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Michael D Cearns, Samantha Hettige, Paolo De Coppi, Dominic N P Thompson
OBJECTIVE It is well established that Currarino syndrome (CS) may be associated with spinal dysraphism. Here, the authors report on 10 CS patients with dysraphic anomalies who had undergone a combined neurosurgical and general surgical approach to repair the dysraphic anomalies and resect the presacral mass in a single operation. They discuss the spectrum of spinal dysraphism that may coexist in CS in the context of its developmental etiology. METHODS Children with a confirmed CS diagnosis who had undergone the combined operative approach were identified from a departmental database...
August 10, 2018: Journal of Neurosurgery. Pediatrics
Jessica Caudwell-Hall, Ixora Kamisan Atan, Rodrigo Guzman Rojas, Susanna Langer, Ka Lai Shek, Hans Peter Dietz
BACKGROUND: Trauma to the perineum, levator ani complex, and anal sphincters is common during vaginal childbirth, but is often clinically underdiagnosed, and many women are unaware of the potential for long term damage. OBJECTIVES: In this study we use transperineal ultrasound to identify how many women will achieve a normal vaginal delivery without substantial damage to the levator ani or anal sphincter muscles, and to create a model to predict patient characteristics associated with successful atraumatic normal vaginal delivery...
July 28, 2018: American Journal of Obstetrics and Gynecology
C Santorelli, J Hollingshead, S K Clark
BACKGROUND: In patients who undergo restorative proctocoletomy (RPC) a pouchogram is often used to assess the integrity of the ileal pouch-anal anastomosis (IPAA) before closing the covering ileostomy. There are no good data to support this practice. The aim of the study was to investigate whether contrast pouchography was clinically useful after RPC. METHODS: We conducted a retrospective study of patients who had undergone RPC with a covering ileostomy between September 2013 and September 2015...
July 30, 2018: Techniques in Coloproctology
Haoxuan Wu, Tao Zhang, Xianze Chen, Xiaoqian Jing, Xi Cheng, Zijia Song, Lan Zhu, Yonggang He, Xiaopin Ji, Huan Zhang, Ren Zhao
OBJECTIVE: To explore the factors affecting the operative difficulty of triple-port laparoscopic surgery (TLS) in anterior resection. METHODS: A retrospective case-control study was carried out. Clinical and MRI imaging data of 106 colorectal cancer cases undergoing TLS anterior resection at Department of Colorectal Surgery of Ruijin Hospital between 2013 and 2016 were retrospectively analyzed. INCLUSION CRITERIA: (1) patients receiving TLS anterior resection (Dixon operation); (2) preoperative stageI( to III( malignant tumor;(3) distance of 5-15 cm from inferior margin of tumor to anal verge; and (4) available preoperative rectal MRI...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Madhusmita, Rohini G Ghasi, M K Mittal, Deepak Bagga
Purpose: To evaluate the spectrum of magnetic resonance imaging (MRI) findings in pediatric patients with anorectal malformation (ARM) and compare the accuracy of MRI and distal cologram (DC) findings using surgery as reference standard. Materials and Methods: Thirty pediatric patients of age less than 14 years (19 boys and 11 girls) with ARM underwent preoperative MRI. MRI images were evaluated for the level of rectal pouch in relation to the pelvic floor, fistula, and development of sphincter muscle complex (SMC)...
April 2018: Indian Journal of Radiology & Imaging
I Karanikas, C Koutserimpas, P Siaperas, A Skarpas, J Karoubalis, G Velimezis
AIM: Two-dimensional transrectal ultrasonography can nowadays be safely used for preoperatively evaluation of perianal fistulas. The aim of this study is to demonstrate its efficacy by comparing the results of this imaging technique with the surgical findings, as well as recurrence rates. PATIENTS AND METHODS: A 4-year retrospective study with a mean follow-up of 4.7 years was performed, including patients treated surgically for a perianal fistula at the surgical department of a tertiary secondary hospital...
July 2018: Il Giornale di Chirurgia
Yu Wang, Chao Gu, Yongjun Huo, Weiwei Han, Jinfen Yu, Chengzong Ding, Xiuyu Zhao, Yunfang Meng, Chuanting Li
To explore the feasibility of using diffusion tensor imaging (DTI) in the diagnosis of anal fistula and evaluating its activity.Thirty-four patients with perianal fistulas were examined with DTI on a 3.0 T magnetic resonance imaging (MRI) before undergoing surgery. Based on the surgery requirement and preoperative examinations, the lesions fell into 2 groups: the positive inflammation activity (PIA) group and the negative inflammation activity (NIA) group. Each lesion was divided into 3 regions of interest (ROIs) (i...
July 2018: Medicine (Baltimore)
Takayuki Yamamoto, Paulo Gustavo Kotze, Antonino Spinelli, Remo Panaccione
Fistula-associated anal carcinoma in patients with Crohn's disease (CD) is a rare condition. More recently, this entity has been increasingly reported likely due to increased recognition, and the incidence may be greater than once appreciated. There remains a paucity of data regarding the incidence, diagnosis, treatment, and outcome of fistula-associated anal carcinoma. Area covered: This review evaluates the clinical features, pathology, treatment, and prognosis of fistula-associated anal carcinoma in patients with CD...
July 24, 2018: Expert Review of Gastroenterology & Hepatology
Elliot A Asare, Timothy J Vreeland, Barry W Feig
INTRODUCTION: The management of perirectal tumors often requires rectal wall resection, and sometimes a complete proctectomy is required. Access to posterior perirectal masses via a posterior, transcoccygeal approach (Kraske procedure) avoids dissection of the intraperitoneal rectum. PATIENT: The patient was a 63-year-old male who presented to his primary care physician with debilitating perirectal pain of several months' duration. He did not respond to therapy with pain medications and topical agents, and underwent a lateral internal sphincterotomy for what was thought to be an anal fissure, without relief prior to referral...
September 2018: Annals of Surgical Oncology
Glaucia Miranda Varella Pereira, Zilma Silveira Nogueira Reis, Beatriz Deoti E Silva Rodrigues, Kelly Cristine Lacerda Rodrigues Buzatti, Maria Cristina da Cruz, Marilene Vale de Castro Monteiro
PURPOSE: Disorders related to pelvic floor include urinary incontinence (UI), anal incontinence, pelvic organ prolapse, sexual dysfunction and pelvic pain. Because pelvic floor dysfunctions (PFD) can be diagnosed clinically, imaging techniques serve as auxiliary tools for establishing an accurate diagnosis. The objective is to evaluate the PFD in primiparous women after vaginal delivery and the association between clinical examination and three-dimensional ultrasonography (3DUS). METHODS: A cross-sectional study was conducted in a in tertiary maternity...
August 2018: Archives of Gynecology and Obstetrics
Kohei Ishioka, Fumikazu Koyama, Hiroyuki Kuge, Takashi Inoue, Shinsaku Obara, Takayuki Nakamoto, Yoshiyuki Sasaki, Yasuyuki Nakamura, Maiko Takeda, Chiho Ohbayashi, Masamitsu Kuwahara, Masayuki Sho
BACKGROUND: Anal gland carcinoma with perianal Paget's disease is rare, and anal gland carcinoma in situ is extremely rare. No cases of anal gland carcinoma in situ with pagetoid spread have been previously reported. CASE PRESENTATION: Physical examination in a 75-year-old woman revealed an erythematous, inflamed, perianal skin lesion. Neither colposcopy, cystoscopy, colonoscopy, computed tomography, nor magnetic resonance imaging showed evidence of malignant genitourinary or gastrointestinal lesions...
June 25, 2018: Surgical Case Reports
Hyo Jung Park, Hyun Jin Kim, Seong Ho Park, Jong Seok Lee, Ah Young Kim, So-Woon Kim, Seung-Mo Hong
OBJECTIVE: The purpose of this study is to evaluate the MRI features of primary anorectal malignant melanoma and to correlate these features with its clinical and pathologic characteristics. MATERIALS AND METHODS: The medical records of 12 patients (five men and seven women; mean age [± SD], 60.8 ± 10.0 years) with pathologically proven primary anorectal melanoma were retrospectively reviewed. MRI findings were analyzed to determine the shape, size, distance from the anal verge, presence of perirectal or anal infiltration, signal intensity on T1- and T2-weighted images, presence of diffusion restriction, contrast enhancement pattern of the lesion, presence of lymphadenopathy, and occurrence of bowel obstruction...
August 2018: AJR. American Journal of Roentgenology
Ali Alsaadi, Hamdi A Alsufiani, Mohammad D Allugmani, Altaf Hussain Gora
Esophageal lung is a rare communicating bronchopulmonary foregut malformation in which the main bronchus arising from the trachea is absent. The affected lung is usually hypoplastic and aerated via an anomalous airway originating from the esophagus. Other anomalies such as esophageal atresia with tracheoesophageal fistula or VACTERL (vertebral defects, anal atresia, cardiac defects, tracheoesophageal fistula, renal anomalies, and limb abnormalities) association can co-exist. The initial radiographic findings may be normal, but subsequent imaging usually shows progressive and recurrent lung collapse, probably because of recurrent aspiration through the anomalous airway and poor compliance of the affected lung during breathing...
April 2018: Radiology Case Reports
Julian C Hong, Yunfeng Cui, Bhavik N Patel, Christel N Rushing, Austin M Faught, Jared S Eng, Kyle Higgins, Fang-Fang Yin, Shiva Das, Brian G Czito, Christopher G Willett, Manisha Palta
PURPOSE: Imaging parameters from 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) before and after chemoradiation therapy (CRT) for anal canal cancer correlate with clinical outcomes. This prospective, hypothesis-generating pilot study investigates the relationship between interim PET imaging during CRT for anal canal cancer and clinical outcome. METHODS AND MATERIALS: From June 2012 to August 2015, 30 patients with anal canal cancer were enrolled in a prospective clinical study of PET prior to and during CRT after ∼30 Gy...
May 4, 2018: International Journal of Radiation Oncology, Biology, Physics
F A Fasola, O W Aworanti
Atopic transverse myelitis is a rare disorder that is defined as a localized myelitis of an unknown cause in patients with either high immunoglobulin E (IgE) level or mite-specific IgE or coexistent atopic disease. It is a cause of intramedullary cord lesions, but its diagnosis does not need tissue confirmation. We report a case of a patient who presented with bladder and anal incontinence, paresthesia, and lower limb weakness. Neither IgE level nor mite-specific IgE level could be determined due to lack of fund; however, magnetic resonance imaging (MRI) of the thoracolumbar region showed hypotense-isotense lesion within the spinal cord at T4 vertebral level, suggestive of transverse myelitis...
June 2018: Nigerian Journal of Clinical Practice
Philippe Bulens, Melissa Thomas, Christophe M Deroose, Karin Haustermans
Radiotherapy is the standard of care in the multimodality treatment of a variety of gastrointestinal (GI) tumours, such as oesophageal cancer, gastric cancer, rectal cancer and anal cancer. Additionally, radiotherapy has served as an alternative for surgery in patients with liver cancer, cancer of the biliary tract and pancreatic cancer. Positron-emission tomography (PET), generally in combination with computed tomography (CT), has an established role in the diagnosis, response assessment and (re-)staging of several GI tumours...
June 4, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
Jonas F Schiemer, Lennart Zimniak, Edin Hadzijusufovic, Hauke Lang, Werner Kneist
BACKGROUND: Pelvic intraoperative neuromonitoring during nerve-sparing robot-assisted total mesorectal excision (RTME) is feasible. However, visual separation of the neuromonitoring process from the surgeon console interrupts the workflow and limits the usefulness of available information as the procedure progresses. Since the robotic surgical system provides multi-image views in the surgeon console, the aim of this study was to integrate cystomanometry and internal anal sphincter electromyography signals to aid the robotic surgeon in his/her nerve-sparing technique...
June 2018: Techniques in Coloproctology
Ali Kilic, Abdullah Sisik
BACKGROUND: One of the minimally invasive methods used in the surgical treatment of large-based polypoid lesions located in the rectum is transanal minimally invasive surgery (TAMIS). This method, which relieves patients from the severe morbidities of invasive surgical procedures, is performed in both malign (T1-T2) and benign lesions. Difficulty of suturation after TAMIS emerges as the most important factor to prolong the procedure. We aimed to analyse the efficacy of TAMIS procedure with partial thickness resection without suturation...
2018: Annali Italiani di Chirurgia
Joshua D Reber, John M Barlow, Amy L Lightner, Shannon P Sheedy, David H Bruining, Christine O Menias, Joel G Fletcher
Ileal pouch-anal anastomosis, or J pouch, surgery has become the procedure of choice for treatment of medically refractory ulcerative colitis and familial adenomatous polyposis. Overall, this operation is associated with a low rate of postoperative morbidity and good long-term function. However, when complications develop, there is a heavy reliance on imaging to facilitate an accurate diagnosis. Reported postoperative complication rates range from 5% to 35%. Complications generally can be categorized as structural, inflammatory, or neoplastic conditions...
July 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Marcel Pratavieira, Anally Ribeiro da Silva Menegasso, Franciele Grego Esteves, Kenny Umino Sato, Osmar Malaspina, Mario Sergio Palma
Aggressiveness in honeybees seems to be regulated by multiple genes, under the influence of different factors, such as polyethism of workers, environmental factors, and response to alarm pheromones, creating a series of behavioral responses. It is suspected that neuropeptides seem to be involved with the regulation of the aggressive behavior. The role of allatostatin and tachykinin-related neuropeptides in honeybee brain during the aggressive behavior is unknown, and thus worker honeybees were stimulated to attack and to sting leather targets hung in front of the colonies...
July 6, 2018: Journal of Proteome Research
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