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Rectal Abscess

M Popiolek, K Dehlaghi, S Gadan, B Baban, P Matthiessen
BACKGROUND AND AIMS: In mid-rectal cancer, the low colorectal anastomosis is, although feasible, sometimes avoided. The aim was to compare low Hartmann's procedure with intersphincteric abdomino-perineal excision of the rectum, in patients operated with total mesorectal excision for mid-rectal cancer in whom the low anastomosis was technically feasible but for patient-related reasons undesired. MATERIAL AND METHODS: A total of 64 consecutive patients with mid-rectal cancer who underwent low Hartmann's procedure (n = 34) or intersphincteric abdomino-perineal excision (n = 30) at one colorectal unit were compared regarding patient demography, short-term oncology, surgical outcome at 3 and 24 months, and long-term overall survival...
November 25, 2018: Scandinavian Journal of Surgery: SJS
B C Olsen, S T Sakkestad, F Pfeffer, A Karliczek
BACKGROUND AND AIMS: The International Study Group of Rectal Cancer has proposed that a pelvic abscess in the proximity of the anastomosis is considered an anastomotic leak, whether or not its point of origin is detectable. This study describes how the inclusion of pelvic abscesses alters the leakage rate. MATERIAL AND METHODS: Risk factors and postoperative complications in patients with visible anastomotic leakage ("direct leakage"), pelvic abscesses alone in the vicinity of a visibly intact anastomosis ("abscess leakage"), and no leakage were retrospectively evaluated...
November 25, 2018: Scandinavian Journal of Surgery: SJS
Elodie Bonin, Valérie Bridoux, Rachid Chati, Sabrina Kermiche, Julien Coget, Jean Jacques Tuech, Horace Roman
OBJECTIVE: Deep endometriosis may simultaneously infiltrate the vagina and the rectosigmoid, which associated resection may increase the risk of postoperative complications. Among these complications, rectovaginal fistula is one of the worst. To reduce the risk of rectovaginal fistula and related complications, surgeons may employ diverting stoma. The literature is rich in data concerning the usefulness of stoma in patients managed for low rectal cancer. However, extrapolation of these data to patients managed for rectal endometriosis is disputable...
November 6, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Mateusz Rubinkiewicz, Agata Czerwińska, Piotr Zarzycki, Piotr Małczak, Michał Nowakowski, Piotr Major, Andrzej Budzyński, Michał Pędziwiatr
BACKGROUND: Transanal total mesorectal excision (TaTME) is a new technique that is designed to overcome the limits of the open and laparoscopic approach for rectal resections. OBJECTIVE: This study is designed to compare TaTME with standard laparoscopic TME (LaTME). METHODS: We searched Medline, Embase, and Scopus databases covering a up to October 2018. Inclusion criteria for study enrolment: (1) study comparing laparoscopic resection of rectal cancer vs...
November 19, 2018: Journal of Clinical Medicine
Chun-Hui Peng, Ya-Jun Chen, Wen-Bo Pang, Ting-Chong Zhang, Zeng-Meng Wang, Dong-Yang Wu, Kai Wang
This study was undertaken to explore the causes, diagnosis, and treatment of anastomotic leakage after pull-through (PT) procedure for Hirschsprung disease (HD).A retrospective analysis of patients with anastomotic leakage after a PT procedure in the General Surgery Department of Beijing Children's Hospital from July 2013 to June 2016 was undertaken. The surgical characteristics, diagnosis, and treatment were retrospectively analyzed.Among the 213 patients who underwent PT procedures, 5 patients had a documented anastomotic leakage...
November 2018: Medicine (Baltimore)
Kerry J Roulston, Tehmina Bharucha, Jane F Turton, Katie L Hopkins, Damien J F Mack
Introduction: Hypervirulent capsular type K1 Klebsiella pneumoniae strains of clonal complex 23 (CC23) are associated with severe community-acquired pyogenic liver abscesses, often complicated by metastatic infections and significant mortality. The majority of hypervirulent strains reported are susceptible to most antibiotics except ampicillin. To the best of our knowledge, this is the first case of New Delhi metallo-β-lactamase ( bla NDM )-producing hypervirulent K. pneumoniae from the UK...
September 2018: JMM Case Reports
Xin Wang, Yongyang Yu, Wenjian Meng, Dan Jiang, Xiangbing Deng, Bing Wu, Hua Zhuang, Cun Wang, Yali Shen, Lie Yang, Hong Zhu, Ke Cheng, Yaqin Zhao, Zhiping Li, Memg Qiu, Hongfeng Gou, Feng Bi, Feng Xu, Rrenmin Zhong, Sen Bai, Ziqiang Wang, Zongguang Zhou
BACKGROUND AND PURPOSE: To evaluate the safety and efficacy of Total neoadjuvant treatment (TNT) in patients with rectal cancer with high risk factors. METHODS AND MATERIALS: We did this phase 2 trial in patients who were diagnosed with stage II-III rectal cancer with at least one of the high risk factors. Three cycles of induction CAPOX were followed by pelvic radiotherapy of 50.4 Gy/28 fractions and two cycles of concurrent CAPOX. Three cycles of consolidation CAPOX were delivered after radiotherapy...
November 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Khaoula Jellali, Ihsane Mellouki, Adil Ibrahimi
Many disorders of the digestive tract cause cutaneous manifestations that may be an indication of an underlying condition; hence dermatologist plays a key role in recommending that the patient see a gastroenterologist. Conversely, gastroenterologist often sees patients with mucocutaneous lesions suggesting possible association with well-known digestive disorders. Chronic inflammatory bowel diseases are the typical example of this essential collaboration between the two specialities. We report a case of Crohn's disease revealed by cheilitis granulomatosa...
2018: Pan African Medical Journal
Muhammed A Memon, Rossita M Yunus, Breda Memon, Aiman Awaiz, Shahjahan Khan
AIMS AND OBJECTIVES: The aim was to conduct a systematic review and meta-analysis of the randomized evidence to determine the relative merits of perioperative outcomes of laparoscopic-assisted (LARR) versus open rectal resection (ORR) for proven rectal cancer. MATERIALS AND METHODS: A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified English-language randomized clinical trials comparing LARR and ORR. The meta-analysis was prepared in accordance with the PRISMA statement...
October 23, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Takahiro Koyanagi, Yoko To, Miho Ando, Sakiko Matsuoka, Sumie Nakamura, Maki Goto, Haruhiko Kondo, Fuyuki Eguchi, Hiroshi Tsujioka
Primary peritoneal carcinosarcoma is extremely rare and only few cases have been reported in the literature to date. We herein present a case of carcinosarcoma of the Douglas pouch in a 73-year-old Japanese woman. The patient complained of fever and lower abdominal pain, and a large pelvic mass (>10 cm in diameter) was detected, with rectal invasion. Laparotomy was performed and revealed a left ovarian abscess and a Douglas pouch mass; however, there was no obvious tumor involvement of the bilateral ovaries or uterus...
November 2018: Molecular and Clinical Oncology
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...
December 2018: Updates in Surgery
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