based on the analysis of Lithuanian and foreign scientific literature, was applied for the research.

Introdução: A colonoscopia é um dos métodos mais completos de investigação das doenças colorretais, com vantagens por proporcionar a observação da mucosa intestinal, em tempo único e de forma direta e também por ser a técnica de maior acurácia para o diagnóstico de lesões estruturais. Salienta-se que o paciente, ao se deparar com a indicação da colonoscopia, interpreta-a como sendo um exame que provoca desconforto e desencadeia sentimentos de vulnerabilidade, vergonha, medo e ansiedade. Perante estas emoções, o procedimento poderá ser percebido como um fator estresse importante ao paciente e que requer a utilização de estratégias para o enfrentamento da situação de desafio. Objetivo: analisar a percepção de estresse e os estilos de coping em pacientes no período que antecede o procedimento colonoscópico, conforme as variáveis biossociais e clínicas. Material e método: tratase de um estudo descritivo, transversal, exploratório e de campo, com abordagem quantitativa, desenvolvido no Serviço de Endoscopia do Hospital Universitário da Universidade de São Paulo (HU-USP). Foram entrevistados 100 pacientes em período de complementação de preparo, adultos, com solicitação formal para a realização do procedimento colonoscópico. Para esta análise, foram utilizados os instrumentos Escala de Estresse Percebido (PSS 10), o Inventário de Estratégias de Enfrentamento de Folkman e Lazarus (1985) e um roteiro de entrevista semiestruturada para caracterização da população do estudo. Resultados: o perfil biossocial da amostra foi, predominantemente, de mulheres (73%), idade superior a 65 anos (50%), casados ou com companheiros (90%), com pelo menos um filho (38%), com escolaridade superior a oito anos de estudos (33%), que pertenciam as religiões evangélica e católica (48% e 45%, respectivamente), em sua maioria aposentados (48%), com antecedentes clínicos de hipertensão arterial sistêmica (90%) e familiar de câncer de colón (68%); 59% dos pacientes em período de preparo revelaram um nível médio de estresse percebido e os estilos de coping com maiores médias foram o Suporte Social (6,43±1,54), Aceitação da Responsabilidade (5,70±2,41) e Reavaliação Positiva (5,64±1,41). As variáveis sexo, idade, estado civil, escolaridade, tipo de preparo e número de exames realizados previamente foram determinadas, como fatores preditores de estresse nessa população. As correlações estatisticamente significativas deste estudo compreenderam a associação entre o PSS-10 e as estratégias de enfrentamento Confronto, Afastamento, Suporte Social, Aceitação da Responsabilidade e Reavaliação Positiva. Entre estes preditores, houve associação do sexo feminino, da idade superior a 65 anos, dos casados ou com namorado, dos não letrados ou daqueles com 2° grau completo/incompleto, do tipo de preparo ambulatorial e dos pacientes com pelo menos um exame realizado com o PSS-10 e os domínios selecionados. Conclusão: a análise da colonoscopia como fator de estresse é pouco estudada em nosso meio, assim como a associação dos processos de enfrentamento. A percepção de estresse foi maior entre os indivíduos da população da pesquisa quando comparados com a população do estudo de tradução e validação do instrumento. Quanto aos estilos de coping foram observados predomínios dos domínios com foco na emoção. Os resultados desta pesquisa permitiram o desenvolvimento de intervenções voltadas para a diminuição do estresse desses pacientes e que os estilos de enfrentamento encontrados nesta análise sejam utilizados para a melhoria da prática assistencial. / Introduction: Colonoscopy is one of the most complete methods of investigation for colorectal diseases, with several advantages. One is that it makes possible the observation of bowel mucus, directly and in a single session. Another is that it is one of the most accurate ways of diagnosing structural lesions in bowel. It is important to understand that patients who face this procedure interpret the exam as one that provokes discomfort, which leads to feelings of vulnerability, shame, fear and anxiety. In light of the emotional factors involved, the procedure may be viewed as a source of stress for the patient, and so, requires the implementation of strategies for approaching such a challenging situation. Objective: To analyze the perception of stress, according to bio-social and clinical variables, and coping styles of patients during the period preceding a colonoscopy procedure. Methods: This is a descriptive, transversal, field study with a quantitative approach developed by the Endoscopy Service of São Paulo Hospital University (HU-USP). One hundred patients in the preparatory stages were interviewed, of whom 100% were adults who had received a formal referral for the colonoscopy procedure. For the analysis, the following were employed: the Perceived Stress Scale (PSS-10), the Ways of Coping Questionare of Folkman and Lazarus (1985), as well as a semi-structured interview guide whose aim was to characterize the study population. Results: The bio-social profile of the sample population was predominantly female (73%), 65 years or older (50%), married or with a partner (90%) with at least one child (38%). The sample population also consisted of individuals with an eighth-grade or above level of education (33%), who professed a Faith of either Catholic or Evangelical (48% and 45%, respectively), for the most part retired (48%), with a history of hypertension (90%) and a family member with colon cancer (68%); 59% of the patients undergoing preparations revealed a medium level of perceived stress and the coping styles most utilized by these patients were the Social Support style (6,43±1,54), Acceptance of Responsibility Style (5,70±2,41) and Positive Reappraisal style (5,64±1,41). The variables of gender, age, marital status, schooling, type of preparation, and number of exams previously realized proved to be predictive factors of stress among this population. The statistically significant correlations within this study revealed themselves to be an association between PSS-10 and the coping strategies of Confrontive Coping, Distancing, Seeking Social Support, Acceptance of Responsibility and Positive Reappraisal. Among these predictors, an association of female, 65 years, married or with a partner, secondary schooling either complete or incomplete, with a outpatients preparation and patients with at least one procedure conducted style of PSS-10. Conclusion: The analysis of stress in the realization of colonoscopy exams is a little studied area in our field, as is the association of coping processes. The perception of stress was greater among the participants of the study, when compared with the instrument validation population. In terms of coping mechanisms, it was observed that those that focus on emotion were prevalent. The results of this study allow for a development of interventions that focus on diminishing stress in these patients. The results also permit that the coping mechanisms encountered in this analysis be utilized to better the work of care practitioners.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-11-21T13:58:27Z No. of bitstreams: 1 josefrancisconunespereiradasneves.pdf: 23381642 bytes, checksum: 2e3529926df5de66b01ea5f651b6a9fe (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-11-23T13:00:33Z (GMT) No. of bitstreams: 1 josefrancisconunespereiradasneves.pdf: 23381642 bytes, checksum: 2e3529926df5de66b01ea5f651b6a9fe (MD5) / Made available in DSpace on 2018-11-23T13:00:33Z (GMT). No. of bitstreams: 1 josefrancisconunespereiradasneves.pdf: 23381642 bytes, checksum: 2e3529926df5de66b01ea5f651b6a9fe (MD5) Previous issue date: 2012-08-30 / A Colonoscopia é um dos procedimentos mais realizados. Sedação e analgesia são fundamentais, pois diminuem ansiedade e o desconforto, minimizando riscos de complicações e proporcionando melhores condições para o exame. Em razão disso, os pacientes preferem que o exame seja realizado sob sedação e analgesia, embora não tenha sido determinada, a combinação de fármacos que possibilite condições ideais de exame com mínimo prejuízo cognitivo pós-procedimento. A combinação de benzodiazepínicos com opióides vem sendo utilizada em procedimentos de colonoscopia para aliviar a dor e o desconforto do paciente. Mais recentemente, o propofol assumiu posição de destaque. Este estudo apresenta-se como o único na literatura médica que especificamente comparou, de forma prospectiva, o uso do propofol e fentanil associado ou não ao midazolam na sedação para colonoscopia realizada por anestesiologista. Os objetivos do estudo foram avaliar os efeitos colaterais da sedação, as condições de alta da sala de recuperação pós-anestésica e a qualidade da sedação nas opiniões do endoscopista e do paciente. Além disso, buscou-se avaliar o consumo de propofol durante a colonoscopia, com ou sem o midazolam como pré-anestésico. Trata-se de um estudo prospectivo, randomizado, duplo cego, que envolveu 140 pacientes submetidos à colonoscopia, no Hospital Universitário – CAS da Universidade Federal de Juiz de Fora. Foram incluídos no projeto os pacientes com idade entre 18 e 60 anos, ASA I e II e que assinaram o Termo de Consentimento Livre e Esclarecido. Foram excluídos os pacientes que não obedeciam aos critérios de inclusão ou que faziam uso de medicações com atuação no sistema nervoso central. Os pacientes foram divididos em dois grupos. O Grupo I recebeu, por via endovenosa, midazolam (0,05 mg.Kg-1) como pré-anestésico, cinco minutos antes da sedação, seguido do fentanil (1 μg.Kg-1) e propofol (1 mg. Kg-1). O Grupo II recebeu, por via endovenosa, anestesia com fentanil (1 μg. Kg-1) e propofol (1 mg. Kg-1). Os pacientes do Grupo II apresentaram maior incidência de reação (motora ou verbal) à introdução do colonoscópio, bradicardia (P < 0,04), hipotensão arterial (P = 0,121) e maior consumo total de propofol (P < 0,001). A satisfação dos pacientes foi maior no Grupo I (P = 0,006). De acordo com a metodologia empregada, a associação de midazolam ao propofol e fentanil para sedação em colonoscopia reduz o consumo total de propofol e cursa com maior satisfação do paciente. / Colonoscopy is one of the most performed procedures. Sedation and analgesia are fundamental, since decrease anxiety and discomfort, minimizing risks of complications and providing better conditions for the exam. As a result, patients prefer the exam to be performed under sedation and analgesia. Although, the combination of drugs that provides ideal conditions for the examination with minimal post-procedure cognitive impairment has not yet been defined. The combination of benzodiazepines with opioids has been used in colonoscopy procedures to relieve the pain and discomfort of the patient. More recently, the propofol took a prominent position. Our study is unique in the literature, specifically comparing, prospectively, the use of propofol and fentanyl associated or not to midazolam on sedation for colonoscopy, performed by anesthesiologist. The objectives of the study were to evaluate the side effects of sedation, discharge conditions from the recovery room and quality of sedation in the opinion of the endoscopist and the patient. Evaluate the consumption of propofol during colonoscopy with or without the midazolam as pre anesthetic. The study was prospective, randomised, double blind and involved 140 patients submitted to colonoscopies procedures at University Hospital – CAS at the Federal University of Juiz de Fora. All the included patients in the project were between 18 and 60 years old, ASA I and II and they signed an informed consent. Some other patients were excluded because they did not attend to the criteria of inclusion or have been using medication that acts on the central nervous system. The patients were divided in two groups. The Group I received midazolam (0.05 mg.Kg-1) intravenously as preanesthetic five minutes before the sedation, followed by the fentanyl (1 μg Kg-1) and propofol (1 mg/Kg-1) (EV). The Group II received anesthesia with fentanyl (1 μg Kg-1) and propofol (1 mg/Kg-1) intravenously. The patients from Group II showed a higher incidence of reaction (motor or verbal) to the introduction of the colonoscope, bradycardia (P < 0.04), hypotension (P = 0.121) and a higher consumption of propofol (P < 0.001). Patient satisfaction was higher in Group I (P = 0.006). In accordance with the methodology, the association of midazolam to propofol and fentanyl for sedation in colonoscopy reduces the total consumption of propofol and ensure a higher patient satisfaction.

Orientadores: Wu Feng Chung, Huei Diana Lee / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T17:40:33Z (GMT). No. of bitstreams: 1 Machado_RenatoBobsin_D.pdf: 21928006 bytes, checksum: efd4a25c4c6dd6e8c6a3f4f4426de95c (MD5) Previous issue date: 2013 / Resumo: A área computacional aplicada à medicina tem contribuído para aumentar a eficiência no armazenamento, na transmissão e na análise de dados referentes aos pacientes e, consequentemente, na precisão do diagnóstico. Nesse contexto, para ampliar ainda mais estas ações, tornam-se essenciais a formação e a consolidação de redes integradas e colaborativas de apoio à área médica à distância. Outro aspecto fundamental que deve ser considerado no trato de informações pertencentes aos pacientes e profissionais médicos é a segurança, contemplando critérios como integridade, confidencialidade e autenticidade dessas informações. Neste trabalho, desenvolveu-se um método original em telemedicina para o acompanhamento e a interação remota entre especialistas da área médica, em tempo real, durante a realização de exames videocolonoscópicos. Para a proteção de dados e para a transmissão segura e eficiente das informações referentes aos pacientes e aos exames, propôs-se um método de segurança específico. Esses métodos foram implementados em um sistema computacional aplicando tecnologia Web e ferramentas open source. Para aferir o desempenho desse sistema, avaliou-se a taxa Quadros por Segundo (QPS) durante a transmissão de vídeos sem compactação. Este processo se deu em dois ambientes distintos, com diferentes resoluções, sendo o primeiro caracterizado apenas pela rede local e, o segundo, pela rede local juntamente com a Internet, simulando ambientes reais de aplicação do método proposto. As análises dos resultados desse trabalho permitiram concluir que: 1. O método proposto, implementado no sistema computacional, cumpre os requisitos estabelecidos para transmissão de dados, segurança de informações e interação em tempo real entre os usuários; 2. O método proposto é aplicável para a realização de procedimentos videocolonoscópicos, em redes locais e na Internet. 3. O método de segurança definido neste trabalho prove privacidade para a transmissão de dados, de vídeos e de imagens, assim como para a interação entre os participantes locais e remotos / Abstract: Computational methods and tools applied to medicine have contributed to increase efficiency in storage, transmission and analysis of data related to patients and, consequently, the accuracy of diagnoses. In this context, to further expand these actions, it became essential the creation and consolidation of integrated and collaborative networks to support the medical area. Another fundamental aspect which must be considered in dealing with information about patients and medical professionals is security, considering criteria such as integrity, confidentiality and authenticity of this information. In this work, we have developed an original telemedicine method for monitoring and remotely interaction among medical experts, in real time, during the performance of video-colonoscopic procedures. For data protection, secure transmission and efficient use of information related to patients and their examinations, we have proposed a specific security method. Both methods were implemented in a computing system by applying Web technology and open source tools. In order to assess the performance of this system, we have evaluated the transmission rate in frames per second (FPS) during the streaming of an uncompressed video. We performed our experiments simulating real environments in two different scenarios with distinct resolutions, one being characterized only by the local network and the second considering the local network and the Internet. The analysis of the results has shown that: (1) the proposed method, implemented in the computational system, meets the requirements for data transmission, information security and real-time interaction among the users; (2) the proposed method is applicable for performing video-colonoscopic procedures, via local networks and the Internet, and; (3) the security method built for this system provides privacy during the transmission of the data, video and images, as well as the interaction between the local and remote participants / Doutorado / Fisiopatologia Cirúrgica / Doutor em Ciências

ABSTRACT In the western world colitis is a common chronic disease and in Sweden the prevalence is around 1%. If a patient has bloody diarrhea it is probably ulcerative proctocolitis or Crohn’s disease, whereas if the diarrhea is watery, it is microscopic colitis. For a diagnosis, the patient has to do a colonoscopy and a colonic biopsy sample has to be taken. The biopsy sample will be sent to a laboratory for sectioning, staining and microscopic analysis. In this study we compared the effects of short and long dehydration time of the sample before the sectioning. We also compared staining with Alcianblue/Van Gieson and Van Gieson alone. Our results showed that a short dehydration time was a milder treatment and made it easier to section the biopsy sample. The comparison of the two methods was unsuccessful because the staining with Alcianblue/Van Gieson failed.

Artificial urinary sphincters have been used for decades for treatment of urinary incontinence. A commonly used device, the AMS 800 consists of a urethral cuff, pump and an abdominal reservoir. Notable complications of this system include scrotal or labial hematomas, infection or erosion of the cuff and rarely migration of its components. Although there are few reported cases related to effects from pump migration, those documenting reservoir related complications are even rarer. We present a case of reservoir migration adjacent to the ascending colon causing ischemic changes mimicking colonic neoplasm. Our patient, a 66-year old male with medical history of adenocarcinoma of prostate status post radical prostatectomy, had been having abdominal pain for a month. A CT scan showed cecal and proximal ascending colonic irregular nodular thickening suggestive of colonic mass. It also revealed a low-density structure next to the ascending colon abutting into area of the mass. A follow up colonoscopy showed a fungating, ulcerated mass extending from cecum to ascending colon concerning for a malignancy of which biopsy was also done. The patient then underwent right open hemicolectomy. During surgery, a balloon reservoir was seen in the abdominal cavity with its adherence to the right colon but not eroding into it. The surgeon dissected the balloon, repositioned and re-peritonealized it before closing the abdomen. The colonoscopic and surgical pathology instead demonstrated findings of ischemic colitis with mucosal ulceration in cecum and ascending colon limited to the mucosa but no evidence of cancer. Retrospective chart review revealed history of artificial urinary sphincter implantation for urinary incontinence related to radical prostatectomy for adenocarcinoma eight years prior. With manufacturer suggested implant location of the reservoir in prevesical space, the possibility of migration needs to be accounted for. Although there are not many reports of artificial sphincter reservoir related complications, there are cases documenting inflatable penile prosthesis reservoir erosion into abdominal and pelvic structures. As the CT scan demonstrated reservoir indentation into the ascending colon, it likely led to chronic irritation of the adjacent colonic wall due to mass effect. It is hypothesized that constant pressure on colonic wall likely led to localized ischemia. This resulted in localized inflammation including submucosal edema, which can create a mass-like appearance when severe. This case emphasizes that, while preliminary radiographic imaging and even gross colonoscopy findings may be suggestive of a malignancy, it is imperative to await biopsy results to confirm the diagnosis of a malignant neoplasm. Our case report emphasizes the consideration of diagnoses other than colon cancer when faced with a colonic mass especially in the setting of implanted intra-abdominal foreign body to avoid unnecessary surgery and related complications.