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Background: The status of anastomotic blood perfusion is associated with the occurrence of anastomotic leakage after intestinal anastomosis. Fluorescence angiography (FA) with indocyanine green (ICG) can objectively assess intestinal blood perfusion. This study aims to investigate whether anastomotic perfusion assessment with ICG influences surgical decision-making during laparoscopic intestinal resection and primary anastomosis for colonic stricture after necrotizing enterocolitis. Methods: Patients who underwent laparoscopic intestinal resection and primary anastomosis between January 2022 and December 2022 were retrospectively analyzed. Before intestinal anastomosis, the ICG fluorescence technology was used to evaluate the blood perfusion of intestinal tubes on both sides of the anastomosis. After the completion of primary anastomosis, the anastomotic blood perfusion was assessed again. Results: Of the 13 cases, laparoscopy was used to determine the extent of the diseased bowel to be excised, and the normal bowel was preserved for anastomosis. The anastomosis was established under the guidance of ICG fluorescence technology, and FA was performed after anastomosis to confirm good blood flow in the proximal bowel. The anastomotic intestinal tube was changed in one case because FA showed a difference between the normal range of intestinal blood flow and the macroscopic prediction. There was no evidence of ICG allergy, anastomotic leakage, anastomotic stricture, or other complications. The median follow-up was 6 months, and all patients recovered well. Conclusions: The ICG fluorescence technology is helpful in precisely and efficiently determining the anastomotic intestinal blood flow during stricture resection and in avoiding anastomotic leakage caused by poor anastomotic intestinal blood flow to some extent, with satisfactory short-term efficacy. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) is a common opportunistic infection in solid organ transplant (SOT) recipients in the first 6 months after transplant. Late onset CMV infection or disease outside the classical risk period is uncommon and can present with atypical signs and symptoms. Here, we report a case of late onset CMV presenting as a colonic stricture more than 10 years after liver transplantation in the absence of traditional CMV risk factors. We also briefly review CMV colitis presenting as a mass or stricture in SOT recipients. [ABSTRACT FROM AUTHOR]

Background: With increasing survival of patients suffering from necrotizing enterocolitis (NEC) colonic strictures, as its late sequelae, is increasingly being seen and most of these patients present with chronic constipation. Case Series: Five patients of acquired colonic stricture presenting with abdominal distension and constipation are being reported here. All five patients varied in clinical features, age at presentation and surgical management. Three of them had abdominal distension and constipation with poor nutritional status. Primary resection with anastomosis could be done in only one while stoma was made initially in other patients. One patient presented with sealed perforation and fistula between jejunum and colon. All, except one patient, had stricture at splenic flexure. Histopathology of colon reported normal ganglion cells in all patients. Conclusion: All survivors of necrotizing enterocolitis, should be followed for the development of colonic stricture; It should be kept as important differential diagnoses of chronic constipation in children. [ABSTRACT FROM AUTHOR]

Colo-duodenal fistula is an extremely rare complication of Crohn’s disease (CD) and most patients require surgical treatment. The common presentation of such cases is fecaloid vomiting and the diagnosis is generally made by upper GI endoscopy. The presence of an associated colonic stricture further supports the fact that the disease started in the colon and requires surgical management to alleviate the symptoms. Small fistulas can be occluded with fibrin glue or clipping by endoscope, whereas the larger fistulas require surgical management. The patient presented to us with features of acute intestinal obstruction and was already on anti-tubercular therapy for 4 months due to a suspicion of abdominal TB. On examination, a lump was palpable in the right hypochondrium along with palpable bowel loops. CT scan showed mesenteric lymphadenopathy along with a stricture in the transverse colon which was confirmed by colonoscopy. A provisional diagnosis of malignant stricture with intestinal obstruction with high probability of carcinoma colon coexisting with tuberculosis was made and the patient underwent extended right hemicolectomy with ileocolic anastomosis with two-layered duodenal wall closure supplemented with jejunal serosal patch. The histopathology report was suggestive of CD. Thus, in any patient presenting with recurrent abdominal colics, episodes of obstruction or abdominal tuberculosis not responding to ATT, a differential diagnosis of IBD must always be kept in mind. The incidence of IBD is slowly rising in India over the past two decades. [ABSTRACT FROM AUTHOR]

Entamoeba histolytica infection can lead to colitis, peri-colic abscess, ameboma, perforation and rarely colonic stricture. Amebic colitis is usually managed with medical management and rarely needs surgical management. We hereby report a case of colonic amebiasis, presenting as a stricture in transverse colon, mimicking malignancy, and managed successfully. [ABSTRACT FROM AUTHOR]

Shiga toxin-producing Escherichia coli ( E. coli) is known to be one of the main causes of hemolytic uremic syndrome (HUS). Of the secondary complications of HUS, colonic stricture is relatively rare. We herein report on a Japanese girl that demonstrated sigmoid colon stricture secondary to HUS caused by an infection of E. coli O-157. Severe HUS occurred after the E. coli O-157 infection, so hemodialysis was performed due to renal failure. However, 1 month after recovery from HUS, abdominal symptoms occurred. A contrast study in the colon revealed a sigmoid colon stricture. The stricture was operatively resected. Thereafter, her postoperative course was uneventful. We also review the occurrence of this complication secondary to HUS in the literature. [ABSTRACT FROM AUTHOR]

The clinical presentations of gastrointestinal involvement from systemic vasculitis are diverse. Colonic involvement from systemic vasculitis is unusual. We report the first case of a symptomatic colonic stricture associated with rheumatoid vasculitis and another associated with systemic lupus erythematosus.The clinical, radiologic, and histologic features of two cases of symptomatic colonic strictures secondary to colonic involvement with vasculitis are described. The literature covering gastrointestinal involvement from vasculitis in these conditions is reviewed.Surgical resection of the colonic strictures was required in both patients and had a satisfactory outcome.These cases provide further evidence of the protean clinical presentations of intestinal involvement in systemic vasculitis. Although immunosuppression has been shown to be of value in the treatment of vasculitis affecting the gastrointestinal tract, surgical resection is required for established strictures. [ABSTRACT FROM AUTHOR]

The article discusses colonic strictures in cystic fibrosis (CF). It cites the gastrointestinal manifestations of pancreatic insufficiency, a feature of CF. It describes the pathophysiology of the gastrointestinal tract in CF as well as the complications associated with CF, including Crohn's disease, appendicitis and bowel tumors. It discusses developments in the management of pancreatic insufficiency in CF.

Conventional treatment for colonic obstruction due to cancer or benign anastomotic stricutres in high-risk patients or unresectable cases in some form of colostomy. This procedure has the negative aspects of requiring a general anesthetic and leaves the infirm patient with a stoma that they cannot easily attend to. Ablation of tumor by Nd-Yag laser has been available for several years, with passage of the laser fiber through a colonoscope. To evaluate the role of laser photocoagulation in the palliation of colorectal tumors or benign strictures, the authors summarized their initial experience, trying to define the indications, various methods of treatment, and complication rate in these patients. This technique is difficult to perform and has the added risk of intestinal perforation but does obviate anesthetic and surgical risks. Seven patients with recurrent metastatic colorectal obstruction, three patients with benign colonic strictures, and two patients with large villous tumors were treated with Nd-Yag laser passed via the colonoscope. The mean age was 71 years (range, 52 to 86 years). Five patients received sedatives only, six patients received epidural anesthetic, and one had a general anesthetic. The average total energy used was 3702 joules on noncontact fibers, and the average number of pulses was 126. Distance of the lesion from the anal margin ranged from 0.5 to 30 cm. Ten of twelve tumors were within 15 cm of the dentate line. In the most distal lesions, manual debulking with biopsy forceps facilitated the laser treatment. Symptomatic relief was achieved in all patients. One patient required a colostomy one month after treatment because of incontinence. Another patient needed a resection of a benign stricture after three laser treatments. Other than one case of microperforation, treated conservatively with antibiotics, no other complications occurred and there was no mortality. The authors believed that the Nd-Yag laser plays a specific role in the treatment of high-risk patients. [ABSTRACT FROM AUTHOR]

Intestinal obstruction in the newborn is a potentially life-threatening complication. The most common causes are meconium plug, meconium ileus, intestinal atresia, intestinal malrotation, and Hirschprung's disease. We present an unusual case of intestinal obstruction caused by torsion of an ovarian cyst. The left fimbria and ovary swirled around the sigmoid colon, causing colonic stricture. [ABSTRACT FROM AUTHOR]

Most patients with cystic fibrosis require oral administration of pancreatic enzymes to treat pancreatic insufficiency. Recent use of higher-strength enzyme preparations in large doses has been found to be associated with fibrotic strictures of the colon. We report a case of pan-colonic fibrosis due to pancreatic enzyme use. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 3 years old girl with post-diarrhea hemolytic uremic syndrome. It presents information on escherichia coli O157 infection occurred in an endothelial injury. It also presents information on the occurrence of serious gastrointestinal sequelae inD+HUS, renal complications, and hemolytic anemia.