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Perianal disease

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
José María Enriquez-Navascués, Garazi Elorza, Carlos Placer, Ander Timoteo, Leyre Velaz, Nerea Borda, Yolanda Saralegui
OBJECTIVE: The aim of this study was to determine factors associated with a prolonged postoperative stay (PS) in patients operated on with bowel resection for Crohn's disease (CD) included in an enhanced recovery program (ERP). METHODS: We included patients operated on for CD between January 2013 and December 2015. ERP was organized following an 8-point protocol. Variables studied were: age, sex, PS, ASA, location and type of CD, presence of perianal disease, Harvey-Bradshaw index, previous resection, type of surgery (minimally invasive vs...
October 19, 2016: Cirugía Española
Kazuhiko Yoshimatsu, Gakuji Osawa, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Akiko Sakuma, Masaya Satake, Yasufumi Yamada, Shinichi Asaka, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Takeshi Shimakawa, Takao Katsube, Yoshihiko Naritaka
A 78-year-old man visited our hospital with a prolapsed hemorrhoid. He was referred to the dermatology unit due to the thickness and redness of the perianal skin. He was diagnosed as having extra mammary Paget's disease by skin biopsy. After a biopsy of the anal polyp was performed to investigate the primary site, he was diagnosed with early anal canal cancer with Pagetoid spread and underwent a radical operation. Abdominoperineal resection with skin(D2 prx D3 lymphadenectomy) was performed with perineal reconstruction using a gracilis muscle graft...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Georgios-Marios Makris, Nikiforita Poulakaki, Aristea-Maria Papanota, Evgenia Kotsifa, Theodoros N Sergentanis, Theodora Psaltopoulou
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that frequently involves the perineal and perianal regions. The association between HS and malignant transformation is a rare but under recognized phenomenon. OBJECTIVE: This systematic review aims to summarize all available cases of vulvar and perianal/perineal cancer emerging in patients with HS, describing clinical and therapeutic particularities of these coexisting conditions in female patients...
October 13, 2016: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
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.
September 30, 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Jatinder Singh, Ryan C Johnson, Carey D Schlett, Emad M Elassal, Katrina B Crawford, Deepika Mor, Jeffrey B Lanier, Natasha N Law, William A Walters, Nimfa Teneza-Mora, Jason W Bennett, Eric R Hall, Eugene V Millar, Michael W Ellis, D Scott Merrell
Skin and soft tissue infections (SSTIs) are common in the general population, with increased prevalence among military trainees. Previous research has revealed numerous nasal microbial signatures that correlate with SSTI development and Staphylococcus aureus colonization. Thus, we hypothesized that the ecology of the inguinal, oropharynx, and perianal regions may also be altered in response to SSTI and/or S. aureus colonization. We collected body site samples from 46 military trainees with purulent abscess (SSTI group) as well as from 66 asymptomatic controls (non-SSTI group)...
September 2016: MSphere
Yuzo Nagai, Sinsuke Kazama, Daisuke Yamada, Takuya Miyagawa, Koji Murono, Koji Yasuda, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Kazushige Kawai, Yuri Masui, Hiroaki Nozawa, Hironori Yamaguchi, Soichiro Ishihara, Takafumi Kadono, Toshiaki Watanabe
Treatment of perianal and vulvar extramammary Paget disease (EMPD), rare intraepithelial malignancies, is often challenging because of its potential to spread into the anal canal. However, there is still no consensus regarding the optimal resection margin within the anal canal. Between 2004 and 2014, six patients (three with perianal EMPD and three with vulvar EMPD) in which the spread of Paget cells into the anal canal was highly suspected were referred to our department. To evaluate the disease extent within the anal canal, preoperative mapping biopsy of the anal canal was performed in five out of six patients...
October 2016: Annals of Dermatology
Solvey Schüle, Jean-Benoît Rossel, Diana Frey, Luc Biedermann, Michael Scharl, Jonas Zeitz, Natália Freitas-Queiroz, Valérie Pittet, Stephan R Vavricka, Gerhard Rogler, Benjamin Misselwitz
BACKGROUND: Low bone mineral density (BMD) remains a frequent problem in patients with inflammatory bowel diseases (IBD). There is no general agreement regarding osteoporosis screening in IBD patients. METHODS: Cases of low BMD and disease characteristics were retrieved from 3172 patients of the Swiss IBD cohort study. Multivariate logistic regression analysis was conducted for predictive modeling. In a subgroup of 877 patients, 253 dual-energy X-ray absorptiometry (DXA) scans were available for validation...
October 2016: United European Gastroenterology Journal
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
D Carrillo-Quintero, L Del Otero Sanz, S Hernández-Egido, A M Martín Sánchez
OBJECTIVE: Enterobius vermicularis, also known as pinworn, is the responsible agent for Human Enterobiasis. It is one of the most prevalent, but underrated, parasitic disease in children population. Diagnosis involves demonstration of either eggs or adult worms by Graham test. The aim of this study is to describe the clinical, demographic and microbiological features of patients with suspected diagnosis of Enterobiasis in southern Gran Canaria. METHODS: Descriptive and prospective study of perianal samples evaluated by Graham test in the Microbiology Department of `Insular de Gran Canaria´ University Hospital between November 2014 and November 2015...
October 7, 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Remigio Pernetti, Fabiano Palmieri, Elisabetta Sagrini, Marco Negri, Claudio Morisi, Andrea Carbone, Paolo Bassi, Salvatore Voce
Fournier's gangrene is a life-threatening acute necrotizing fasciitis of perianal,genitourinary and perineal areas. Nowadays, is well known that Fournier gangrene is almost never an idiopathic disease. In this article we report a case of a 70-year-old patient that initially was not treated properly. The gold standard therapy of the Fournier's gangrene remains today a complete, early and extended surgical debridement.
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Ariana Singh, Kamran Ahmed, Abdullatif Aydin, Muhammad Shamim Khan, Prokar Dasgupta
INTRODUCTION AND HYPOTHESIS: Fournier's gangrene is a rare, necrotising fasciitis of the external genitalia, perineal or perianal regions. The disease has a higher incidence in males and risk factors for development include diabetes, HIV, alcoholism and other immune-compromised states. The aggressive disease process is associated with a high mortality rate of 20-30%. In addition, the increasing age and prevalence of diabetes in the population, begs the need for increased clinical awareness of Fournier's gangrene with emphasis on early diagnosis and management...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Yana Davidov, Bella Ungar, Haggai Bar Yoseph, Dan Carter, Ola Haj-Natour, Miri Yavzori, Yehuda Chowers, Rami Eliakim, Shomron BenHorin, Uri Kopylov
BACKGROUND: The association of infliximab (IFX) trough levels with clinical and endoscopic outcomes in inflammatory bowel disease is well established. However there is scarce data regarding the association of perianal fistula response with IFX. The aim of the study was to establish whether early induction infliximab levels and anti-infliximab antibodies (ATI) are associated with perianal fistula response. METHODS: Consecutive CD patients with perianal fistulae that were treated with IFX between 2008 and 2016 were included in the study...
October 4, 2016: Journal of Crohn's & Colitis
Neslihan Edeer Karaca, Guzide Aksu, Ezgi Ulusoy, Serap Aksoylar, Salih Gozmen, Ferah Genel, Sanem Akarcan, Nesrin Gulez, Tatjana Hirschmugl, Savas Kansoy, Kaan Boztug, Necil Kutukculer
Alterations of immune homeostasis in the gut may result in development of inflammatory bowel disease. A five-month-old girl was referred for recurrent respiratory and genitourinary tract infections, sepsis in neonatal period, chronic diarrhea, perianal abscess, rectovaginal fistula, and hyperemic skin lesions. She was born to second-degree consanguineous, healthy parents. Her elder siblings were lost at 4 months of age due to sepsis and 1 year of age due to inflammatory bowel disease, respectively. Absolute neutrophil and lymphocyte counts, immunoglobulin levels, and lymphocyte subsets were normal ruling out severe congenital neutropenia and classic severe combined immunodeficiencies...
2016: Case Reports in Immunology
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
Seung Woo Cho, Hak Chang, Sung Tack Kwon
Extramammary Paget's disease (EMPD) is a rare, slow-growing intraepithelial malignancy that mainly involves the genital region, including the vulva, penis, scrotum, perianal, and periurethral areas. Although several treatment options exist, wide local excision with a safe margin is considered the treatment of choice. After resection of the lesion, it is often challenging to reconstruct the defect because defects in the perineal region require adequate volume for protection and are susceptible to infections, which is a particularly significant risk for large defects...
September 2016: Archives of Plastic Surgery
Gautam Ray
There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India. IBD in second generation Indian migrants to the West takes the early onset and more severe form of the West whereas it retains the nature of its country of origin in migrants to SEA countries...
September 28, 2016: World Journal of Gastroenterology: WJG
Meeta Dipak Mantri, Mahajan M Pradeep, Patil O Kalpesh, Raj J Pranavsinh
Hyaline fibromatosis syndrome (HFS) is rare autosomal recessive disease characterized by the deposition of amorphous hyaline material in skin and visceral organs. It represents a disease spectrum with infantile systemic hyalinosis (ISH) being the severe form and juvenile hyaline fibromatosis (JHF) being the mild form. Dermatologic manifestations include thickened skin, perianal nodules, and facial papules, gingival hyperplasia, large subcutaneous tumors on the scalp, hyperpigmented plaques over the metacarpophalangeal joints and malleoli, and joint contractures...
September 2016: Indian Journal of Dermatology
Cláudia Camila Dias, Pedro Pereira Rodrigues, Rosa Coelho, Paula Moura Santos, Samuel Fernandes, Paula Lago, Cidalina Caetano, Ângela Rodrigues, Francisco Portela, Ana Oliveira, Paula Ministro, Eugénia Cancela, Ana Isabel Vieira, Rita Barosa, José Cotter, Pedro Carvalho, Isabelle Cremers, Daniel Trabulo, Paulo Caldeira, Artur Antunes, Isadora Rosa, Joana Moleiro, Paula Peixe, Rita Herculano, Raquel Gonçalves, Bruno Gonçalves, Helena Tavares Sousa, Luís Contente, Henrique Morna, Susana Lopes, Fernando Magro
INTRODUCTION: The establishment of prognostic models for Crohn's disease (CD) is highly desirable, as they have the potential to guide physicians in the decision-making process concerning therapeutic choices, improving patients' health and quality of life. Our aim was to derive models for disabling CD disease and reoperation based solely on clinical/demographic data. METHODS: A multicentric and retrospectively-enrolled cohort of CD patients, subject to early surgery or immunosuppression, was analized to build Bayesian network models and risk matrices...
September 28, 2016: Journal of Crohn's & Colitis
Xi Chen, Xiaosheng He, Yifeng Zou, Ping Lan
OBJECTIVE: To determine the indications of colonoscopic screening for Crohn's disease in patients with fistula-in-ano. METHODS: Clinical data of 302 patients with perianal fistula who received colonoscopy examination from January 2010 to December 2013 in the Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University were analyzed retrospectively. Parameters for differentiating perianal Crohn's disease from nonspecific fistulae were screened by logistic regression analysis...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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