Endoscopic radial incision and cutting technique for treatment-naive stricture of colorectal anastomosis:Two case reports

BACKGROUND Anastomotic stenosis(AS)after colorectal surgery was treated with balloon dilation,endoscopic procedure or surgery.The endoscopic procedures including dilation,electrocautery incision,or radial incision and cutting(RIC)were preferred because of lower complication rates than surgery and are less invasive.Endoscopic RIC has a greater success rate than dilation methods.Most reports showed that repeated RICs were needed to maintain patency of the anastomosis.We report that single session RIC was applied only to treatment-naive patients with AS.CASE SUMMARY Two female patients presented with AS.One patient had advanced rectal cancer and the other had a refractory stenosis following surgery for endometriosis at sigmoid colon.The endoscopic RIC procedure was performed as follows.A single small incision was carefully made to increase the view of the proximal colon and the incision was expanded until the surgical stapling line.Finally,we made a further circumferential excision with endoscopic knife along the inner border of the surgical staple line.At the end of the procedure,the standard colonoscope was able to pass freely through the widened opening.All patients showed improved AS after a single session of RIC without immediate or delayed procedure-related complications.Follow-up colonoscopy at 7 and 8 mo after endoscopic RIC revealed intact anastomotic sites in both patients.No treatment-related adverse events or recurrence of the stenosis was demonstrated during follow-up periods of 20 and 23 mo.CONCLUSION The endoscopic RIC may play a role as one of treatment options for treatmentnaive AS with short stenotic lengths.

A case of idiopathic colonic varices: A rare cause of hematochezia misconceived as tumor

结肠的静脉曲张是更低的胃肠的流血的一个很稀罕的原因。少数在英语文学比自发的结肠的静脉曲张(ICV ) 的结肠的静脉曲张，和 30 个案例的 100 个案例被报导了。在 ICV 的这 30 个案例之中， 19 个案例被血管造影术诊断，并且 7 个操作案例以后作为回盲肠静脉赤字被诊断，缝血管瘤，并且在 1 自发， 1， 5 个案例分别地。我们报导受不了在 11 年岁时改变学位的便血的多重事件的一个 24 岁的人的案例。他与 21 g/L 的血红素有严重贫血症。在结肠镜检查上，曲折地扩大了特别在书籍的右页 sigmoid 区域被黑暗坏死的纸巾盖住的粘膜下层静脉和脆的溃疡从直肠被看见直到远侧的下降结肠。它开始看起来是有静脉曲张的癌。肠系膜 angiographic 学习建议了一个结肠的缝血管瘤。低前面的切除术由于难处理的医学上和周期性的便血被做。另外的肠和 mes 伤寒脉管的结构显得正常。没有代表新容器生长，显微镜检查在整个粘膜下层和浆膜与扩大静脉揭示了正常结肠的粘膜。一起这些调查结果拿所有，病人作为 ICV 被诊断。他的手术后的功课是平静的。