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https://www.readbyqxmd.com/read/28438771/unusual-presentation-for-a-tailgut-cyst
#1
Daniel Hancu, James Williams, Faris Kubba, Abhay Chopada
A 67-year-old man with a slow-growing, asymptomatic perianal lesion was presented to the colorectal clinic. Physical examination and radiological investigation were suggestive of an externally prolapsing colonic polyp. However, intraoperative findings of a cystic lesion containing a thick brown substance questioned the initial diagnosis. After complete surgical resection of the encapsulated lesion, histological examination revealed a tailgut cyst (cystic hamartoma). These uncommon lesions originate from an embryological remnant of the hindgut...
April 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28435477/acrodermatitis-enteropathica-in-a-pair-of-twins
#2
Abdullatif Al Rashed, Mohja Al Shehri, Feroze Kaliyadan
BACKGROUND: Acrodermatitis enteropathica (AE) is a rare autosomal recessive metabolic disorder. First described by Brandt in 1936 and was named by Danbolt. A mutation in the SLC39A4 gene on chromosome 8 q24.3 is responsible for this disorder, which encodes zinc transporter Zip4. The diagnosis is made by the clinical presentation and histopathology and laboratory tests. In this case, we reported a twin presented with a typical rash and low zinc level. To our knowledge, very few cases reported as a twin with typical acrodermatitis enteropathica presentation...
December 31, 2016: Journal of Dermatological Case Reports
https://www.readbyqxmd.com/read/28432678/anal-metastasis-of-rectal-cancer-adenocarcinoma-of-squamous-cells-a-case-report-and-literature-review
#3
Shun Sasaki, Masahiko Sugiyama, Yu Nakaji, Ryota Nakanishi, Yuichiro Nakashima, Hiroshi Saeki, Eiji Oki, Yoshinao Oda, Yoshihiko Maehara
Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. She had a 1.5-cm anal tumor on the perianal skin, and a Bollman type 2 rectal tumor on the Ra portion was found on colonoscopy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28431853/transmission-of-methicillin-resistant-staphylococcus-aureus-to-health-care-worker-gowns-and-gloves-during-care-of-residents-in-veterans-affairs-nursing-homes
#4
Lisa Pineles, Daniel J Morgan, Alison Lydecker, J Kristie Johnson, John D Sorkin, Patricia Langenberg, Natalia Blanco, Alan Lesse, John Sellick, Kalpana Gupta, Luci Leykum, Jose Cadena, Nickie Lepcha, Mary-Claire Roghmann
BACKGROUND: This was an observational study designed to estimate the frequency of methicillin-resistant Staphylococcus aureus (MRSA) transmission to gowns and gloves worn by health care workers (HCWs) interacting with Veterans Affairs Community Living Center (VA nursing home) residents to inform MRSA prevention policies. METHODS: Participants included residents and HCWs from 7 VA nursing homes in 4 states and Washington, DC. Residents were cultured for MRSA at the anterior nares, perianal skin, and wound (if present)...
April 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28426453/indications-for-mode-of-delivery-in-pregnant-women-with-inflammatory-bowel-disease
#5
Kristin E Burke, Miriam J Haviland, Michele R Hacker, Scott A Shainker, Adam S Cheifetz
BACKGROUND: Reasons for the increased incidence of cesarean delivery among women with inflammatory bowel disease remain unclear. We assessed cesarean delivery incidence and factors influencing mode of delivery in women with inflammatory bowel disease. METHODS: We performed a 10-year retrospective cohort study of nulliparous women who delivered a singleton infant at our institution. We compared the risk of each mode of delivery in women with Crohn's disease and ulcerative colitis with women without inflammatory bowel disease...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28426452/defining-the-most-appropriate-delivery-mode-in-women-with-inflammatory-bowel-disease-a-systematic-review
#6
Arthur Foulon, Jean-Louis Dupas, Charles Sabbagh, Julien Chevreau, Lionel Rebibo, Franck Brazier, Guillaume Bouguen, Jean Gondry, Mathurin Fumery
INTRODUCTION: High cesarean section (CS) rates are observed in patients with inflammatory bowel disease (IBD), but limited data are available to support this decision. We conducted a comprehensive review to evaluate the most appropriate mode of delivery in women with IBD according to disease phenotype and activity, as well as surgical history. MATERIALS AND METHODS: We searched MEDLINE (source PubMed) and international conference abstracts, and included all studies that evaluated digestive outcome after delivery in patients with IBD...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28416240/efficacy-of-tumour-necrosis-factor-antagonists-in-stricturing-crohn-s-disease-a-tertiary-center-real-life-experience
#7
Mariangela Allocca, Cristiana Bonifacio, Gionata Fiorino, Antonino Spinelli, Federica Furfaro, Luca Balzarini, Stefanos Bonovas, Silvio Danese
BACKGROUND: Stenosis is the most common complication of Crohn's disease (CD). Long-term outcome of patients receiving tumour necrosis factor (TNF) antagonists for such disease complication is poorly understood. METHODS: 51 CD patients (from July 2006 to November 2015) who had a diagnosis of small bowel or colonic stenosis, diagnosed by colonoscopy and/or MRI enterography, and were treated with TNF antagonists (adalimumab or infliximab) were enrolled. The primary outcome was to assess the rate of success of TNF antagonists on avoiding abdominal surgery for stricturing CD patients...
March 30, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28416052/-a-38-year-old-woman-with-an-anovaginal-fistula-after-consensual-penile-anal-intercourse
#8
Lærke Albertsen, Heidi Beate Christensen
In this case report a 38-year-old woman was admitted to hospital with anal bleeding and perianal pain after a consensual vaginal intercourse followed by an anal intercourse during which she felt a sudden profound pain. Nine days later she was diagnosed with an anovaginal fistula. A diverting sigmoideostomy was performed, and spontaneous healing was awaited. Rectovaginal fistula without concomitant anal sphincter injury as a result of consensual penile anal intercourse is an extremely rare occurrence, described only once previously...
April 10, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28412052/-the-relationship-between-preoperative-anxiety-levels-and-vasovagal-incidents-during-the-administration-of-spinal-anesthesia
#9
Mürsel Ekinci, Birzat Emre Gölboyu, Onur Dülgeroğlu, Murat Aksun, Pınar Karaca Baysal, Erkan Cem Çelik, Ayşe Nur Yeksan
BACKGROUND: It was aimed to investigate the relationship between preoperative anxiety and vasovagal symptoms observed during the administration of spinal anesthesia in patients undergoing surgery in the perianal and inguinal regions. METHODS: The study included patients with planned surgery for inguinal hernia repair, anal fissure, hemorrhoid and pilonidal sinus excision. The study included a total of 210 patients of ASA I-II, aged 18-65 years. Patients were evaluated in respect of demographic characteristics, smoking and alcohol consumption, ASA grade and educational level...
April 12, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28410345/development-of-a-novel-predictive-model-for-the-clinical-course-of-crohn-s-disease-results-from-the-connect-study
#10
Yehyun Park, Jae Hee Cheon, Yi Lang Park, Byong Duk Ye, You Sun Kim, Dong Soo Han, Joo Sung Kim, Sung Noh Hong, Young Ho Kim, Seong Ran Jeon, Won Ho Kim
BACKGROUND: A considerable number of patients with Crohn's disease (CD) develop irreversible intestinal damage, although the early administration of immunomodulatory or biological therapies might prevent this. The aims of our study were to develop and validate a novel predictive model that can be used to predict the risk of surgical intervention in Korean patients with CD. METHODS: The prognostic model was derived from the multicenter longitudinal CONNECT (CrOhn's disease cliNical NEtwork and CohorT) study cohort consisting of 1338 patients with CD, who were split into training and validation sets...
April 13, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28401051/surgery-in-pediatric-crohn-s-disease-indications-timing-and-post-operative-management
#11
REVIEW
Seung Kim
Pediatric onset Crohn's disease (CD) tends to have complicated behavior (stricture or penetration) than elderly onset CD at diagnosis. Considering the longer duration of the disease in pediatric patients, the accumulative chance of surgical treatment is higher than in adult onset CD patients. Possible operative indications include perianal CD, intestinal stricture or obstruction, abdominal abscess or fistula, intestinal hemorrhage, neoplastic changes and medically untreatable inflammation. Growth retardation is an operative indication only for pediatric patients...
March 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28400193/autologous-mesenchymal-stem-cells-applied-in-a-bioabsorbable-matrix-for-treatment-of-perianal-fistulas-in-patients-with-crohn-s-disease
#12
Allan B Dietz, Eric J Dozois, Joel G Fletcher, Greg W Butler, Darcie Radel, Amy L Lightner, Maneesh Dave, Jessica Friton, Asha Nair, Emily T Camilleri, Amel Dudakovic, Andre J van Wijnen, William A Faubion
In patients with Crohn's disease (CD), perianal fistulas frequently recur, causing substantial morbidity. We performed a 12 patient, 6 month phase I trial to determine whether autologous mesenchymal stem cells (MSCs), applied in a bioabsorbable matrix, can heal the fistula. Fistula repair was not associated with any serious adverse events related to MSCs or plug placement. At 6 months, 10/12 patients (83%) had complete clinical healing and radiographic markers of response. We found placement of MSC-coated matrix fistula plugs in 12 patients with chronic perianal fistulas to be safe and lead to clinical healing and radiographic response in 10 patients...
April 8, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28399604/transperineal-ultrasound-for-perianal-fistulas-and-abscesses-a-systematic-review-and-meta-analysis
#13
Giovanni Maconi, Maria Teresa Greco, Anil Kumar Asthana
Purpose Transperineal ultrasound (TPUS) is a practical tool for assessing perianal inflammatory lesions. We systematically review its accuracy for detecting and classifying perianal fistulae and abscesses. Method The National Library of Medicine and Embase were searched for articles on TPUS for the assessment of idiopathic and Crohn's perianal fistulae and abscesses. Two reviewers independently reviewed eligible studies and rated them for quality using the QUADAS tool. The primary outcome measure was the accuracy of TPUS as measured by its sensitivity and positive predictive value (PPV) in detecting and classifying perianal fistulae, internal openings and perianal abscesses...
April 11, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28398924/factors-leading-to-transmission-risk-of-acinetobacter-baumannii
#14
Kerri A Thom, Clare Rock, Sarah S Jackson, J Kristie Johnson, Arjun Srinivasan, Laurence S Magder, Mary-Claire Roghmann, Robert A Bonomo, Anthony D Harris
OBJECTIVES: To identify patient and healthcare worker factors associated with transmission risk of Acinetobacter baumannii during patient care. DESIGN: Prospective cohort study. SETTING: ICUs at a tertiary care medical center. PATIENTS: Adult ICU patients known to be infected or colonized with A. baumannii. MEASUREMENTS AND MAIN RESULTS: Cultures of skin, respiratory tract, and the perianal area were obtained from participants and evaluated for the presence of A...
April 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28395191/comparison-of-t2-weighted-imaging-diffusion-weighted-imaging-and-contrast-enhanced-t1-weighted-mr-imaging-for-evaluating-perianal-fistulas
#15
Jiyeon Baik, Seung Ho Kim, Yedaun Lee, Jung-Hee Yoon
PURPOSE: To compare the lesion conspicuity and diagnostic performance of three imaging data sets (T2WI, combined T2WI and DWI [combined DWI], contrast-enhanced (CE)-T1WI) in assessing perianal fistulas. METHODS: Two radiologists with 7 and 15years of experience assessed 28 fistulas from 24 patients in each image set. RESULTS: The lesion conspicuity was improved for only one reader after reading the combined DWI (P=0.0039) and CE-T1WI (P=0...
March 31, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28394805/factors-associated-with-fecal-incontinence-in-women-of-childbearing-age-with-crohn-s-disease
#16
Charlène Brochard, Laurent Siproudhis, Jean Levêque, Amélie Grouin, Anne-Laure Mallet, Jean-François Bretagne, Alain Ropert, Guillaume Bouguen
BACKGROUND: Fecal incontinence is common in women with Crohn's disease, but little is known about the impact of childbirth, perianal Crohn's disease, and past surgical history on fecal incontinence. METHODS: Self-administered questionnaires were mailed to consecutive women referred to a tertiary gastroenterology centre with a focus on fecal incontinence and childbirth. These data were cross-referenced with a prospective database of the same patients' own Crohn's disease histories...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28393301/structured-reporting-of-ct%C3%A2-enterography%C3%A2-for%C3%A2-inflammatory-bowel-disease-effect-on-key-feature%C3%A2-reporting-accuracy-across-training-levels-and-subjective-assessment-of-disease-by-referring-physicians
#17
Benjamin Wildman-Tobriner, Brian C Allen, Mustafa R Bashir, Morgan Camp, Chad Miller, Lauren E Fiorillo, Alan Cubre, Sanaz Javadi, Alex D Bibbey, Wendy L Ehieli, Nancy McGreal, Reinaldo Quevedo, Julie K Thacker, Maciej Mazurowski, Tracy A Jaffe
PURPOSE: To compare the content and accuracy of structured reporting (SR) versus non-structured reporting (NSR) for computed tomographic enterography (CTE) of inflammatory bowel disease (IBD). MATERIALS AND METHODS: This IRB-approved, HIPAA-compliant, retrospective study included 30 adult subjects (15 male, 15 female; mean age 41.9 years) with IBD imaged with CTE. Nine radiologists (3 faculty, 3 abdominal imaging fellows, and 3 senior radiology residents) independently interpreted all examinations using both NSR and SR, separated by four weeks...
April 9, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28387832/mesenchymal-stem-cell-injections-for-the-treatment-of-perianal-crohn-s-disease-what-we-ve-accomplished-and-what-we-still-need-to-do
#18
Amy L Lightner, William A Faubion
Perianal Crohn's disease (CD) is found in a quarter of patients with CD and remains notoriously difficult to treat. Several medical and surgical therapies are available. However, none are particularly effective or reliably provide sustained remission. In addition, surgical intervention is complicated by poor healing and the potential for incontinence. Mesenchymal stem cell based therapies provide a promising treatment alternative for perianal CD with demonstrated safety, improved efficacy, and a decreased side effect profile...
April 6, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28387062/association-of-coloproctology-of-great-britain-and-ireland-consensus-exercise-on-surgical-management-of-fistulating-perianal-crohn-s-disease
#19
M J Lee, N Heywood, P M Sagar, S R Brown, N S Fearnhead
BACKGROUND: Management of fistulating perianal Crohn's disease (fpCD) is a significant challenge for a colorectal surgeon. A recent survey of surgical practice in this condition showed variation in management approaches. As a result we set out to devise recommendations for practice for UK colorectal surgeons. METHODS: Results from a national survey were used to devise a set of potential consensus statements. Consultant colorectal surgeons were invited to participate in the exercise via the previous survey and the mailing list of the professional society...
April 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28381141/rare-inverted-verrucous-carcinoma-carcinoma-cuniculatum-of-the-sacrogluteal-region
#20
David John Tobias McArdle, John Patrick McArdle, Frances Lee, Emilio Dino Mignanelli
A 49-year-old woman with a past history of several infundibular cysts in the head and neck region presented with a 6-month history of a nonhealing perianal abscess on a background of 13 years of chronic sacral-buttock abscesses and discharging sinuses as part of hidradenitis suppurativa. After 2 surgical procedures and inadequate healing, a wide local excision was performed. The surgical specimen revealed an extensive, infiltrating, cystic and deeply penetrating, dermal and subcutaneous neoplasm with multiple fistulous tracts extending to the skin surface...
February 1, 2017: International Journal of Surgical Pathology
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