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A fixed narrowing means that it is not expansile. This can be because of the;
1) Inflammatory; like Crohn's disease or ulcerative colitis
2) Neoplastic; some growth (neo=new, plastic =growth), these can be benign or malignant (cancerous).
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Expansile means which can't be expanded or which does not have elasticity, which normally the sigmoid colon or the intestinal muscles have.
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Stenosis means constriction. The constriction can be again benign or cancerous. These constrictions can be because of some organ pushing the sigmoid colon wall from the outside. The constriction can also be because of the adhesions or scarring in the wall of sigmoid. The biopsy (taking a small piece from the constriction and sending for histopathology) only can tell the nature of the constriction/stenosis. This or narrowing of the colon cannot be corrected conservatively (by medical measures) and would need surgery. The biopsy report can only determine if it is serious (cancerous) or not (benign).
Diverticulum are outpouching of the walls of colon. They usually occur with the age and people who eat less fibers in diet are prone to it. Most of the people after the age of 50 will have single to multiple diverticulum. They are benign things and most of the times are without any symptoms unless complication like infection or perforation occurs. This is not worrisome. Read about them in this resource;
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As I mentioned, a stenosis can be benign. Of course few can be malignant also, but the histopathology can only answer this. So from your narrowing, a piece would be taken for the microscopic examination and that will decide the issue. The colon cancer survival is dependent on two things;
2) Staging, which is called as Duke's staging. Any cancer which is just confined to the wall of the colon will have almost normal life expectancy and it is treatable.
Fatty benign adrenal nodule and reactive porta hepatis lymph node are considered as non pathological phenomenon and are not worrying. Still I would further evaluate the porta hepatis nodule and may go for further investigations for it. As I said they do not require treatment.
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