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https://www.readbyqxmd.com/read/27885389/mri-features-of-perianal-fistulas-is-there-a-difference-between-crohn-s-and-non-crohn-s-patients
#1
Irai S Oliveira, Aoife Kilcoyne, Melissa C Price, Mukesh Harisinghani
PURPOSE: Though perianal fistulas are commonly seen in patients with Crohn's disease, they can also be seen in patients without inflammatory bowel disease. The purpose of this study was to evaluate MR imaging differences of perianal fistulas in patients with and without Crohn's disease. METHODS: Our retrospective search from January 2012 to December 2015 of the Radiology database for perianal fistula yielded 207 patients. Only patients with dedicated MR fistula protocol studies were included, whereas patients with previous anal surgery or anastomosis, anorectal tumors, and equivocal findings that could not be definitely assessed as a fistula were excluded...
November 24, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27822874/spinal-epidural-abscess-a-rare-complication-of-ulcerative-colitis-after-ileal-pouch-anal-anastomosis
#2
Mikio Kawamura, Toshimitsu Araki, Yoshiki Okita, Satoru Kondo, Takashi Ichikawa, Hiroyuki Fujikawa, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
BACKGROUND: Spinal epidural abscess is a rare condition with high morbidity and mortality, for which a delay in diagnosis and treatment can lead to irreversible neurologic deficit or even death. Although patients with spinal epidural abscess have systemic predisposing immunocompromised conditions, spinal intervention, or trauma, this condition has been reported as a result of perforation or fistulization arising from inflammatory bowel disease. We describe herein a rare case of spinal epidural abscess as a complication of ileal pouch anal anastomosis...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27822614/outcome-and-functional-prognosis-of-pelvic-sepsis-after-ileal-pouch-anal-anastomosis-in-patients-with-ulcerative-colitis
#3
Shozo Ide, Toshimitsu Araki, Yoshiki Okita, Mikio Kawamura, Yuji Toiyama, Minako Kobayashi, Masaki Ohi, Koji Tanaka, Yasuhiro Inoue, Keiichi Uchida, Yasuhiko Mohri, Masato Kusunoki
PURPOSE: Restorative proctocolectomy with ileal pouch-anal anastomosis is a surgical procedure for ulcerative colitis, but pouch failure or pelvic sepsis still occurs in some patients. We conducted this study to investigate the cause of pouch failure and evaluate defecatory function after pelvic sepsis. METHODS: A total of 234 patients who underwent restorative proctocolectomy were enrolled. We analyzed the cause of pouch failure, as well as defecatory function and manometric outcomes, with and without the complication of pelvic sepsis...
November 7, 2016: Surgery Today
https://www.readbyqxmd.com/read/27806522/application-of-repeated-measures-method-to-compare-physical-maternal-health-index-in-a-follow-up-study
#4
Hourieh Shamshiri Milani, Nezhat Shakeri, Taha Asbaghi
Maternal health is a concept indicating the health of mothers during pregnancy, childbirth and the post-partum period. Recent literature indicates that the maternal mortality rate in Iran is 23 per 100,000 live birth. For every death, 20 to 30 mothers suffer from chronic and acute illnesses arising from pregnancy and delivery; therefore, using a valid and reliable indicator will help researchers assess maternal health more precisely. In this longitudinal study, attempt has been made to compare mothers' health status by using a subjective tool for evaluating the Physical-Maternal Health Index (P-MHI)...
August 1, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27771095/transanal-hemorrhoid-dearterialization-is-a-safe-and-effective-outpatient-procedure-for-the-treatment-of-hemorrhoidal-disease
#5
Zoran Bjelanovic, Miroljub Draskovic, Milic Veljovic, Ivan Lekovic, Menelaos Karanikolas, Dusica Stamenkovic
INTRODUCTION: This prospective, observational study evaluated transanal dearterialization (THD) efficacy and safety in grade 2-4 hemorrhoids (HD). METHODS: THD was performed under sedation-locoregional anesthesia in 402 outpatients. Patients had follow-up evaluation 3 days, 2 weeks, 1, 6 and 12 months postoperatively. RESULTS: Mean patient age was 46.4 (range 20-85) years. A total of 268 patients (66.6%) were male. Sixteen patients (4.0%) had grade 2 HD, 210 (52...
October 19, 2016: Cirugía Española
https://www.readbyqxmd.com/read/27768009/ligasuretm-hemorrhoidectomy-how-we-do
#6
Giovanni Milito, Giorgio Lisi, Elena Aronadio, Michela Campanelli, Dario Venditti, Simona Grande, Michele Grande
BACKGROUNDS: Hemorrhoidectomy is considered the gold standard and the most effective and definitive treatment for grades 3 or 4 haemorrhoids, and Milligan-Morgan's and Ferguson's procedures are the most widely used techniques throughout the world. The aim of the study is to present our surgical technique using LigasureTM vessel sealing, focus on technical aspects and surgical tricks showing our results with a huge number of patients and a long-term follow-up. METHODS: Between June 2001 and June 2014 at the University Hospital of Tor Vergata, Rome, Italy, 1000 patients were selected to underwent LigaSureTM hemorrhoidectomy for III and IV degree haemorrhoids...
October 21, 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27757396/feasibility-of-transanal-endoscopic-total-mesorectal-excision-for-rectal-cancer-results-of-a-pilot-study
#7
Jae Hwan Oh, Sung Chan Park, Min Jung Kim, Byung Kwan Park, Jong Hee Hyun, Hee Jin Chang, Kyung Su Han, Dae Kyung Sohn
PURPOSE: To evaluate the feasibility of transanal total mesorectal excision (TME) in patients with rectal cancer. METHODS: This study enrolled 12 patients with clinically node negative rectal cancer located 4-12 cm from the anal verge who underwent transanal endoscopic TME with the assistance of single port laparoscopic surgery between September 2013 and August 2014. The primary endpoint was TME quality; secondary endpoints included number of harvested lymph nodes and postoperative complications within 30 days (NCT01938027)...
October 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27749400/benign-anal-disease
#8
Susannah J Clark
Benign anal disease encompasses common problems including hemorrhoids, anal fissures, pruritus ani, perianal abscesses, and fistulae. Although many people will suffer from at least one of these conditions in their lives, healthcare practitioners diagnose and treat them accurately about 50% to 83% of the time. This article reviews common anal problems and the importance of a thorough history and physical examination to proper patient management.
November 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27723447/anal-health-care-basics
#9
Jason Chang, Elisabeth Mclemore, Talar Tejirian
Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy.The first step in this process is to take an accurate history and physical examination. Specific questions include details about bowel habits, anal hygiene, and fiber supplementation...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27721924/rubber-band-ligation-of-hemorrhoids-a-guide-for-complications
#10
Andreia Albuquerque
Rubber band ligation is one of the most important, cost-effective and commonly used treatments for internal hemorrhoids. Different technical approaches were developed mainly to improve efficacy and safety. The technique can be employed using an endoscope with forward-view or retroflexion or without an endoscope, using a suction elastic band ligator or a forceps ligator. Single or multiple ligations can be performed in a single session. Local anaesthetic after ligation can also be used to reduce the post-procedure pain...
September 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27704203/ileal-pouch-anal-anastomosis-for-ulcerative-colitis-a-canadian-institution-s-experience
#11
E Zittan, Grace W Ma, N Wong-Chong, R Milgrom, R S McLeod, M Silverberg, Z Cohen
BACKGROUND: We aimed to summarize the outcomes of ulcerative colitis (UC) patients receiving an ileal pouch-anal anastamosis (IPAA) over an 11-year period at a high-volume Canadian inflammatory bowel disease (IBD) center. METHODS: A retrospective chart review was performed for subjects with UC who underwent IPAA between 2002 and 2013. Patient charts were reviewed for demographic data, clinical characteristics, preoperative medical treatment, and surgical outcomes...
October 4, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27697696/basal-cell-carcinoma-mimicking-pilonidal-sinus-a-case-report-with-literature-review
#12
Abdulwahid M Salih, F H Kakamad, Goran M Rauf
INTRODUCTION: Pilonidal sinus is a common benign disease that accounts for almost 15% of anal suppurations while basal cell carcinoma is the most common malignancy of the sun-exposed area occurring mainly on the head and neck. We report a case of basal cell carcinoma presented with signs and symptoms of PNS. A 40-year-old male presented with swelling of the lower back for 2 years. On examination, there was a round, mobile, soft 4×2.5cm mass on the sacrococcygeal area. Ultrasound showed subcutaneous cystic lesion...
September 28, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27692346/the-operative-management-of-children-with-complex-perianal-crohn-s-disease
#13
Natashia M Seemann, Sebastian K King, Abdul Elkadri, Thomas Walters, Joel Fish, Jacob C Langer
BACKGROUND/PURPOSE: Perianal Crohn's disease (PCD) can affect both quality of life and psychological wellbeing. A subset of pediatric patients with complex PCD require surgical intervention, although appropriate timing and treatment regimens remain unclear. This study aimed to describe a large pediatric cohort in a tertiary center to determine the range of surgical management in children with complex PCD. METHODS: A retrospective review of children requiring operative intervention for PCD over 13 years (2002-2014) was performed...
September 15, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27631776/to-drain-or-not-to-drain-infraperitoneal-anastomosis-after-rectal-excision-for-cancer-the-greccar-5-randomized-trial
#14
Quentin Denost, Philippe Rouanet, Jean-Luc Faucheron, Yves Panis, Bernard Meunier, Eddy Cotte, Guillaume Meurette, Sylvain Kirzin, Charles Sabbagh, Jèrôme Loriau, Stèphane Benoist, Christophe Mariette, Igor Sielezneff, Bernard Lelong, François Mauvais, Benoit Romain, Marie-Line Barussaud, Christine Germain, Marie-Quitterie Picat, Eric Rullier, Christophe Laurent
OBJECTIVE: To assess the effect of pelvic drainage after rectal surgery for cancer. BACKGROUND: Pelvic sepsis is one of the major complications after rectal excision for rectal cancer. Although many studies have confirmed infectiveness of drainage after colectomy, there is still a controversy after rectal surgery. METHODS: This multicenter randomized trial with 2 parallel arms (drain vs no drain) was performed between 2011 and 2014. Primary endpoint was postoperative pelvic sepsis within 30 postoperative days, including anastomotic leakage, pelvic abscess, and peritonitis...
September 14, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27607335/preoperative-anti-tumor-necrosis-factor-therapy-in-patients-with-ulcerative-colitis-is-not-associated-with-an-increased-risk-of-infectious-and-noninfectious-complications-after-ileal-pouch-anal-anastomosis
#15
Eran Zittan, Raquel Milgrom, Grace W Ma, Nathalie Wong-Chong, Brenda OʼConnor, Robin S McLeod, Helen M MacRae, Gordon R Greenberg, Geoffrey C Nguyen, Kenneth Croitoru, A Hillary Steinhart, Zane Cohen, Mark S Silverberg
BACKGROUND: There are conflicting data regarding the effect of previous exposure to anti-tumor necrosis factor (anti-TNF) therapy on complication rates after pelvic pouch surgery for patients with ulcerative colitis (UC). In particular, there is concern surrounding the rates of pouch leaks and infectious complications, including pelvic abscesses, in anti-TNF-treated subjects who require ileal pouch-anal anastomosis (IPAA) surgery. METHODS: A retrospective study was performed in UC subjects who underwent IPAA between 2002 and 2013...
October 2016: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/27585438/severe-fournier-s-gangrene-in-a-patient-with-rectal-cancer-case-report-and-literature-review
#16
Yu Yoshino, Kimihiko Funahashi, Rei Okada, Yasuyuki Miura, Takayuki Suzuki, Takamaru Koda, Kimihiko Yoshida, Junichi Koike, Hiroyuki Shiokawa, Mitsunori Ushigome, Tomoaki Kaneko, Yasuo Nagashima, Mayu Goto, Akiharu Kurihara, Hironori Kaneko
BACKGROUND: Fournier's gangrene in the setting of rectal cancer is rare. Treatment for Fournier's gangrene associated with rectal cancer is more complex than other cases of Fournier's gangrene. We report on a patient with severe Fournier's gangrene in the setting of locally advanced rectal cancer who was treated with a combined modality therapy. CASE PRESENTATION: A 65-year-old man presented with general fatigue and anal pain. The medical and surgical histories were unremarkable...
September 1, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27562822/internal-dressings-for-healing-perianal-abscess-cavities
#17
REVIEW
Stella R Smith, Katy Newton, Jennifer A Smith, Jo C Dumville, Zipporah Iheozor-Ejiofor, Lyndsay E Pearce, Paul J Barrow, Laura Hancock, James Hill
BACKGROUND: A perianal abscess is a collection of pus under the skin, around the anus. It usually occurs due to an infection of an anal gland. In the UK, the annual incidence is 40 per 100,000 of the adult population, and the standard treatment is admission to hospital for incision and drainage under general anaesthetic. Following drainage of the pus, an internal dressing (pack) is placed into the cavity to stop bleeding. Common practice is for community nursing teams to change the pack regularly until the cavity heals...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27553198/outcome-of-laparoscopic-treatment-of-anorectal-malformations-in-children
#18
Sergey V Minaev, Igor V Kirgizov, Aleksander Gladkyy, Ilya Shishkin, Igor Gerasimenko
BACKGROUND: Operative correction of anorectal malformations (ARMs) remains a challenge in pediatric surgery. The study aimed to evaluate the outcomes of laparoscopic treatment of ARM in children. METHODS: From 2007 to 2014, we performed 104 laparoscopic-assisted anorectal pull-through procedures in children with a mean age of 11.3 ± 0.4 months and ARMs. Clinical assessment, surgical durations, complications, and postoperative outcome were investigated. RESULTS: The mean duration of the operation was 126...
August 23, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27477896/expanded-allogeneic-adipose-derived-mesenchymal-stem-cells-cx601-for-complex-perianal-fistulas-in-crohn-s-disease-a-phase-3-randomised-double-blind-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Julián Panés, Damián García-Olmo, Gert Van Assche, Jean Frederic Colombel, Walter Reinisch, Daniel C Baumgart, Axel Dignass, Maria Nachury, Marc Ferrante, Lili Kazemi-Shirazi, Jean C Grimaud, Fernando de la Portilla, Eran Goldin, Marie Paule Richard, Anne Leselbaum, Silvio Danese
BACKGROUND: Complex perianal fistulas in Crohn's disease are challenging to treat. Allogeneic, expanded, adipose-derived stem cells (Cx601) are a promising new therapeutic approach. We aimed to assess the safety and efficacy of Cx601 for treatment-refractory complex perianal fistulas in patients with Crohn's disease. METHODS: We did this randomised, double-blind, parallel-group, placebo-controlled study at 49 hospitals in seven European countries and Israel from July 6, 2012, to July 27, 2015...
September 24, 2016: Lancet
https://www.readbyqxmd.com/read/27468181/anorectal-emergencies
#20
Varut Lohsiriwat
Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer...
July 14, 2016: World Journal of Gastroenterology: WJG
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