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Concept: Ascending colon


Intussusception is uncommon in adults. To our knowledge, synchronous colocolic intussusceptions have never been reported in the literature. Here we described the case of a 59-year-old female of synchronous colocolic intussusceptions presenting as acute abdomen that was diagnosed by CT preoperatively. Laparotomy with radical right hemicolectomy and sigmoidectomy was undertaken without reduction of the invagination due to a significant risk of associated malignancy. The final diagnosis was synchronous adenocarcinoma of proximal transverse colon and sigmoid colon without lymph nodes or distant metastasis. The patient had an uneventful recovery. The case also emphasizes the importance of thorough exploration during surgery for bowel invagination since synchronous events may occur.

Concepts: Large intestine, Sigmoid colon, Lymph node, Colectomy, Ascending colon, Peritoneum, Cancer, Medical terms


Colonic ameboma is a rare inflammatory pseudo-tumor of the colon that can mimic cancer development. This case was located in the cecum and appeared malignant from a macroscopic view. Accordingly a right hemicolectomy was performed, followed by an end-to-side ileocolic anastomosis. The pathology study enabled us to correct the diagnosis and affirm its amebic origin.

Concepts: Ascending colon, Cecum, Oncology, Large intestine, Digestive system, Colon, Pathology, Cancer


This study aims to characterize the in vivo Raman spectroscopic properties of normal colorectal tissues and to assess distinctive biomolecular variations of different anatomical locations in the colorectum for cancer diagnosis. We have developed a novel 785 nm excitation fiber-optic Raman endoscope that can simultaneously acquire in vivo fingerprint (FP) spectra (8001800 cm-1) and high-wavenumber (HW) Raman spectra (28003600 cm-1) from the subsurface of colorectal tissue. We applied the FP/HW Raman endoscope for in vivo tissue Raman measurements of various normal colorectal anatomical locations (i.e. ascending colon (n=182), transverse colon (n=249), descending colon (n=124), sigmoid (n=212), and rectum (n=362)) in 50 subjects. Partial least squares (PLS) - discriminant analysis (DA) was employed to evaluate the inter-anatomical variability. The normal colorectal tissue showed a subtle inter-anatomical variability in molecular constituents (i.e., proteins, lipids and water content) and could be divided into three major clusterings: (1) ascending colon, transverse colon, (2) descending colon, and (3) sigmoid and rectum. The PLS-DA multiclass algorithms were able to identify different tissue sites with varying sensitivities (SE) and specificities (SP) (ascending colon: SE: 1.10%, SP: 91.02, transverse colon: SE: 14.06%, SP: 78.78, descending colon: SE: 40.32%, SP: 81.99, sigmoid: SE: 19.34%, SP: 87.90, rectum: SE: 71.55%, SP: 77.84). The inter-anatomical molecular variability was orders of magnitude less than neoplastic tissue transformation. Further PLS-DA modeling on in vivo FP/HW tissue Raman spectra yielded a diagnostic accuracy of 88.8% (sensitivity: 93.9% (93/99); specificity 88.3% (997/1129) for colorectal cancer detection. This work discloses that inter-anatomical Raman spectral variability of normal colorectal tissue is subtle compared to cancer tissue; and the simultaneous FP/HW Raman endoscopic technique has promising potential for real-time, in vivo diagnosis of colorectal cancer at the molecular level.

Concepts: Colorectal cancer, Rectum, Peritoneum, Colon, Sigmoid colon, Ascending colon, Sigmoidoscopy, Cancer


Complete mesocolic excision for right-sided colon cancer may offer an oncologically superior excision compared to traditional right hemicolectomy through high vascular tie and adherence to embryonic planes during dissection, supported by preoperative scanning to accurately define the tumour lymphovascular supply and drainage. The authors support and recommend precision oncosurgery based on these principles, with an emphasis on the importance of understanding the vascular anatomy. However, the anatomical variability of the right colic artery (RCA) has resulted in significant discord in the literature regarding its precise arrangement.

Concepts: Dissection, Conservatism, Biology, Ascending colon, Anatomy, Right colic artery, Colon, Cancer


Diversity and composition of microbial communities was compared across the 13 major sections of the digestive tract (esophagus, reticulum, rumen, omasum, abomasum, duodenum, jejunum, ileum, cecum, ascending colon, transverse colon, descending colon, and rectum) in two captive populations of American bison (Bison bison), one of which was finished on forage, the other on grain.

Concepts: Colon, Peritoneum, Cecum, Sigmoid colon, Digestion, Ascending colon, Midgut, Digestive system


Metastatic colorectal carcinoma (mCRC) is a heterogeneous disease with differing outcomes and clinical responses and poor prognosis. CRCs can be characterised by their primary tumour location within the colon. The left-sided colon, derived from the hindgut, includes the distal third of the transverse colon, splenic flexure, descending colon, sigmoid colon and rectum. The right-sided colon, derived from the midgut, includes the proximal two-thirds of the transverse colon, ascending colon and caecum. Sometimes, the rectum is described separately, despite originating from the hindgut, and in many clinical series, the left-sided colon includes only tumours within and distal to the splenic flexure. Differences in the microbiome, clinical characteristics and chromosomal and molecular characteristics have been reported between the right and left side of the colon, regardless of how this is defined. There is now strong evidence from clinical studies in patients with mCRC for the prognostic effect of primary tumour location. The impact of primary colonic tumour location on response to treatment is now under investigation in a large number of clinical studies in patients with mCRC. In this review, we summarise the microbiome, clinical, chromosomal and molecular differences associated with the primary location of CRC. We present an overview of the proven prognostic impact of primary tumour location for patients with mCRC and discuss emerging data for the predictive impact of primary tumour location on clinical outcome.

Concepts: Descending colon, Peritoneum, Colorectal cancer, Sigmoid colon, Hindgut, Ascending colon, Cancer, Colon


A previously well 76-year-old woman underwent elective colonoscopy for the investigation of persistent rectal bleeding and abdominal pain. The procedure was prolonged owing to the presence of a redundant sigmoid colon, and considerable manipulation was required in order to advance to the cecum. After the procedure, sudden abdominal distention developed, with signs of peritoneal irritation. A chest radiograph obtained while the patient was in the upright position showed a tension pneumoperitoneum with medial displacement of the liver (Panel A, arrow), raising concern about torsion of vessels in the porta hepatis. A radiograph of the abdomen showed Rigler’s sign - air . . .

Concepts: Gallbladder, Abdomen, Ascending colon, Sigmoid colon, Abdominal pain, Rectum, Peritoneum, Liver


Developing rapidly from the cecal diverticulum in a 5-week-old embryo, the cecum, which is developed from the caudal limb of the midgut loop, is different from the ascending colon. The aim of this study was to analyze the different clinicopathological and biological characteristics of patients with carcinoma of the cecum and ascending colon. We accessed data for 59,035 patients with adenocarcinomas of the cecum and ascending colon from the Surveillance, Epidemiology and End Results database to explore the potential associations between the clinicopathological characteristics and overall survival. Furthermore, we analyzed the differences in gene expression between the two segments in the Gene Expression Omnibus database. The results were validated in The Cancer Genome Atlas database, as well as with another independent dataset from the First Affiliated Hospital of Xi'an Jiaotong University. The results of this study revealed the potential prognostic differences between adenocarcinoma of the cecum and ascending colon, which may be caused by the differential expression levels of the SLCO1B3 gene. When including the expression levels of SLCO1B3 in intraoperatively examined lymph nodes, 8 factors were found able to predict the prognosis of patients with carcinomas of the cecum and ascending colon. As regards the surgical therapeutic strategies, the resection of >15 local lymph nodes is appropriate for improving the prognosis of patients.

Concepts: Carcinoma, Ascending colon, Gene, Gene expression, Adenocarcinoma, Cecum, Lung cancer, Cancer


Appendiceal intussusception is a very rare condition with an estimated incidence of 0.01%. Most cases present in adults with chronic waxing and waning of symptoms over a period of weeks to months. We report a case of a 39-year-old Caucasian female with a 5-week history of worsening right-sided abdominal pain. Computed tomography revealed cecal thickening without visualization of the appendix. A colonoscopy revealed mild diffuse erythema and edema in the ascending colon as well as a mass within the lumen of the cecum. Biopsies of the colon were suggestive of mild ulcerative colitis (UC). The patient’s symptoms continued and laparoscopic assisted ileocecectomy was performed revealing an inverted appendix protruding into the cecal lumen. The patient was discharged without any complications and began mesalamine therapy for her UC.

Concepts: Colonoscopy, Abdominal pain, Ascending colon, Colon, Large intestine, Cecum, Crohn's disease, Ulcerative colitis


Anticoagulation therapy after coronary stent implantation is necessary and crucial for patients with severe coronary heart disease. Submucosal bleeding of the colon is an infrequent complication of anticoagulants.

Concepts: Cardiology, Rectum, Heart, Heart disease, Ascending colon