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Related Experiment Videos

Sigmoid stricture at colonoscopy--an indication for surgery.

D W King1, D Z Lubowski, A S Armstrong

  • 1Colorectal Unit, St. George Hospital, Sydney, Australia.

International Journal of Colorectal Disease
|August 1, 1990
PubMed
Summary

Sigmoid colon strictures present a diagnostic challenge. Resection is recommended for impassable strictures when the cause is unclear, as malignancy must be ruled out.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Background:

  • Sigmoid colon strictures are diagnostically challenging.
  • Differentiating between diverticular disease and carcinoma is crucial.
  • Some strictures lack an obvious cause.

Purpose of the Study:

  • To evaluate the diagnostic dilemma of sigmoid colon strictures.
  • To determine the optimal management strategy for these strictures.

Main Methods:

  • Analysis of 1039 consecutive colonoscopies (1984-1986).
  • Inclusion of 19 cases of unnegotiable sigmoid strictures.
  • Review of clinical findings, barium enema, and surgical outcomes.

Main Results:

  • Fifteen patients (79%) underwent laparotomy.
  • Final diagnoses: 9 diverticular disease, 6 adenocarcinoma.
  • Barium enema showed poor predictive value for malignancy.
  • Conservative treatment led to persistent symptoms in 2/4 patients.

Conclusions:

  • Sigmoid strictures preventing colonoscope passage require careful evaluation.
  • Resection is advised when the cause of the stricture is not apparent.
  • Early surgical intervention may be necessary to exclude malignancy.

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