In Lynch syndrome II, colon cancer was associated with endometrial and ovarian cancer. The aim of this study was an evaluation for the clinicopathologic characteristics of rectosigmoid adenomas on preoperative sigmoidoscopy in gynecologic cancer patients.
A total 187 gynecologic cancer patients(139 cervical, 35 ovarian, 13 endometrial cancer) and 58 normal controls were reviewed sigmoidscopic finding and pathologic reports retrospectively from September 1993 to March 2001.
The mean age of gynecologic cancer patients was 54(38-82) year-old and normal controls was 50(20-68) year-old. Total 26 adenomas were in 21 patients(11.2%) and 3 adenomas were in 3 normal controls(5.2%). The incidence of adenomas was 9.4% in cervical cancer, 8.6% in ovarian cancer and 38.5% in endometrial cancer. Multiple adenomas were in 5 gynecologic cancer patients and 0 normal controls. The incidence of advanced adenoma was 12.5% in cervical cancer, 25.5% in ovarian cancer, 83.5% in endometrial cancer and 33.3% in normal controls. The location of adenoma was 23.1% in rectum and 76.9% in sigmoid colon.
The incidence of adenomas and multiple adenomas were higher in gynecologic cancer patients than normal controls but not significantly. The incidence of advanced adenoma and adenomas were significantly higher in endometrial cancer than normal controls. Colonoscopic evaluation of whole colon will be recommanded in gynecologic cancer than sigmoidoscopy.
A case of massive intestinal bleeding from jejunal diverticulum is describe. A 62-year-old man was refered to our hospital because of melena and anemia. After admission, he showed massive hematochezia with unstable vital sign. Esophagogastroduodenocopy and colonoscopy, selective abdominal angiography, and RBC bleeding scanning were performed to seek the cause of the intestinal bleeding, but none of these studies revealed the source of bleeding. The examination of small bowel with methylcellulose showed multiple small jejunal diverticuli and a large diverticulum. Resection of the involved portion of jejunum was performed. On pathological examination, two mucosal loss lesions were detected, but ulcer or arteriovenous malformation were not seen in the resected jejunal diverticulum. The patient showed no more intestinal bleeding after operation. Although jejunal diverticuli are rare, the careful search for this complication in a patient with intestinal bleding is important.