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Rectal fissure

Thirumaraichelvan Perungo, Johnrose John Grifson, Anbazhagan Amudhan, Kannan Devy Gounder
A 23-year-old woman presented to the outpatients department with symptoms of acute onset perianal pain of 2 weeks' duration and constipation. She was a known case of Hirschsprung's disease and was operated on in infancy. Rectal examination ruled out acute fissure or perianal sepsis, and subsequent colonoscopy was normal. Because of persistent symptoms, she was evaluated further by imaging which revealed a presacral lesion closely abutting the nerve roots, suggesting the possibility of a nerve sheath tumour...
October 12, 2016: BMJ Case Reports
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...
October 10, 2016: Permanente Journal
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
Daška Štulhofer Buzina, Ivana Martinac, Daniela Ledić Drvar, Romana Čeović, Ivan Bilić, Branka Marinović
Dear Editor, Inhibition of the epidermal growth factor receptor (EGFR) is a new strategy in treatment of a variety of solid tumors, such as colorectal carcinoma, non-small cell lung cancer, squamous cell carcinoma of the head and neck, and pancreatic cancer (1). Cetuximab is a chimeric human-murine monoclonal antibody against EGFR. Cutaneous side effects are the most common adverse reactions occurring during epidermal growth factor receptor inhibitors (EGFRI) therapy. Papulopustular rash (acne like rash) develop with 80-86% patients receiving cetuximab, while xerosis, eczema, fissures, teleangiectasiae, hyperpigmentations, and nail and hair changes occur less frequently (2)...
April 2016: Acta Dermatovenerologica Croatica: ADC
Patricia Sachi Kawada, Edward Vincent O'Loughlin, Michael Oswald Stormon, Shoma Dutt, Cheng Hiang Lee, Kevin John Gaskin
INTRODUCTION: Lower gastrointestinal endoscopy (LGIE)/colonoscopy is frequently performed for rectal bleeding, recurrent abdominal pain and the diagnosis of Inflammatory Bowel Disease (IBD). Although these are common indications, the yield for isolated rectal bleeding and recurrent abdominal pain in the otherwise well child has not been described. METHODS: A retrospective analysis of patients who had had a LGIE/colonoscopy from January 2001 - December 2010 was performed...
March 7, 2016: Journal of Pediatric Gastroenterology and Nutrition
Young Wook Kim, Hwang Choi, Gi Jun Kim, Seung Jee Ryu, Sung Min Park, Joon Sung Kim, Jeong-Seon Ji, Byung-Wook Kim, Bo-in Lee, Myung-Gyu Choi
BACKGROUND/AIMS: Although colonoscopy is not indicated in patients with hematochezia, many surgeons, internists, and physicians are recommending colonoscopy for these patients in Korea. The aim of this study is to evaluate the diagnostic value of colonoscopy for patients with hematochezia. METHODS: We retrospectively reviewed the data of colonoscopy between January 2010 and December 2010. A total of 321 patients among 3,038 colonoscopies (10.6%) underwent colonoscopy to evaluate the cause of hematochezia...
February 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Jacek Hermann, Piotr Eder, Tomasz Banasiewicz, Konrad Matysiak, Liliana Łykowska-Szuber
Anal fistulas occurring in Crohn's disease (CD) comprise a risk factor of severe course of inflammation. They are frequently intractable due to various factors such as penetration of the anal canal or rectal wall, impaired wound healing, and immunosuppression, among others. Anal fistulas typical to CD develop from fissures or ulcers of the anal canal or rectum. Accurate identification of the type of fistula, such as low and simple or high and complex, is crucial for prognosis as well as for the choice of treatment...
2015: Przegla̜d Gastroenterologiczny
F Gaj, L Candeloro, I Biviano
BACKGROUND AND AIMS: Our experience in colon-proctology showed the need to update the post-surgical complications score we published (1), adding others that may have an impact on outcome of treatment. The aim of this study was to assess the efficacy of a score obtained from the analysis of the quality of life and severity of complications after proctologic surgery. MATERIALS AND METHODS: Between January and December 2013, we studied 150 patients undergoing several ano-rectal surgeries for the presence of hemorrhoids of grade III and IV (63 patients), anal fissures (42 patients), anal fistulas (19 patients), rectocele (15 patients) and mucosal prolapse of the rectum (11 patients)...
2015: La Clinica Terapeutica
B A Nanaeva, A V Vardanian, I L Khalif
AIM: To determine the efficacy of 0.1% tacrolimus ointment in patients with perianal Crohn's disease (CD). SUBJECTS AND METHODS: This prospective randomized trial enrolled 20 patients with perianal CD as anal fissures and rectal fistulas. The inclusion criteria were rectovaginal or extrasphincteric fistulas and purulent leakages. A study group comprised 11 patients, including 9 with anal fissures and 2 with fistulas. A control group included 9 patients, including 8 with fissures and 1 with fistulas...
2015: Terapevticheskiĭ Arkhiv
Ahmad Amouzeshi, Zahra Amouzeshi, Ghodratollah Naseh, Seyyed Amir Vejdan, Amir Saber Tanha, Mahmood Hosseinzadeh, Seyyedeh Raziyeh Vagharseyyedin
BACKGROUND: Given the limited data on the need of mechanical bowel preparation application before anorectal surgeries and the preferred method for bowel preparation, we aimed to compare saline enema and bisacodyl in rectal preparation before anorectal surgery. MATERIALS AND METHODS: This is a randomized clinical trial study. Seventy-nine hospitalized patients for anorectal surgery (hemorrhoid, fissure, and fistula) were recruited by convenient sampling and then randomly allocated to receive 500 cc Saline by rectal enema or six bisacodyl tablets (Sobhan company) beginning from a day before the operation in order to prepare the bowel...
December 2015: Journal of Surgical Research
Natalia Mihailovna Grekova, Elena Anatolyevna Maleva, Yuliana Lebedeva, Viktor Nicolaevich Bordunovsky, Larisa Fedorovna Telesheva, Vladimir Anatolyevich Bychkovskikh
BACKGROUND: Chronic anal fissures (CAFs) rarely heal with conservative management. Because they are associated with strong anal sphincter tone, most treatment aim to reduce anal pressure. Although infections can cause fissures, as can traumatic injury to the anal canal, antimicrobial treatment is not recommended. In a previous study, we reported identifying a wide spectrum of pathogenic microorganisms in the bases of CAFs, anaerobic bacteria being present in half the cases. We postulated that microbial colonization delays healing of CAF and aimed to determine whether decreasing the bacterial load with topical antibacterial treatment accelerates fissure healing...
March 2015: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
Vijaya Kumari Kurapati, K Nishteswar
BACKGROUND: Ano-rectal complaints are usually benign in origin. Most of the patients suffering with these disorders do not seek medical advice at an early stage due to embarrassment. It results in advancement of the disease and significant disturbance in the quality of life. Among the available treatment modalities of ano-rectal disorders (ARDs), Kṣārasūtra (medicated thread) appears to be the best in terms of relief and nonrecurrence. AIMS AND OBJECTIVES: The aim of this study is to provide evidence-based data about the practical application of Kṣārasūtra (medicated thread) in the management of ARDs...
October 2014: Ancient Science of Life
Seyed Mohsen Dehghani, Niloofar Kulouee, Naser Honar, Mohammad-Hadi Imanieh, Mahmood Haghighat, Hazhir Javaherizadeh
BACKGROUND Constipation is one of the most frequent cause of patient visits to pediatric gastroenterology clinics. Early diagnosis and treatment is important. There are few studies about clinical manifestations of constipation in children. We aimed to find the relative frequency of gastrointestinal manifestations of constipation among constipated children. METHODS This cross-sectional study was carried out on children aged < 18 years old with chronic functional constipation referred to Imam Reza Clinic of Shiraz University of Medical Sciences...
January 2015: Middle East Journal of Digestive Diseases
Tukaram S Dudhamal, Madhav Singh Baghel, Chaturbhuja Bhuyan, Sanjay Kumar Gupta
BACKGROUND: Parikartika resembles fissure-in-ano which is very common among all ano-rectal disorders. In Ayurvedic texts, Parikartika is described as a complication of Vamana and Virechana as well as complication of Atisara. Ksharasutra was proved successful in the management of fistula-in-ano, piles, and there is a need to try its efficacy in fissure-in-ano. AIM: To evaluate the role of Ksharasutra suturing (KSS) in fissure bed in chronic fissure-in-ano. MATERIALS AND METHODS: Total 100 patients of chronic fissure-in-ano were selected and randomly divided into two groups (50 in each group)...
April 2014: Ayu
Mehdi Moghaddasi, Mahboubeh Aghaii, Mansoureh Mamarabadi
Rectal and perianal pain is a common problem. Most people have experienced it at least once in their lifetime. It usually manifests as mild discomfort, but sometimes the pain can be so severe that it is incapacitating. A 59-year-old woman admitted with a 2-year history of paroxysmal perianal pain underwent a full work-up including proctoscopy, sigmoidoscopy, full colonoscopy, and barium enema that were unremarkable. Lumbosacral magnetic resonance imaging with and without gadolinium showed an intradural-extramedullary lesion at the level of L5...
December 2014: Journal of Neurological Surgery Reports
Baruch Klin, Yigal Efrati, Matitiahu Berkovitch, Ibrahim Abu-Kishk
BACKGROUND: We aimed to evaluate efficacy and safety of the use of nifedipine gel with lidocaine in the treatment of acute anal fissures in children by reviewing the cases of 106 children with acute anal fissure treated conservatively by nifedipine gel with lidocaine between the years 2003-2012. METHODS: The patients included in this study were 48 males and 58 females. Their clinical presentation consisted of constipation, rectal bleeding, anal pain, perianal itching, abdominal pain, irritability and rectal prolapse...
June 2016: Minerva Pediatrica
Katie H Stowers, Amber D Hartman, Jillian Gustin
BACKGROUND: Perineal pain is a frequent complaint of patients with advanced cancer (colorectal, genitourinary, prostate), and often quite difficult to manage with significant impact on quality of life. Calcium channel blockers (CCBs) are potent inhibitors of intestinal smooth muscle contraction and have been shown to impact tone and motility of the gastrointestinal tract. As such, they have been used in various pain syndromes of the lower gastrointestinal tract, such as chronic anal fissure, to promote healing and improve pain...
September 2014: Journal of Palliative Medicine
Arnold Wald, Adil E Bharucha, Bard C Cosman, William E Whitehead
These guidelines summarize the definitions, diagnostic criteria, differential diagnoses, and treatments of a group of benign disorders of anorectal function and/or structure. Disorders of function include defecation disorders, fecal incontinence, and proctalgia syndromes, whereas disorders of structure include anal fissure and hemorrhoids. Each section reviews the definitions, epidemiology and/or pathophysiology, diagnostic assessment, and treatment recommendations of each entity. These recommendations reflect a comprehensive search of all relevant topics of pertinent English language articles in PubMed, Ovid Medline, and the National Library of Medicine from 1966 to 2013 using appropriate terms for each subject...
August 2014: American Journal of Gastroenterology
P O Igwe, A Dodiyi-Manuel, K C Oparaku
INTRODUCTION: Disorders of the anus and rectum occurcommonly in surgical practice. Common anorectal disorders include haemorrhoids, carcinoma of the rectum, anal fissures, anorectal fistulae and abscesses. Less frequently encountered disorders include perineal injuries, anal cancers and rectal polyps. The purpose of this study is to determine the pattern of anorectal diseases which were surgically treated in University of Port Harcourt Teaching Hospital. PATIENTS AND METHODS: This is a 4 year retrospective study of all adult patients with anorectal diseases who were admitted into the surgical wards of University of Port Harcourt Teaching Hospital...
January 2014: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
Giuseppe Brisinda, Giuseppe Bianco, Nicola Silvestrini, Giorgio Maria
Anal fissure is a split in the lining of the distal anal canal. Lateral internal sphincterotomy remains the gold standard for treatment of anal fissure. Although technique is simple and effective, a drawback of this surgical procedure is its potential to cause minor but some times permanent alteration in rectal continence. Conservative approaches (such as topical application of ointment or botulinum toxin injections) have been proposed in order to treat this condition without any risk of permanent injury of the internal anal sphincter...
August 2014: Expert Review of Pharmacoeconomics & Outcomes Research
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