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Ricardo E Núñez-Rocha, Jerónimo Andrade-Restrepo, Daniel Gómez-Carrillo, Mariam Rolón, Rafael García Duperly, Rocio Del Pilar López-Panqueva
INTRODUCTION AND IMPORTANCE: Pemphigus Vulgaris (PV) is a low incidence autoimmune mucocutaneous bullous disease, in which pathogenic antibodies are directed against the keratinocyte cell surface. Although anal involvement is unusual, correlations between its appearance and disease severity have been recently reported. CASE PRESENTATION: A 42-year-old male presented with an anal fissure and a year of recurrent oral and pharyngeal aphtha. A chemical sphincterotomy with botulinum toxin plus fissurectomy was performed...
January 2024: International Journal of Surgery Case Reports
#22
JOURNAL ARTICLE
Levent Eminoğlu
UNLABELLED: OBJECTIVE; The aim of this study is to evaluate the results of patients treated by stapler hemorrhoidopexy for hemorrhoidal disease with a long term foloow up. MATERIAL AND METHOD: Patients who were operated with stapled hemorrhoidopexy (SH) technique between 01/01/2009 and 01/01/2019 in the general surgery department were included. Patients with stage 2 and stage 3 hemorrhoidal disease included. All patients were operated by the same surgeon using a 33-mm circular PPH stapler...
2023: Annali Italiani di Chirurgia
#23
JOURNAL ARTICLE
W W Li, N Li, K Ma, L Q Huang, C Y Sun, N Li, Z G Zhang
In the surgical treatment of hemorrhoids, rectal prolapse, rectal cancer, anal fissures, or anal fistulas, inadvertent damage to the nerves or muscles responsible for bowel control may potentially lead to varying degrees of fecal incontinence (FI). Surgeons need to conduct preoperative assessments based on the patient's individual condition to select an appropriate surgical plan, aiming to minimize the incidence of postoperative FI and improve the patient's postoperative quality of life as much as possible while effectively treating the disease...
December 25, 2023: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
#24
JOURNAL ARTICLE
Y Yang, F Zheng, J Li, Z Xu, L L Li, P F Duan, J Tang, Q Huang
Objective: This study aimed to investigate the viability and safety of a novel defecator in managing rectal fecal impaction. Methods: In a descriptive case series, this new defecator was administered to constipated individuals among the ages of 18 and 80 years who met the diagnostic criteria for rectal fecal impaction and were identified with acute rectal fecal impaction through CT scans. The contraindications for this defecator included: (1) Anal stenosis, acute intestinal obstruction, and intestinal perforation; (2) Concomitant rectal malignant tumors; (3) Coagulation dysfunction, low platelet counts, gastrointestinal bleeding, or other bleeding risks; (4) Patients with severe underlying conditions affecting the heart, brain, lungs, or other systems; (5) Individuals with mental health disorders...
December 25, 2023: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
#25
JOURNAL ARTICLE
Ishaq Malik, Abdus Sami, Waseem Yousuf, Syed Tariq, Shadan Jan, Tabish Niyaz
Background: Lower gut bleeding is an alarming sign among caregivers. Determining the etiology is of utmost importance for further management. This is the first study conducted in northernmost India. Methods: This cross-sectional study was conducted at the Department of Pediatrics, Government Medical College, Srinagar. This study aimed to describe the etiology of lower gastrointestinal bleeding in the age group of 1-18 years over the past 5 years from June 2017 to June 2022. Results: A total of 310 children presented with hematochezia (53...
July 2023: Middle East Journal of Digestive Diseases
#26
JOURNAL ARTICLE
Zelalem Asefa, Atalel Fentahun Awedew
Chronic anal fissure is one of the most common benign anorectal health conditions, causing significant morbidity, quality of life, and economic loss. Eight randomized controlled trials with a total population size of 1035 were eligible for analysis. Seven studies included both males and female, while one only included females. The majority of randomized controlled trials involved female dominance [54.9% (43.5-66.3)] and posterior midline location [86.1% (95% CI 81.5-90.8%)]. This meta-analysis of randomised control trials found that overall postoperative healing was 90...
November 28, 2023: Scientific Reports
#27
REVIEW
Keith J Geraghty, Colum A O'Reilly, Peter M Neary
BACKGROUND: Haemorrhoidectomy in Crohn's disease is controversial due to fears over poor wound healing leading to proctectomy. We aim to review the available literature and establish the role of excisional haemorrhoidectomy in Crohn's disease. METHODS: A review of the current scientific literature was conducted using Medline, PubMed and the Cochrane Central Registry of Controlled Trials. Clinical trials from 2005 to present, reporting outcomes of excisional haemorrhoidectomy in Crohn's disease, were included...
November 14, 2023: Irish Journal of Medical Science
#28
JOURNAL ARTICLE
Ignacio Fernández Hurtado, Naila Pagés Valle, Santiago Baena Bradaschia, Enrique Colás Ruiz, Marta Castro Suárez, José Andrés Cifuentes Ródenas
We are thrilled to present a new technique for treating chronic anal fissures using ultrasound-guided botulinum toxin injections. Our approach involves injecting botulinum toxin into the internal anal sphincter (IAS) guided by ultrasound for maximum effectiveness. We believe that our technique has significant potential to improve outcomes. We could not find any studies where ultrasound-guided TB puncture was used to treat chronic anal fissures.
November 6, 2023: Revista Española de Enfermedades Digestivas
#29
REVIEW
Katie L R Cross, Steven R Brown, Jos Kleijnen, James Bunce, Melanie Paul, Sophie Pilkington, Oliver Warren, Oliver Jones, Jon Lund, Henry J Goss, Michael Stanton, Tatenda Marunda, Artaza Gilani, L Wee Sing Ngu, Philip Tozer
AIM: The management of anal fissure: ACPGBI position statement was written 15 years ago. [KLR Cross et al., Colorectal Dis, 2008]. Our aim was to update the guideline and provide recommendations on the most effective treatment for patients with anal fissures utilising a multidisciplinary, rigorous guideline methodology. METHODS: The development process consisted of six phases. In phase 1 we defined the scope of the guideline. The patient population included patients with acute and chronic anal fissure...
December 2023: Colorectal Disease
#30
JOURNAL ARTICLE
Tatsuya Abe, Masao Kunimoto, Yoshikazu Hachiro, Shigenori Ota, Kei Ohara, Mitsuhiro Inagaki, Yusuke Saitoh, Masanori Murakami
OBJECTIVES: Conventional anal dilatation for anal fissures has long been abandoned because of the high incidence of anal incontinence. However, less invasive and more precise dilation techniques have been developed that have shown high healing and low incontinence rates. This study aimed to evaluate the efficacy and safety of controlled anal dilatation (CAD) using a standardized maximum anal diameter. METHODS: This study included 523 patients who underwent CAD for chronic anal fissures between January 2010 and December 2014...
2023: Journal of the Anus, Rectum and Colon
#31
JOURNAL ARTICLE
Varut Lohsiriwat, Aitsariya Mongkhonsupphawan
No abstract text is available yet for this article.
2023: Journal of the Anus, Rectum and Colon
#32
Silvana Ancona, Sara Signa, Chiara Longo, Giuliana Cangemi, Roberta Carfora, Enrico Drago, Alessandro La Rosa, Marco Crocco, Andrea Chiaro, Paolo Gandullia, Serena Arrigo
BACKGROUND: Treatment of infantile-onset inflammatory bowel disease (IO-IBD) is often challenging due to its aggressive disease course and failure of standard therapies with a need for biologics. Secondary loss of response is frequently caused by the production of anti-drug antibodies, a well-known problem in IBD patients on biologic treatment. We present a case of IO-IBD treated with therapeutic drug monitoring (TDM)-guided high-dose anti-tumor necrosis factor therapy, in which dose escalation monitoring was used as a strategy to overcome anti-drug antibodies...
October 14, 2023: World Journal of Gastroenterology: WJG
#33
REVIEW
Melissa K Drezdzon, Carrie Y Peterson
Anorectal emergencies are rare presentations of common anorectal disorders, and surgeons are often called on to assist in their diagnosis and management. Although most patients presenting with anorectal emergencies can be managed nonoperatively or with a bedside procedure, surgeons must also be able to identify surgical anorectal emergencies, such as gangrenous rectal prolapse. This article provides a review of pertinent anatomy; examination techniques; and workup, diagnosis, and management of common anorectal emergencies including thrombosed hemorrhoids, incarcerated hemorrhoids, anal fissure, anorectal abscess, rectal prolapse, and pilonidal abscess and unique situations including rectal foreign body and anorectal sexually transmitted infections...
December 2023: Surgical Clinics of North America
#34
JOURNAL ARTICLE
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Francesca Iacobellis, Luigi Brusciano, Luigi Monaco, Domenico Izzo, Alfredo Giordano, Michele Pinto, Corrado Fantini, Marcello Gasparrini, Michele Schiano Di Visconte, Francesca Milazzo, Giovanni Ferreri, Andrea Braini, Umberto Cocozza, Massimo Pezzatini, Valeria Gianfreda, Alberto Di Leo, Vincenzo Landolfi, Umberto Favetta, Sergio Agradi, Giovanni Marino, Massimilano Varriale, Massimo Mongardini, Claudio Eduardo Fernando Antonio Pagano, Riccardo Brachet Contul, Nando Gallese, Giampiero Ucchino, Michele D'Ambra, Roberto Rizzato, Giacomo Sarzo, Bruno Masci, Francesca Da Pozzo, Simona Ascanelli, Fabrizio Foroni, Alessio Palumbo, Patrizia Liguori, Angela Pezzolla, Luigi Marano, Antonio Capomagi, Eugenio Cudazzo, Francesca Babic, Carmelo Geremia, Alessandro Bussotti, Mario Cicconi, Antonia Di Sarno, Federico Maria Mongardini, Antonio Brescia, Leonardo Lenisa, Massimiliano Mistrangelo, Maria Laura Sandoval Sotelo, Luciano Vicenzo, Antonio Longo, Ludovico Docimo
INTRODUCTION: The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every physician in the choice of the best treatment option, according with the available literature. METHODS: A panel of experts was designed and charged by the Board of the SIUCP to develop key-questions on the main topics covering the management of anal fissure and to performe an accurate search on each topic in different databanks, in order to provide evidence-based answers to the questions and to summarize them in statements...
October 13, 2023: BMC Surgery
#35
JOURNAL ARTICLE
Andrea Balla, Federica Saraceno, Mostafa Shalaby, Gaetano Gallo, Salomone Di Saverio, Paola De Nardi, Roberto Perinotti, Pierpaolo Sileri
The best nonoperative or operative anal fissure (AF) treatment is not yet established, and several options have been proposed. Aim is to report the surgeons' practice for the AF treatment. Thirty-four multiple-choice questions were developed. Seven questions were about to participants' demographics and, 27 questions about their clinical practice. Based on the specialty (general surgeon and colorectal surgeon), obtained data were divided and compared between two groups. Five-hundred surgeons were included (321 general and 179 colorectal surgeons)...
December 2023: Updates in Surgery
#36
RANDOMIZED CONTROLLED TRIAL
Erhan Gökçek, Recep Gökçe, Cem Kivilcim Kaçar
BACKGROUND: Chronic anal fissure is called the reaching the muscle layer under the skin by deepening of the fissure in the breech skin. Our purpose is to enable the tissue to heal by relaxing the anal sphincter with caudal epidural injection. METHODS: One hundred twenty cases were included in this randomized, controlled study. The cases were categorized into 2 groups; Under ultrasound guidance, the first group, caudal epidural injection group (Group CE, n = 60) was treated with 5 cc bupivakain + 5 cc isotonic from a caudal epidural for a total of 3 sessions at the beginning, 1 week and 2 weeks later; the second group, control group (Group C, n = 60) were provided medical treatment (cream, pill etc...
September 15, 2023: Medicine (Baltimore)
#37
JOURNAL ARTICLE
Wasay A Mohajir, Shruti Khurana, Khushboo Singh, Reubyn William Chong, Manoop S Bhutani
The discovery of botulinum toxin A (BTX)'s therapeutic properties has led to studies evaluating its usefulness in multiple medical disorders. Its use in the gastrointestinal (GI) tract has been studied for 30 years. Multiple databases, including PubMed, AccessMedicine, ClinicalKey, Cochrane Library, Embase, and Medline, were used to review research from case series to randomized controlled trials on BTX use in the GI tract. This article reviews the current literature on the efficacy of BTX and the strength of recommendations for or against its use in various disorders, including cricopharyngeal dysphagia, achalasia, nonachalasia motility disorders, gastroparesis, obesity, sphincter of Oddi disorders, chronic anal fissure, chronic idiopathic anal pain, and anismus...
April 2023: Gastroenterology & Hepatology
#38
JOURNAL ARTICLE
Saher-Zahra S Khan, Scott Martin, Chang Yoon Doh, Sharon L Stein, Emily Steinhagen
BACKGROUND: It is unclear how patients with anal fissures are treated in real-world settings, particularly since patients may not see colorectal surgeons. This study describes trends in treatment with medical therapies (calcium-channel blockers [CCBs], nitroglycerin [NTG], and narcotics) and surgical treatments. METHODS: Cohorts were created within the TriNetX database platform using codes for anal fissures and surgical interventions. Demographics were compared between patients that received surgical intervention within 1 year of diagnosis, CCB or NTG within 1 year (or preoperatively), or narcotics within 30 days or postoperatively vs those who did not...
September 2, 2023: American Surgeon
#39
JOURNAL ARTICLE
Sthela M Murad-Regadas, Francisco Sergio P Regadas, Ricardo E Dias Mont'Alverne, Graziela O da Silva Fernandes, Milena M de Souza, Nayane de A Frota, David G Ferreira
BACKGROUND: Few studies measured the pre- and postoperative anatomic and functional anal canal using 3-dimensional endoanal ultrasound and anal manometry and correlated sphincter division with fecal incontinence, severity, and function. OBJECTIVE: To assess the incidence of fecal incontinence in patients who underwent internal anal sphincter division for anal fissure or intersphincteric anal fistula and correlate severity of symptoms with percentage of divided muscle, anatomical measurements, and anal pressures...
December 1, 2023: Diseases of the Colon and Rectum
#40
RANDOMIZED CONTROLLED TRIAL
Sara Razdar, Yunes Panahi, Ramtin Mohammadi, Leila Khedmat, Hossein Khedmat
OBJECTIVE: Haemorrhoids are one of the most common gastrointestinal and anal diseases. In olive oil and honey propolis, flavonoids have beneficial effects on improving vascular function and decreasing vascular resistance. In this study, we aimed to produce a combination of these two substances in the form of lotions and assess their healing and side effects in comparison with routine treatment, anti-haemorrhoid ointment (containing hydrocortisone and lidocaine). DESIGN: In this randomised clinical trial study, 86 patients with grade 2 or more haemorrhoid degrees, diagnosed by colonoscopy, were divided into two groups, the case (n=44) and control (n=42)...
August 2023: BMJ Open Gastroenterology
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