1/37. Retrorectal cystic harmatoma (tailgut cyst) in an infant: case report.We report the case of a day old infant who presented with a large cystic swelling in the sacroccoygeal area distorting the gluteal folds and displacing the anus anteriorly. Rectal examination revealed less than twenty five per cent of the lesion in retrorectal space, plain x-rays did not show any calcification. The infant had excision surgery at seven days of age and did well thereafter. Although most TGC cases were reported in adults the present case fulfills the anatomical and histological criteria for diagnosis, and it may be the first such case in a child less than one month old.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
2/37. Solitary rectal ulcer syndrome in children.Solitary rectal ulcer syndrome (SRUS) is rare in children. Few reported cases have undergone detailed investigations, treatments have been extremely varied and outcome poorly documented. We report two cases of SRUS in children, each with a different macroscopic pathology. The diagnosis was delayed in both cases. The importance of appropriate investigation and the need to tailor treatment to the type of lesion are emphasised. One case of SRUS was associated with a complete, full thickness rectal prolapse and symptoms improved after an abdominal sutured rectopexy. The other patient responded well to endoanal excision of polypoid lesions. The diagnosis and management of this condition in children deserves wider recognition.- - - - - - - - - - ranking = 227.43975090547keywords = rectal prolapse, prolapse (Clic here for more details about this article) |
3/37. Solitary rectal ulcer syndrome (colitis cystica profunda) in spinal cord injury patients: 3 case reports.Clinically indicated endoscopic examinations of 56 patients with spinal cord injury (SCI) (31 for bleeding) were performed over a 3-year period, of which 3 (6%) showed solitary rectal ulcer syndrome (SRUS). The presentation was rectal bleeding or mucoid discharge. The endoscopic appearance was multiple pseudopolyps and occasional mucosal ulcers extending proximally 8 to 40cm from the anus. Mucosal biopsy specimens showed distorted mucosal glands and displaced smooth muscle fibers wrapping around the glands, the hallmark of SRUS. The affected patients had routinely used suppositories and digital stimulation for bowel care and had been paralyzed 7 to 50 years. None had rectal prolapse. These cases show that SRUS (colitis cystica profunda) can be found among patients with SCI.- - - - - - - - - - ranking = 228.43975090547keywords = rectal prolapse, prolapse, anus (Clic here for more details about this article) |
4/37. Solitary rectal ulcer syndrome presenting with rectal prolapse, severe mucorrhea and eroded polypoid hyperplasia: case report and review of the literature.A case of solitary rectal ulcer syndrome in a 36-year-old woman presenting with severe, persistent mucorrhea and eroded polypoid hyperplasia as the predominant clinical features, who was ultimately noted to have symptoms of rectal prolapse, is presented. Endoscopically, she had multiple (50 to 60) small, whitish polypoid lesions in the rectum that were initially misinterpreted as being a carpeted villous adenoma, juvenile polyposis or atypical proctitis. The lesions were treated with argon plasma coagulation with resolution, but a solitary rectal ulcer developed. The patient then admitted to a history of massive rectal prolapse over the preceding six months and underwent surgical treatment. Severe mucorrhea as the presenting feature and the presence of multiple polypoid lesions consistent with a histological diagnosis of eroded polypoid hyperplasia make the present case unique.- - - - - - - - - - ranking = 1364.6385054328keywords = rectal prolapse, prolapse (Clic here for more details about this article) |
5/37. Treatment of proctalgia fugax with botulinum A toxin.Two recent studies described a temporal association between a high-amplitude and high-frequency myoelectrical activity of the anal sphincter and the occurrence of proctalgia, which suggest that paroxysmal hyperkinesis of the anus may cause proctalgia fugax. We describe a single case of proctalgia fugax responding to anal sphincter injection of clostridium botulinum type a toxin. The presumed aetiology of proctalgia fugax is discussed and the possible mechanism of action of botulinum toxin (BTX) in this condition is outlined. Botulinum A toxin seems to be a promising treatment for patients with proctalgia fugax, and further trials appear to be worthwhile for this condition, which has been described as incurable.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
6/37. The solitary ulcer syndrome of the rectum.The solitary ulcer syndrome of the rectum is not rare but often remains unrecognised. A greater awareness of the condition will lead to more frequent diagnosis. The aetiology remains unproven but the evidence would suggest that a combination of prolapse, trauma and ischaemia, caused by excessive straining at stool may be important factors. The reasons for straining at stool are also obscure but in some cases a failure in the normal behaviour of the puborectalis may be involved. The history and clinical features of the condition are described, and the pathogenesis discussed.- - - - - - - - - - ranking = 4.8384733889002keywords = prolapse (Clic here for more details about this article) |
7/37. Acid-secreting rectal duplication cyst with associated peptic ulcer eroding through the anal sphincters.A rectal duplication cyst with heterotopic gastric mucosa that resulted in a trans-sphincteric peptic ulcer on the opposite wall of the anus of a child is described. The management and outcome and a review of the literature is presented.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
8/37. A rare and often unrecognized cause of hematochezia and tenesmus in childhood: solitary rectal ulcer syndrome.Solitary rectal ulcer syndrome (SRUS) is an unusual disorder of childhood, which usually presents with rectal bleeding, mucous discharge, prolonged straining, tenesmus, and localized pain in the perineal area. After the first description by Cruveilhier, Madigan and Morson further detailed the clinical and pathologic features of SRUS in 1969. The pathogenesis of the syndrome is not well-understood. The postulated mechanism responsible for rectal prolapse in most cases seems to be excessive straining efforts during which high intra-abdominal pressure forces the anterior rectal mucosa firmly into the contracting puborectalis muscle. The anterior rectal mucosa is frequently forced into the anal canal and as a consequence becomes strangulated, causing congestion, edema, and ulceration. Histologically, the presence of fibromuscular obliteration of the lamina propria with disorientation of muscle fibers is characteristic, which could be secondary to chronic mechanical and ischemic trauma and inflammation by hard stools, and intussusception of the rectal mucosa. Although the syndrome is well-recognized in adults, the pediatric experience with this condition is limited and often remains unrecognized or misdiagnosed. A misdiagnosis has been reported in one fourth of adult cases, and the correct diagnosis usually delayed approximately 5 to 7 years. There are few pediatric case reports in English literature. Here, we describe 2 children with SRUS, aged 11 and 14 years, whose SRUS was diagnosed 2 and 6 years, respectively, after the onset of the first signs and symptoms.- - - - - - - - - - ranking = 227.43975090547keywords = rectal prolapse, prolapse (Clic here for more details about this article) |
9/37. Enterolithiasis with imperforate anus: report of a case.A three-year-old child presented with imperforate anus. A local perineal procedure was performed at birth, possibly without repairing the fistula. The child later presented with severe anal stenosis, which required a divided sigmoid colostomy. The child later presented at the age of two years with multiple radio-opaque shadows in the pelvis. These proved to be enteroliths, which had developed in the distal rectal stump possibly due to a large associated recto-urethral fistula with associated urinary stasis.- - - - - - - - - - ranking = 5keywords = anus (Clic here for more details about this article) |
10/37. Perianal mucinous adenocarcinoma: unusual case presentations and review of the literature.Perianal mucinous adenocarcinoma is a rare cancer constituting 3 to 11 per cent of all anal carcinomas. It may arise de novo or from a fistula or abscess cavity. We present two cases of this disease process. Case One is a 52-year-old man with a chronic history of perianal abscesses who presented to the emergency room with a large bowel obstruction. He required diversion and wide local excision with lateral internal sphincterotomy for relief of the obstruction. pathology from the excised material revealed the unexpected diagnosis of invasive mucinous adenocarcinoma of the anus. Case Two is a 59-year-old man with a chronic history of complex fistulas and abscesses who presented to our office with a horseshoe fistula and deep postanal space abscess. Because of the nonhealing nature of the wound, biopsies from the abscess crater, fistulous tract, and the perianal skin opening were taken. The pathology department identified the specimens as invasive mucinous adenocarcinoma of the anal canal. This is an aggressive cancer often misdiagnosed clinically as benign pathology. A high index of suspicion and biopsy of fistulous tracts and abscesses are the keys to early diagnosis and treatment. With combination chemotherapy and radiation therapy in conjunction with aggressive surgical resection long-term survival might be obtained.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
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