A primary adenocarcinoma of the transverse colon mimicking Crohn’s disease: a case report and literature review

Diarrhoea and weight loss are presenting features of both Crohn’s disease and colorectal cancer; however, the two conditions can usually be distinguished on the basis of characteristic patterns of abnormalities observed at the time of initial blood testing and imaging. In patients with suspected Crohn’s disease these are often considered sufficient grounds to commence empirical treatment before the results of histology are available. This case report describes a 45-year-old man whose initial clinical, endoscopic and radiological investigations were strongly suggestive of a diagnosis of Crohn’s disease, but who subsequently was found to have an adenocarcinoma of the mid-transverse colon. He went on to have an emergency extended right hemi-colectomy

A rare case of isolated wound implantation of colorectal adenocarcinoma complicating an incisional hernia: case report and review of the literature

Abstract Background The reported case illustrates an instance of colonic adenocarcinoma presenting as an isolated tumour 3 1/2 years after open surgery. The presentation was in some respects unique as it was complicated by an incisional hernia and occurred in the anterior abdominal wall. A literature review was performed. Case presentation An 83 year old lady initially underwent an extended right open hemicolectomy for a mid-transverse colonic adenocarcinoma (T4N2M0). No adjacent structures were involved. After adjuvant chemotherapy, she was kept under regular surveillance. A CT scan and colonoscopy at one year were normal. At 18 months investigations including an ultrasound scan of the liver and a radioisotope bone scan were all negative. Over three and half years later the patient presented with an incisional hernia. Repeat CT scan and tumour markers were reported as negative. At operation, a mass was found within the anterior abdominal wall complicating the incisional hernia. This mass was widely resected and a laparotomy performed. Histology confirmed an adenocarcinoma of colonic origin extending to one of the lateral margins. A post-operative PET scan confirmed the absence of intra-abdominal pathology. Conclusion The literature regarding recurrence of colonic tumours after open surgery reports low incidences of this occurring within abdominal incisions. The literature indicates prognosis is poor, but the numbers are small and distinction is often not made between isolated recurrence and those with other sites of tumour recurrence. In order to avoid missing isolated wound implantation, careful consideration should be given to those who present with new pathology related to previous cancer surgery incisions, both clinically and radiologically.</p

Potential Factors of Mental Health Challenges During COVID-19 on the Young People in Dhaka, Bangladesh

In this manuscript, we perform a Chi-square association test to find whether there is an association between the quarrelsome environment in the residence and mental health challenge and the corresponding p-value found to be 0.011, which is statistically significant. In addition, we fit a logistic model to determine the factors influencing mental health challenges during the pandemic. The model shows that age, number of leaving home during the past 14 days, the effectiveness of work from home or online class, and feeling in response to COVID-19 are the significant factors affect the odds that a participant faces mental health challenges

Determinants of Internet Usage During COVID-19 on the Young People in Dhaka, Bangladesh

As the COVID-19 pandemic is spreading and becoming more contagious, people tend to stay home and face mental health challenges such as anxiety, fear, nervousness, and loneliness. In this time, students are using the internet heavily for their study purpose, and jobholders are for their official works. At the same time, the use of the internet might be a relief from those mental challenges. This manuscript assesses a correlation between daily internet usage before and during COVID-19 and found to be nearly strong positive (r=0.66). Then we determine the potential factors affecting daily internet usage during COVID-19 among Bangladeshi students and jobholders who are currently living in Dhaka city by the ordinary least square (OLS) regression method. Our results underpin that the type of internet, regular internet usage before COVID-19, and the effect of internet usage on the study are significantly affecting current internet usage

Occult small bowel perforation in a patient with Ehlers Danlos syndrome: a case report and review of the literature

Patients who present with a co-existing connective tissue disorder add a degree of complexity to operative intervention. We present an unusual case of a 53-year-old Caucasian female patient with Ehlers Danlos syndrome who presented with an occult perforation of the distal ileum. The patient had known small bowel diverticulae yet the perforation occurred within the normal bowel wall. The pre-operative CT only showed malrotation of the large bowel and did not correlate with the intra-operative findings. Our case has highlighted that although small bowel perforation is a rare occurrence, it may be more common in Ehlers Danlos and may present with atypical features. Perforation may also occur alongside normal bowel as well as diverticulae within the bowel. Where diverticulae exists within a patient with Ehlers Danlos syndrome and there is some diagnostic uncertainty, there should be a lower threshold for operative intervention. We present in the discussion a number of salient features and learning points