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Jason K Lee, Alexander J Towbin
Currarino syndrome is a congenital disorder, consisting of a triad of anomalies including an anorectal malformation, sacral anomaly, and a presacral mass. Anterior sacral meningoceles are the most common presacral mass. A young child presented to our institution with an unrepaired anorectal malformation and a large anterior sacral meningocele. We describe how the anterior meningocele affected the imaging work-up.
June 2016: Journal of Radiology Case Reports
Mridul Dhar, Ram Badan Singh, Bikram Kumar Gupta, Vishal Krishna Pai
No abstract text is available yet for this article.
October 2016: Indian Journal of Anaesthesia
Robson Azevedo Dutra, Adriana Cartafina Perez Boscollo
Background: The anorectal anomalies consist in a complex group of birth defects. Laparoscopic-assisted anorectoplasty improved visualization of the rectal fistula and the ability to place the pull-through segment within the elevator muscle complex with minimal dissection. There is no consensus on how the fistula should be managed. Aim: To evaluate the laparoscopic-assisted anorectoplasty and the treatment of the rectal urinary fistula by a bipolar sealing device...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Zareen Vadva, Samuel Nurko, Rebecca Hehn, Sara O Vargas
OBJECTIVES: 1. To determine rates of histologically positive, negative and inconclusive rectal suction biopsies in post-pull-through patients with Hirschsprung disease evaluated for potential residual aganglionosis at our institution. 2. To determine how patients were managed after a post-pull-through rectal suction biopsy. METHODS: Thirty-nine post-pull-through suction biopsies from our institution were reviewed. Samples, stained with H&E and often acetylcholinesterase and/or calretinin, were categorized as "histologically" positive, negative or inconclusive for aganglionosis...
October 13, 2016: Journal of Pediatric Gastroenterology and Nutrition
Barrett Cromeens, Jennifer L McKinney, Jeffrey Leonard, Lance Governale, Judy Brown, Christina Henry, Marc Levitt, Richard Wood, Gail Besner, Monica P Islam
Conjoined twins occur in up to 1 in 50,000 live births with approximately 18% joined in a pygopagus configuration at the buttocks. Twins with this configuration display symptoms and carry surgical risks during separation related to the extent of their connection which can include anorectal, genitourinary, vertebral, and neural structures. Neurophysiologic intraoperative monitoring (NIOM) for these cases has been discussed in the literature with variable utility. We present a case of pygopagus twins with fused spinal cords and imperforate anus where the use of NIOM significantly impacted surgical decision making in division of these critical structures...
October 1, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Cristina Saldaña Dueñas, Silvia Goñi Esarte, Jose Francisco Juanmartiñena Fernández, Marta Montes Diaz, Rosa Iglesias Picazo
No abstract text is available yet for this article.
October 12, 2016: Gastroenterología y Hepatología
Lisa Altieri, Michael K Wong, David H Peng, Myles Cockburn
BACKGROUND: Mucosal melanomas are rare, poorly understood neoplasms without a consensus standard of care. OBJECTIVE: We sought to define mucosal melanoma tumor characteristics and the racial/ethnic attributes of patients with mucosal melanomas. METHODS: We analyzed 130,920 cutaneous melanomas and 1919 mucosal melanomas recorded in the population-based California Cancer Registry from 1988 to 2013. RESULTS: Although only 1% of melanomas occurring in nonHispanic whites were mucosal, other racial/ethnic groups had a higher proportion of mucosal melanomas (15% for Asian/Pacific Islanders, 9% for nonHispanic blacks, and 4% for Hispanics)...
October 11, 2016: Journal of the American Academy of Dermatology
Hui Min Yang, Susan J Hsiao, David F Schaeffer, Chi Lai, Helen E Remotti, David Horst, Mahesh M Mansukhani, Basil A Horst
Anorectal melanoma is a rare disease that carries a poor prognosis. To date, limited genetic analyses confirmed KIT mutations as a recurrent genetic event similar to other mucosal melanomas, occurring in up to 30% of anorectal melanomas. Importantly, a subset of tumors harboring activating KIT mutations have been found to respond to c-Kit inhibitor-based therapy, with improved patient survival at advanced tumor stages. We performed comprehensive targeted exon sequencing analysis of 467 cancer-related genes in a larger series of 15 anorectal melanomas, focusing on potentially actionable variants based on gain- and loss-of-function mutations...
October 14, 2016: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Diego Pérez-Sotelo, Arturo Roca-Rivada, María Larrosa-García, Cecilia Castelao, Iván Baamonde, Javier Baltar, Ana Belen Crujeiras, Luisa María Seoane, Felipe F Casanueva, María Pardo
The secretion of the hepatokine alpha-2-Heremans-Schmid glycoprotein/Fetuin A, implicated in pathological processes including systemic insulin resistance, by adipose tissue has been recently described. Thus, we have recently identified its presence in white adipose tissue secretomes by mass spectrometry. However, the secretion pattern and function of adipose-derived alpha-2-Heremans-Schmid glycoprotein are poorly understood. The aim of this study is to evaluate the expression and secretion of total and active phosphorylated alpha-2-Heremans-Schmid glycoprotein by adipose tissue from visceral and subcutaneous localizations in animals at different physiological and nutritional status including anorexia and obesity...
October 14, 2016: Endocrine
Marta Penna, Roel Hompes, Steve Arnold, Greg Wynn, Ralph Austin, Janindra Warusavitarne, Brendan Moran, George B Hanna, Neil J Mortensen, Paris P Tekkis
OBJECTIVE: This study aims to report short-term clinical and oncological outcomes from the international transanal Total Mesorectal Excision (taTME) registry for benign and malignant rectal pathology. BACKGROUND: TaTME is the latest minimally invasive transanal technique pioneered to facilitate difficult pelvic dissections. Outcomes have been published from small cohorts, but larger series can further assess the safety and efficacy of taTME in the wider surgical population...
October 4, 2016: Annals of Surgery
G Cocorullo, R Tutino, N Falco, T Fontana, G Salamone, L Licari, G Gulotta
Rectal bleeding is very common in general population with a prevalence of 10-20 %. Primary care physicians have to stratify patients basing on urgency and on the colo-rectal cancer risk and to conduct a decision making for the correct management. We report a case of a 61-years-old woman, complaining rectal bleeding and an anal mass attended to their family doctor who does a visit but without a digital rectal examination and diagnosed a hemorrhoidal prolapse suggesting medical therapy. For the persistence of symptoms she comes to our service from emergency attention...
May 2016: Il Giornale di Chirurgia
L Rodriguez, M Sood, C Di Lorenzo, M Saps
BACKGROUND: Over the last few years, the study of the colon and anorectal function has experienced great technical advances that have facilitated the performance of the tests and have allowed a more detailed characterization of reflexes and motor patterns. As a result, we have achieved a much better understanding of the pathophysiology of children with defecation problems. Anorectal and colonic manometry are now commonly used in all major pediatric referral centers as diagnostic tools and to guide the management of children with intractable constipation and fecal incontinence, particularly when a surgical intervention is being considered...
October 9, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
P Midrio, S Battaglia, E Urso, M Castagnetti, P Gamba
AIM: Anorectal malformation (ARM) is a rare congenital disorder of the anus and rectum. In the last 30 years virtually all patients born with ARM have survived and surgeons from adult care may be called to deal with new and long-term sequelae, including tumors of the pulled-through anorectum. Two new cases of colorectal carcinoma in young adults born with ARM and a review of the literature is reported to emphasize the importance of a multidisciplinary follow-up. METHODS: A man and a woman, with previous history of ARM, presented at 34 years of age with symptoms of intestinal occlusion and a large pelvic mass...
2016: SpringerPlus
David O Prichard, Taehee Lee, Gopanandan Parthasarathy, Joel G Fletcher, Alan R Zinsmeister, Adil E Bharucha
BACKGROUND & AIMS: Contrary to conventional wisdom, the rectoanal gradient during evacuation is negative in many healthy people, undermining the utility of anorectal high resolution manometry (HRM) for diagnosing defecatory disorders. We aimed to compare HRM and magnetic resonance imaging (MRI) for assessing rectal evacuation and structural abnormalities. METHODS: We performed a retrospective analysis of 118 patients (all female; 51 with constipation, 48 with fecal incontinence, and 19 with rectal prolapse; age, 53±1 years) assessed by HRM, the rectal balloon expulsion test (BET), and MRI at Mayo Clinic, Rochester, Minnesota, from February 2011 through March 2013...
October 5, 2016: Clinical Gastroenterology and Hepatology
Paola De Nardi, Sabrina Gloria Giulia Testoni, Maura Corsetti, Hulda Andreoletti, Patrizia Giollo, Sandro Passaretti, Pier Alberto Testoni
BACKGROUND: An altered anorectal function is reported after chemoradiotherapy (CRT) and surgery for rectal cancer. AIM: The aim of this study was to clarify the relative contribution of neoadjuvant chemoradiation and surgical resection on the impairment of anorectal function as evaluated by anorectal manometry. METHODS: Thirty-nine patients with rectal cancer, who underwent neoadjuvant CRT and laparoscopic rectal resection, were evaluated with the Pescatori Faecal Incontinence score, and with anorectal manometry: before neoadjuvant therapy (T0), after neoadjuvant therapy and before surgery (T1), 12 months after stoma closure (T2)...
September 22, 2016: Digestive and Liver Disease
Adil E Bharucha, Tae Hee Lee
Although pelvic pain is a symptom of several structural anorectal and pelvic disorders (eg, anal fissure, endometriosis, and pelvic inflammatory disease), this comprehensive review will focus on the 3 most common nonstructural, or functional, disorders associated with pelvic pain: functional anorectal pain (ie, levator ani syndrome, unspecified anorectal pain, and proctalgia fugax), interstitial cystitis/bladder pain syndrome, and chronic prostatitis/chronic pelvic pain syndrome. The first 2 conditions occur in both sexes, while the latter occurs only in men...
October 2016: Mayo Clinic Proceedings
Osama Ibrahim Almosallam, Ali Aseeri, Saud Al Shanafey
BACKGROUND: Colostomy is a common part of the management of high anorectal malformation (ARM) in the pediatric population. OBJECTIVE: To evaluate whether the type of colostomy (loop vs divided) has an impact on outcome in patients with ARM. DESIGN: A retrospective study. SETTING: King Faisal Specialist Hospital and Research Center, a tertiary care center. PATIENTS AND METHODS: All patients who were managed with colostomy for ARM and had definitive repair during the period of January 2000 to December 2014...
September 2016: Annals of Saudi Medicine
Manoswini Chakrabarti, Ilika Ghosh, Aditi Jana, Manosij Ghosh, Anita Mukherjee
CONTEXT: Obesity is a major global health problem associated with various adverse effects. Pharmacological interventions are often necessary for the management of obesity. Orlistat is an FDA-approved antiobesity drug which is a potent inhibitor of intestinal lipases. OBJECTIVE: In the current study, orlistat was evaluated for its genotoxic potential in human lymphocyte cells in vitro and was compared with that of another antiobesity drug sibutramine, presently withdrawn from market due its undesirable health effects...
October 6, 2016: Drug and Chemical Toxicology
Shingo Noura, Masayuki Ohue, Norikatsu Miyoshi, Masayoshi Yasui
Transanal excision (TAE) for rectal tumors is increasingly applied and it is generally recommended that the defect following full-thickness excision should be closed. The aim of this study was to compare the complications and anal function following TAE between cases where the defect was closed and those where it was not. A total of 43 consecutive rectal malignant tumor patients eligible for TAE were investigated. Regarding anorectal function, incontinence was assessed using the Wexner score. The defect of the rectum was closed in 21 of the 43 patients...
October 2016: Molecular and Clinical Oncology
S Chakraborty, K J Feuerhak, A R Zinsmeister, A E Bharucha
BACKGROUND: While widely used in clinical practice, the reproducibility of high-definition anorectal manometry (HD-ARM) remains unclear. We evaluated the intra-individual reproducibility of HD-ARM and compared pressures measured with HD-ARM and high-resolution anorectal manometry (HR-ARM). METHODS: Thirty-six women with fecal incontinence had an initial HD-ARM (HD-ARM1); on the same day, after randomization, 21 had a second (HD-ARM2). Sixteen women had a third (HD-ARM3) 4 weeks later...
October 2, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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