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Rectal Abscess

Emma Westerduin, Marinke Westerterp, Willem A Bemelman, Pieter J Tanis, Anna A van Geloven
BACKGROUND: Low Hartmann's procedure (LHP) and intersphincteric abdominoperineal resection (iAPR) are both surgical options in the treatment of distal rectal cancer when there is no intention to restore bowel continuity. This study aimed to evaluate current practice among members of the Dutch Association of Coloproctology (WCP). METHODS: An online survey among members of the WCP who represent 66 Dutch hospitals was conducted. The survey consisted of 15 questions addressing indications for surgical procedures and complications...
October 17, 2018: Acta Chirurgica Belgica
Ismail Mahmood, Fuad Mustafa, Basil Younis, Khalid Ahmed, Ayman El-Menyar, Mohammad Asim, Ammar Al-Hassani, Ruben Peralta, Hassan Al-Thani
BACKGROUND: Intestinal disruption following blunt abdominal trauma (BAT) continues to be associated with significant morbidity and mortality despite the advances in resuscitation and management. We aim to analyze the management and postoperative outcomes of intestinal injuries secondary to blunt abdominal trauma. METHOD: We retrospectively reviewed all adult patients with intestinal injuries who underwent laparotomy for BAT between December 2008 and September 2015 at Level I trauma center...
September 24, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
M Boulianne, G Bouchard, J Cloutier, A Bouchard
INTRODUCTION: A rectoseminal vesicle fistula after a low anterior resection for rectal cancer is a rare complication despite their anatomic proximity. From a Medline search from 1966 to date, a total of twenty-one previous cases of coloseminal vesicle fistula have been reported. From these cases, eleven were a complication of laparoscopic low anterior resection for rectal cancer. DESCRIPTION OF THE CASE: This report presents the case of a 63-year-old patient who was readmitted to the hospital on the fifteenth postoperative day after his surgical intervention for fever, abdominal pain, dysuria and pneumaturia...
2018: International Journal of Surgery Case Reports
Grégoire Bessi, Laurent Siproudhis, Alexandre Merlini l'Héritier, Timothée Wallenhorst, Eric Le Balc'h, Guillaume Bouguen, Charlène Brochard
AIM: Rectal flap advancement is still a part of therapeutic management of anal fistulas. Data on the outcome of rectal flap advancement in patients with Crohn's Disease (CD) is scarce. Our objective was to ascertain rates of failure of rectal flap advancement and to determine predictive factors for failure, with a special focus on CD. METHOD: The patients details, the characteristics of the fistula and the main clinical and therapeutic events were prospectively assessed among patients who underwent rectal flap advancement...
September 10, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Peter Mallett, Caroline Hart, Josip Marjanovic, Damian Maguire, Majella McCullagh, Andrew Thompson
QUESTION 1: Which procedure may have been most appropriate to offer an initial clue to her diagnosis? Abdominal X-ray. Digital rectal examination. Perianal swab for streptococcal infection. Sweat test. Ultrasound scan of the abdomen. At 6 months of age, she presented with a second abscess, constipation and poor weight gain. QUESTION 2: What is the most likely diagnosis?  Congenital anorectal anomaly. Cow's milk protein allergy. Hirschsprung's disease. Immunodeficiency disorder. Infantile perianal Crohn's disease...
September 3, 2018: Archives of Disease in Childhood. Education and Practice Edition
Lei Wang, Tenghui Ma
OBJECTIVE: The aim of this study is to introduce a new type of cross suture in closing peritoneal incision after abdominoperineal resection (APR) for rectal cancer. METHODS: This new type of cross suture was firstly proposed and applied in a small cohort in our hospital. In this study, we reported its efficacy and safety. From Feb 2018 to May 2018, 8 cases (5 male, 3 female) of rectal cancer from the Sixth Affiliated Hospital of Sun Yat-Sen University receiving APR with new cross suture, were analyzed retrospectively...
August 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Steven Schulberg, Vanessa Al-Feghali, Kevin Bain, Josef Shehebar
Kaposi's sarcoma is a fatal disease that typically presents with cutaneous manifestations in immunocompromised individuals. There are a small number of documented cases where patients diagnosed with this disease present without cutaneous lesions. We present a 35-year-old man with recurrent rectal abscesses and fistula-in-ano, which required multiple drainage procedures. Further investigation revealed a diagnosis of HIV-AIDS, and biopsy of a rectal mass confirmed the diagnosis of visceral Kaposi's sarcoma, despite the absence of cutaneous involvement...
August 20, 2018: BMJ Case Reports
Nao Kakizawa, Shingo Tsujinaka, Yasuyuki Miyakura, Rina Kikugawa, Fumi Hasegawa, Hideki Ishikawa, Sawako Tamaki, Jun Takahashi, Toshiki Rikiyama
BACKGROUND: Diversion colitis (DC) is characterized by nonspecific inflammation in the remaining colon or rectum, and loss of the fecal stream plays a major role in the disease's development. Although the majority of patients are asymptomatic, medical and/or surgical treatment is required for those who are symptomatic. There is a particular interest on how to manage patients with acute and severe clinical presentations, but the pathogenesis is not fully understood. We report the rare case of a man with acute and severe DC mimicking ulcerative colitis (UC) with extra-intestinal manifestations that was successfully managed with surgical treatment...
August 2, 2018: Surgical Case Reports
Piotr Małczak, Magdalena Mizera, Grzegorz Torbicz, Jan Witowski, Piotr Major, Magdalena Pisarska, Michał Wysocki, Marcin Strzałka, Andrzej Budzyński, Michał Pędziwiatr
Introduction: Over the past years the incidence of colorectal cancers has increased worldwide. Currently it is the most common gastrointestinal malignancy worldwide. The laparoscopic approach has become the gold standard for surgical treatment. However, a recently published meta-analysis showed no difference in short- and long-term oncological outcomes of laparoscopy for treating rectal cancer. Aim: To assess current literature on short-term outcomes of rectal cancer treatment using laparoscopic surgery in comparison to the open approach...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Giuliano Barugola, Elisa Bertocchi, Irene Gentile, Nicola Cracco, Carlo Augusto Sartori, Giacomo Ruffo
The aim was to report our experience with delayed colo-anal anastomosis (DCA) to avoid permanent stoma for complex rectal cases evaluating short- and long-term outcomes. Nine patients who underwent DCA from 2011 to 2016 were collected and analysed case by case. We considered medical history and surgical outcomes. Long-term bowel function was evaluated using the Wexner and low anterior resection syndrome (LARS) score at 6, 12 and 24 months. The range from previous surgery and salvage procedure was 337 days...
June 27, 2018: Updates in Surgery
Sarah Blue, Melissa Najarian
Penetrating gluteal wounds with retained foreign bodies are relatively uncommon and therefore there is no agreed-upon method of extraction. Retrieval of such objects can be difficult to achieve due to imperfect anatomy and a lack of clear planes across which the objects traverse, sometimes requiring novel techniques for foreign body retrieval. We saw a 37-year-old male with a 2-month history of a draining abscess on his right buttock. CT and manual probing of the wound demonstrated a 5-cm tract with a possible foreign body within...
June 2018: Journal of Surgical Case Reports
Luciana La Rosa, Laura Svidler López, Andrea C Entrocassi, Brian Santos, Dolores Caffarena, Marcelo Rodríguez Fermepin
From 2003 to date there has been a rising number of reports from developed countries on cases of lymphogranuloma venereum with anorectal localization in HIV-infected men who have sex with men. This localization differs from the classical inguinal abscesses which are typical of the disease in the tropics. The objective of this work is to document the presence of anorectal lymphogranuloma venereum in Buenos Aires and to describe its varied clinical manifestations. In the context of a systematic survey of rectal chlamydial infection, in just one trimester, eight cases of lymphogranuloma venereum caused by Chlamydia trachomatis biovar LGV were identified in HIV-infected men who have sex with men...
2018: Medicina
Tahrin Mahmood, Robert Puckrin, Linda Sugar, David Naimark
Rationale: Staphylococcus-associated glomerulonephritis (SAGN) is a rare immune complex-mediated glomerulonephritis associated with active Staphylococcus infection. We report a case illustrating the importance of clinical history and kidney biopsy findings in establishing the correct diagnosis. Presenting concerns of the patient: We report the case of a 64-year-old man with alcohol-associated cirrhosis, type 2 diabetes mellitus, and hypertension who presented to hospital with lower back and abdominal pain, rectal bleeding, a purpuric lower extremity rash, and oliguric acute kidney injury with microscopic hematuria and nephrotic-range proteinuria...
2018: Canadian Journal of Kidney Health and Disease
R O Perez, A Habr-Gama
The surgical management of rectal cancer has evolved from a disease without any possibility of cure in the early 1700s where surgical management consisted of the palliative drainage of disease related abscesses to the present day where surgical cure is not only possible but also possible with sphincter or even organ preservation. Prof Habr-Gama's lecture describes the evolution of the surgical management of rectal cancer and the current focus on organ preservation.
May 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Ken Imaizumi, Yuji Nishizawa, Koji Ikeda, Yuichiro Tsukada, Takeshi Sasaki, Masaaki Ito
PURPOSE: Perineal wound infection (PWI) rates are high after abdominoperineal resection (APR) and total pelvic exenteration (TPE). This study identified risk factors for PWI after surgery for anorectal tumors and examined the relationship between the surgical excision volume with the PWI degree. METHODS: A retrospective review involving 135 patients who underwent surgical excision of anorectal tumors was performed. Superficial PWI included cellulitis and superficial dehiscence; deep PWI included major dehiscence, perineal abscess, and presacral abscess...
June 1, 2018: Surgery Today
Andreas Brandt Gormsen, Jon Erik Fraes Diernæs, Jørgen Skov Jensen, Uffe Koppelhus
This is a case report of lymphogranuloma venereum (LGV) manifesting as haemorrhagic proctocolitis in a homosexual HIV-positive male. The primary symptom was a rectal abscess, which was initially surgically treated and subsequently insufficiently treated with single-dose tablet azithromycin. The patient's symptoms were successfully treated after a 21-day doxycycline regime. LGV is a se xually transmitted infection with a rising incidence among persons with risk behaviour. This case report underlines the importance, that all positive rectal screenings for Chlamydia trachomatis should be routinely serotyped...
May 14, 2018: Ugeskrift for Laeger
Hamza Rahimi, Anthony C Venbrux, Vincent Obias
Enterocutaneous fistulas (ECFs) can be one of the complications found after surgical intervention for rectal cancer. Interventional modalities consisting of surgical, endoscopic, and radiological methods are often implemented to treat postoperative symptomatic complications. We present the case of 61-year-old Caucasian man who presented to us with a recent diagnosis of rectal cancer that had invaded the levators as well as anteriorly into the prostate, and who underwent low anterior resection with a diverting loop ileostomy...
June 2018: Radiology Case Reports
Yun Hee Kang, Eunji Han, Geon Park
PURPOSE: The purpose of this study was to present various clinical etiologies of hypermetabolic pelvic lesions on postoperative positron emission tomography/computed tomography (PET/CT) images for patients with rectal and sigmoid cancer. METHODS: Postoperative PET/CT images for patients with rectal and sigmoid cancer were retrospectively reviewed to identify hypermetabolic pelvic lesions. Positive findings were detected in 70 PET/CT images from 45 patients; 2 patients who were lost to follow-up were excluded...
April 2018: Annals of Coloproctology
Romain Didailler, Quentin Denost, Paula Loughlin, Edouard Chabrun, Julie Ricard, Flor Picard, Frank Zerbib, Eric Rullier
BACKGROUND: Total mesorectal excision and preoperative radiotherapy in mid and low rectal cancer allow us to achieve very good oncological results. However, major and refractory low anterior resection syndrome and fecal incontinence alter the quality of life of patients with a long expected life span. OBJECTIVE: We assessed the functional results of patients treated by antegrade enema for refractory low anterior resection syndrome and fecal incontinence after total mesorectal excision...
June 2018: Diseases of the Colon and Rectum
K You, R Bendl, C Taut, R Sullivan, M Gachabayov, R Bergamaschi
BACKGROUND: The aim of this RCT was to determine whether elective resection following successful non-operative management of a first episode of acute sigmoid diverticulitis complicated by extraluminal air with or without abscess is superior to observation in terms of recurrence rates. METHODS: This was a single-centre, sequential design RCT. Patients were randomized to elective surgery or observation following non-operative management and colonoscopy. Non-operative management included nil by mouth, intravenous fluids, intravenous antibiotics, CT with intravenous contrast on arrival at hospital, and repeat CT with intravenous and rectal contrast on day 3 in hospital...
July 2018: British Journal of Surgery
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