Inguinal herniation justifies sigmoidoscopy

Article Abstract:

Cancer of the colon is a leading cause of cancer deaths. It is important that a screening method be developed to detect malignant or premalignant lesions as early as possible. For patients over the age of 40, an association has been found between development of inguinal hernia and colon cancer. This group of patients might benefit from sigmoidoscopy (a procedure that provides visualization of the interior of the colon using an illuminated optic instrument). A prospective study was undertaken with 464 inguinal hernia patients to determine the role of sigmoidoscopy in colon cancer screening. All patients were male, and the ages ranged from 40 to 89 (average age 58). Sigmoidoscopy identified 97 patients with polyps (21 percent of the group), and 22 patients with carcinoma (5 percent). Five of the 22 patients with cancer had in situ disease and were able to be treated by removal of the lesion with the instrument used to perform sigmoidoscopy. Testing for occult (hidden) blood, another method of colon cancer screening, detected blood in the stool specimens of 8 percent of the total group, but in only 13 percent of the patients with either polyps or cancer. It was found that one of every four patients screened by sigmoidoscopy who had inguinal hernia also had either cancer or a premalignant lesion. Therefore it is recommended that sigmoidoscopy be used for screening for colon tumors in patients with inguinal hernia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Usage, Complications and side effects, Risk factors, Colorectal cancer, Medical screening, Health screening, Sigmoidoscopy

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Ethanol diffuses across the gastric muscle wall

Article Abstract:

Alcohol (ethanol) influences the stomach muscle by depressing motility (the peristaltic motion that moves food through the stomach) and delaying stomach emptying. This effect seems to be largely a result of the concentration of ethanol in the gastric contents. Previous laboratory studies of stomach muscle specimens have shown a dose-related effect of ethanol on stomach muscle activity. The effects of ethanol on stomach motility occur at concentrations higher than can be expected by delivery of ethanol to the stomach muscle via the blood stream. To investigate the possibility that local diffusion may occur across the mucosa of the stomach after ingestion of ethanol, an animal model was created. Using stapling to partition the stomach, carbon-14 labeled ethanol was instilled into the stomachs of two dogs. The flow of ethanol was followed by study of serial sections of the stomach wall. A gradient of C-14 activity progressing through the stomach wall was established. The results of studying this model indicate that direct diffusion of ethanol through the mucosal surface of the stomach muscle can produce dramatically higher concentrations of ethanol than would be anticipated by serum alone. These results may help in the understanding of the clinical effects of ethanol on stomach emptying and alcohol-related gastrointestinal disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Alcohol, Ethanol, Stomach, Gastric mucosa

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Management of indirect inguinal hernias by laparoscopic closure of the neck of the sac

Article Abstract:

New technology has permitted some major operations to be replaced by less invasive surgical techniques. A new method for repairing indirect inguinal hernias, performed on 15 dogs, is described. An indirect inguinal hernia is a protrusion of a portion of intestine into the inguinal canal. This occurs through an abnormal opening between the peritoneal cavity and the process vaginalis, and is fairly common. While about 25 percent of all men have this abnormality present at birth, only a fraction of them develop a hernia in this location. The new surgical technique involves partial closure of the opening at the neck of the hernial sac using a special device that allows staples to be applied through a laparoscope, an illuminated tube inserted through the abdomen into the peritoneal cavity. This less invasive surgery may have advantages over the presently used operation, such as creation of a puncture wound rather than a skin incision, less risk of bladder or spermatic cord damage, and ability to perform the procedure on an outpatient basis. Patients also experience less postoperative pain and have a shorter recovery time. Two patients have been successfully treated with this technique. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Innovations, Surgery, Laparoscopy

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