Carcinoma of sigmoid colon following urinary diversion: a case report and review of literature
- PDF / 818,685 Bytes
- 4 Pages / 610 x 792 pts Page_size
- 14 Downloads / 196 Views
Open Access
Case report
Carcinoma of sigmoid colon following urinary diversion: a case report and review of literature Muhammad N Khan*1, Abul H Naqvi2 and Richard E Lee3 Address: 1General Surgery, L & D Hospital, Lewsey Road, Luton. LU 4 0ET, UK, 2General Surgery, Mullingar General Hospital, West Meath Co. Ireland and 3Colorectal Surgery, Queens Hospital Burton, UK Email: Muhammad N Khan* - [email protected]; Abul H Naqvi - [email protected]; Richard E Lee - [email protected] * Corresponding author
Published: 08 June 2004 World Journal of Surgical Oncology 2004, 2:20
Received: 13 January 2004 Accepted: 08 June 2004
This article is available from: http://www.wjso.com/content/2/1/20 © 2004 Khan et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
Urinary diversionadenocarcinoma colonexstrophy
Abstract Background: The association of ureterosigmoidostomy with colonic cancer is well established. A 100-fold increased risk of malignancy has been proposed in association with ureterosigmoidostomy. Characteristically there is a latent period of around 20–30 years before the occurrence of cancer. Case presentation: An unusual case of adenocarcinoma of the colon in a 36-year-old patient is presented. The patient underwent three operations in his infancy for exstrophy but after failure to close bladder, ureterosigmoidostomy was attempted at the age of 5 years and was converted to an ileal conduit after 8 months. At the age of 36 years, 30 years following ileal conduit urinary diversion for exstrophy, he presented in emergency with large bowel obstruction due to adenocarcinoma of the sigmoid colon. Conclusion: Patients who undergo urinary diversion for exstrophy may be kept on a regular follow-up surveillance colonoscopy as most of these young adults may later present with vague abdominal symptoms which may not be taken seriously until they increase to an extent as to present with intestinal obstruction as in the present case.
Background The ureterosigmoidostomy is reported to increase the risk of malignancy by 100-fold increased risk of malignancy [1-3]. Characteristically this occurs after a latent period of 20–30 years. Colonic mucosa has been shown to be at increased risk of cancer development after prolonged exposure to urine [4], a term urocolonic tumors was coined by Gittes to explain this phenomenon [5]. The pathogenesis of these tumors is
not clear. One theory suggests production of nitrite and Nnitroso compounds from nitrate by the nitrate reducing bacterial flora in the presence of neutral colonic pH [6]. Although this was challenged by Stribling [7] and Sahands et al [8], who documented very low levels of Nnitroso compounds production in the rat models treated with ascorbic acid as compared to controls, yet both groups of rats produced urocolonic tumors with same frequency. To answer the question another theory of phagoc
Data Loading...
