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Rectal stenosis

Maja Gruber, Ida Füglistaler, Andreas Zettel, Mark Fox, Michael Manz
Solitary rectal ulcer syndrome (SRUS) is a benign disease that is often misdiagnosed. It is characterized by a combination of symptoms, endoscopic findings and histology. Patients present with constipation, rectal bleeding, mucous discharge, pain and a sensation of incomplete defecation. There are many different manifestations of this disease, with or without rectal prolapse. We report an unusual presentation of SRUS as a circular stenosis in a middle-aged male.
May 2016: Case Reports in Gastroenterology
Bindey Kumar, Amit Kumar Sinha, Prem Kumar, Anil Kumar
Currarino syndrome (CS) is a rare clinical condition. The classical presentation includes a triad of sacral anomaly, anorectal malformations, and presacral mass. This syndrome belongs to the group of persistent neuroenteric malformations. This article presents two cases of Currarino syndrome, where there was rare clinical variants such as rectal atresia in the first case and rectal stenosis in the second case. The clinical presentations were very deceptive as the first case presented as high anorectal malformation and the second case was simulating Hirschprung's disease...
October 2016: Journal of Indian Association of Pediatric Surgeons
Ramez R Hanna, Nicholas Kolanko, Carlos Torres
History A 70-year-old woman presented to a peripheral hospital with signs and symptoms of acute chronic obstructive pulmonary disease (COPD) exacerbation. The patient also reported acute on chronic onset of thoracolumbar back pain over a period of 24 hours. She denied any history of recent trauma or intravenous drug use. She did not have any long-term indwelling catheters. The patient's medical history was also complicated by stage 4 renal failure from long-standing type II diabetes, hypertension, iron deficiency anemia, aortic stenosis, and prior bariatric surgery...
October 2016: Radiology
Qiyuan Qin, Tenghui Ma, Yanhong Deng, Jian Zheng, Zhiyang Zhou, Hui Wang, Lei Wang, Jianping Wang
BACKGROUND: Evidence regarding the effect of preoperative radiotherapy on anastomotic integrity remains conflicting in rectal cancer surgery. Prospective comparisons with appropriate controls are needed. OBJECTIVE: This study aimed to assess the impact of preoperative radiotherapy on anastomotic leakage and stenosis after rectal cancer resection. DESIGN: This was a post hoc analysis of a randomized controlled trial (NCT01211210). SETTINGS: Data were retrieved from the leading center of the trial, which is a tertiary hospital...
October 2016: Diseases of the Colon and Rectum
Fumihiko Matsuzawa, Shigenori Homma, Tadashi Yoshida, Susumu Shibasaki, Nozomi Minagawa, Tatsushi Shimokuni, Hideyasu Sakihama, Hideki Kawamura, Norihiko Takahashi, Akinobu Taketomi
BACKGROUND: The incidence of rectovaginal fistula in women with Crohn's disease has been reported to be 3-10 %. Although rectovaginal fistulas can be managed medically and surgically, they have high rates of recurrence and complications. Rectal stenosis is another condition that occurs due to perianal Crohn's disease. A novel, minimally invasive procedure, dual-port laparoscopic abdominoperineal resection using a multichannel port, has been shown effective in patients with lower rectal cancer and patients with medically uncontrolled ulcerative colitis...
December 2016: Surgical Case Reports
Toshinari Kawasaki, Hitoshi Fukuda, Yoshitaka Kurosaki, Akira Handa, Masaki Chin, Sen Yamagata
BACKGROUND: The patient with SAH by hemorrhagic AVFs usually presents with meningeal signs including headache and nausea, and focal neurological deficit is found in rare cases. In this article, we report a case of acute compressive cervical myelopathy caused by hemorrhagic AVF at the craniocervical junction. CLINICAL DESCRIPTION: A 73-year-old woman was transferred to our hospital for sudden headache and subsequent left hemiparesis. Head CT showed subarachnoid hemorrhage (SAH) exclusively in the posterior fossa, and catheter angiography revealed a perimedullary arteriovenous fistula at the craniocervical junction as a source of the SAH...
August 24, 2016: World Neurosurgery
Shenghui Huang, Pan Chi, Huiming Lin, Xingrong Lu, Ying Huang, Zongbin Xu, Yanwu Sun, Daoxiong Ye, Xiaojie Wang, Xiaohan Lin
OBJECTIVE: To compare the short-term efficacy of laparoscopic and open transabdominal intersphincteric resection (ISR) for low rectal cancer. METHODS: Clinicopathological data of 246 patients with low rectal cancer undergoing transabdominal ISR in our department from January 2005 to January 2015 were retrospectively analyzed. According to gender, age, ASA score, neoadjuvant chemoradiotherapy or not, pathological T stage, pathologic N stage, and tumor differentiation, propensity score matching was performed by R plug-in(version 2...
August 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
S L Siow, H A Mahendran, C J Seo
PURPOSE: The management of haemorrhagic radiation proctitis is challenging because of the necessity for repeated intervention. The efficacy of argon plasma coagulation has been described before but the optimum treatment strategy remains debatable. This is a review of our experience over a decade treating patients with haemorrhagic radiation proctitis and their follow-up. METHODS: This is a retrospective review of consecutive patients who underwent argon plasma coagulation for haemorrhagic radiation proctitis between January 2003 and December 2013...
August 15, 2016: International Journal of Colorectal Disease
Shinichi Sameshima, Shinichiro Koketsu, Takashi Okuyama, Yawara Kubota, Yuko Ono, Tamaki Noie, Masatoshi Oya
BACKGROUND: Previous studies reported that nephrotic syndrome is associated with ulcerative colitis (UC) patients treated with mesalazine. Dysplasia associated with UC often develops into colorectal carcinoma. CASE PRESENTATION: A 17-year-old man was referred to our hospital, complaining of diarrhea and bloody stool. Total colonoscopy (TC) was performed and total-type UC was diagnosed. After treatment with mesalazine for 5 years, a low-grade dysplasia (LGD) was detected in the rectum by histological analysis of a biopsy sample...
2016: World Journal of Surgical Oncology
Masafumi Kuramoto, Satoshi Ikeshima, Kenichiro Yamamoto, Keisuke Morita, Tomoyuki Uchihara, Rumi Itouyama, Shinichi Yoshimatsu, Shinya Shimada, Hideo Baba
The double stapling technique (DST) is an intestinal reconstruction technique that has been widely adopted in anterior resection (AR) for rectal cancer. However, anastomotic leakage (AL) after the operation remains a major concern for colorectal surgeons. The sharp-angled corner of the remnant rectum that is often created by the ordinary DST can be a risk factor for AL. We have developed a new method of performing intentional oblique transection DST (IOT-DST). Using this technique, the anal side of the rectum is intentionally obliquely transected with linear staplers, and the area of the sharp-angled edge is totally punched out with a circular stapler...
July 14, 2016: Surgery Today
Tetsuro Tominaga, Katsunori Takagi, Hiroaki Takeshita, Tomo Miyamoto, Kozue Shimoda, Ayano Matsuo, Keitaro Matsumoto, Shigekazu Hidaka, Naoya Yamasaki, Terumitsu Sawai, Takeshi Nagayasu
The use of patient-specific organ models in three-dimensional printing systems could be helpful for the education of patients and medical students. The aim of this study was to clarify whether the use of patient-specific stoma models is helpful for patient education. From January 2014 to September 2014, 5 patients who underwent colorectal surgery and for whom a temporary or permanent stoma had been created were involved in this study. Three-dimensional stoma models and three-dimensional face plates were created...
January 2016: Case Reports in Gastroenterology
Renaud Mazeron, Lars U Fokdal, Kathrin Kirchheiner, Petra Georg, Noha Jastaniyah, Barbara Šegedin, Umesh Mahantshetty, Peter Hoskin, Ina Jürgenliemk-Schulz, Christian Kirisists, Jacob C Lindegaard, Wolfgang Dörr, Christine Haie-Meder, Kari Tanderup, Richard Pötter
PURPOSE: To establish dose volume-effect relationships predicting late rectal morbidity in cervix cancer patients treated with concomitant chemoradiation and MRI-guided adaptive brachytherapy (IBABT) within the prospective EMBRACE study. MATERIAL AND METHOD: All patients were treated with curative intent according to institutional protocols with chemoradiation and IGABT. Reporting followed the GEC-ESTRO recommendations ( [Formula: see text] , [Formula: see text] ), applying bioeffect modeling (linear quadratic model) with equieffective doses (EQD23)...
July 7, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
G D'Agostino, C Franzese, F De Rose, D Franceschini, T Comito, E Villa, F Alongi, R Liardo, S Tomatis, P Navarria, P Mancosu, G Reggiori, L Cozzi, M Scorsetti
AIMS: The aim of this phase II study was to evaluate the efficacy and toxicity of stereotactic body radiotherapy in patients with low or intermediate risk prostate cancer. MATERIALS AND METHODS: Biopsy-confirmed prostate cancer patients were enrolled, provided that they had the following characteristics: initial prostate-specific antigen (PSA) ≤ 20 ng/ml, Gleason Score < 7, International Prostate Symptom Score < 7. The treatment schedule was 35 Gy in five fractions, delivered with volumetric modulated arcs with flattening filter free beams...
July 4, 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Fanghai Han, Hongming Li
Prevention of intraoperative incidental injuries during radical operation for rectal cancer and management of postoperative complication are associated with successful operation and prognosis of patients. This paper discusses how to prevent such intraoperative incidental injuries and how to manage postoperative complication. (1) Accurate clinical evaluation should be performed before operation and reasonable treatment decision should be made, including determination of the distance from transection to lower margin of the tumor, T and M staging evaluated by MRI, fascia invasion of mesorectum, metastasis of lateral lymph nodes, metastatic station of mesentery lymph node, association between levator ani muscle and anal sphincter, course and length of sigmoid observed by Barium enema, length assessment of pull-through bowel...
June 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Lílian Vital Pinheiro, Raquel Franco Leal, Cláudio Saddy Rodrigues Coy, João José Fagundes, Carlos Augusto Real Martinez, Maria de Lourdes Setsuko Ayrizono
INTRODUCTION: Rectal prolapse is a disabling condition that often affects older patients with multiple comorbidities making complex surgeries impossible to perform. METHODS: A retrospective review of patients who underwent perineal rectosigmoidectomy (Altemeier procedure) for rectal prolapse from January 1999 to March 2015 was performed in a Reference Hospital, being evaluated complications and surgery recurrence. RESULTS: Thirty-six Altemeier procedures were performed in 33 patients during the study...
August 2016: International Journal of Surgery
Seiji Okimasa, Yasufumi Saito, Hiroshi Okuda, Toshikatsu Fukuda, Masatsugu Yano, Yuzo Okamoto, Eiji Ono, Hideki Ohdan
BACKGROUND: The number of patients who have difficulty with mutual understanding has been increasing recently due to an aging society. This emerging issue needs to be addressed. We report an instructive case of a patient who had communication difficulties due to dementia and sequelae of alcoholic encephalopathy. CASE PRESENTATION: A 66-year-old man of Mongolian race presented with coronary arteriosclerosis, spinal canal stenosis, transverse colon cancer, and alcoholic encephalopathy...
2016: Journal of Medical Case Reports
Wouter B van der Sluis, Mark-Bram Bouman, Marlon E Buncamper, Garry L S Pigot, Margriet G Mullender, Wilhelmus J H J Meijerink
OBJECTIVE: To describe our experience and results obtained in the management of neovaginal fistulas after vaginoplasty as gender reassignment surgery in transgender women. METHODS: A retrospective study was performed of 1,082 transgender women who underwent 1,037 primary and 80 revision vaginoplasty procedures between 1990 and 2015. Thirty-five women underwent both primary and later revision vaginoplasty at our institution. Patient, clinical, surgical, and outcome characteristics were reviewed...
June 2016: Obstetrics and Gynecology
Seiichiro Abe, Taku Sakamoto, Hiroyuki Takamaru, Masayoshi Yamada, Takeshi Nakajima, Takahisa Matsuda, Yutaka Saito
BACKGROUND: Endoscopic submucosal dissection (ESD) is a minimally invasive treatment option for large rectal tumors. There are limited data available on stenosis rates following ESD of large rectal lesions. We aimed to evaluate the stenosis rate following ESD of large rectal tumors with rectal mucosal defects greater than three quarters of the circumference. METHODS: We retrospectively identified patients who underwent rectal ESD between January 1998 and July 2014...
April 28, 2016: Surgical Endoscopy
Shenghui Huang, Pan Chi, Huiming Lin, Xingrong Lu, Ying Huang, Weizhong Jiang, Zongbin Xu, Yanwu Sun, Daoxiong Ye, Xiaojie Wang
OBJECTIVE: To explore the risk factors and clinical features of delayed anastomotic fistula (DAF) following sphincter-preserving operation for rectal cancer. METHODS: Clinical data of 1 594 patients with rectal cancer undergoing sphincter-preserving operation in our department from January 2008 to May 2015 based on the prospective database of Dpartment of Colorectal Surgery, Fujian Medical University Union Hospital were retrospectively analyzed. Sixty patients(3...
April 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Siho Kim, Sang Su Bae, Hyung Jun Chu, Ji Hwan Park, Gyu Cheon Kyung, Hyo Dong An, Keun Kim, Eun Gyu Gang
Capsule endoscopy is being increasingly recognized as a gold standard for diagnosing small bowel disease, but along with the increased usage, capsule retention is being reported more frequently. We report a case of capsule endoscopy retention in a diverticulum of the duodenal proximal third portion, which we treated by esophagogastroduodenoscopy. A 69-year-old male visited hospital with hematochezia. He had hypertension and dyslipidemia for several years, and was taking aspirin to prevent heart disease. CT and colonoscopy revealed a diverticulum in the third portion of the duodenum, rectal polyps, and internal hemorrhoids...
April 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
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