1/25. Characteristic intracytoplasmic material in a perianal wart that contains human papillomavirus type 56 and 16 dna.We report the case of a perianal wart in which human papillomavirus type 56 and 16 DNAs were detected, arising in a 29-year-old healthy Japanese female. Clinically, moist erythema and small flat pinkish papules appeared around the anus and worsened over a period of 6 months. Histopathologically, no signs of dysplasia or atypia were apparent. An area of intracytoplasmic material, which was homogeneous and eosinophilic, was contained in each epidermal cell. The wart showed HPV-56 and HPV-16 DNAs by PCR and reverse-phase dot blot hybridization. Additional Southern blot analysis showed the amount of HPV-56 dna to be more than 10 times that of HPV-16 dna. This is the first case, to our knowledge, of a perianal wart with intracytoplasmic material, which contains HPV DNAs causing mucous lesions.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
2/25. Anal tuberculosis: report of two cases and literature review.Tuberculous involvement of the anus is an extreme rarity. We report two cases of anal tuberculosis and discuss the clinical features, the difficulty in differentiating from Crohn's disease, and the diagnostic aspects in the context of the pertinent medical literature.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
3/25. Urogenital sinus, rectovaginal fistula, and an anterior stenosed anus--another cloacal variant.The persistent cloaca is one of the most complex and challenging developmental malformations. It is a rare anomaly occurring only in the female newborn and is represented by the association of urogenital sinus with an anorectal malformation (arm). Each case is probably unique. We report here one such case of cloaca with the VATER association-tracheoesophageal fistula (TOF) with a urogenital sinus, rectovaginal fistula, and an anteposed stenosed anus, along with preaxial syndactyly of the right hand. The spine, renal, and cardiac systems were normal. Interim management was directed towards repair of the TOF and a right transverse defunctioning colostomy. Despite thorough radioendoscopic preoperative investigations, the complexity of the cloacal anomaly was not delineated until surgery. This case is a rather rare combination of an intermediate form of the cloacal-arm spectrum. Such patients present with many diagnostic and therapeutic problems. Interval surgery should be directed towards decompression of the affected organ systems, and definitive surgery must be carefully planned and, whenever possible, done in a single stage with simultaneous multisystem repair to correct all significant malformations related to the cloacal complex.- - - - - - - - - - ranking = 5keywords = anus (Clic here for more details about this article) |
4/25. Heterotopic gastric mucosa of the anus: a case report and review of the literature.Ectopic gastric mucosa has been described at various locations of the body, including all levels of the gastrointestinal tract. However, this finding is rare in the rectum and anus, with 38 reported cases. In only six cases, including the present one, has the heterotopic tissue been located within 2 cm of the dentate line. We report a case of gastric heterotopia discovered in a 21-year-old male who presented with anal pain and pruritis. Flexible sigmoidoscopy demonstrated an anal polyp, and biopsy confirmed fundic-type gastric tissue. A (99m)technetium-pertechnetate scan confirmed increased uptake in the anus. After minimal clinical improvement with proton-pump inhibitors, the patient underwent local surgical excision and remains symptom-free at a follow-up of 9 months. We review the potential etiologies, clinical manifestations, treatment options, and patient outcomes.- - - - - - - - - - ranking = 6keywords = anus (Clic here for more details about this article) |
5/25. Multiple brain abscesses following surgical treatment of a perianal abscess.We report a case of multiple brain abscesses (BAs) in a 67-year-old man with symptoms of progredient disorientation and amnestic aphasia. Onset of symptoms occurred one week after surgical treatment of a perianal abscess. No other source of infection was identified and the abscesses were limited to the brain. The immune status was normal but a patent foramen ovale (pFO) was found. The patient was treated with high-dose antibiotics, leading to a complete radiological disappearance of the BAs. Hematogenous spread of infectious emboli from a perianal focus exclusively to the brain is very rare. In our patient, the mechanisms of infectious spread into the brain might have occurred via a cardiac right-to-left shunt or alternatively via the non-valvular vertebral venous system. In this manuscript, both pathways are critically reviewed.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
6/25. Symptomatic anal anomalies in chromosome 22q11 deletion syndrome: a report of three patients.Deletion of chromosome 22q11 is a common genetic condition with varying clinical presentation ranging from neonatal fatality to patients whose presentation to medical services will be prompted after a few years by speech delay or mild developmental concerns. While most published data relating to patients with 22q11 deletions has focused on the "classical" presentation of the condition with cardiac manifestations, hypocalcaemia and velopharyngeal insufficiency, a much wider range of clinical presentations can characterise this syndrome. Anal anomalies, comprising imperforate anus and symptomatic anal stenosis, are a rarely described presentation of this multisystem disorder. In this report we document three patients presenting to paediatric services with symptoms attributed initially to symptomatic anal stenosis/atresia.- - - - - - - - - - ranking = 1.0019061229354keywords = anus, atresia (Clic here for more details about this article) |
7/25. Malakoplakia. Two unusual cases which presented diagnostic problems.Two unusual cases of malakoplakia are presented. Both cases occurred outside the urinary tract (retroperitoneum and anus) and were diagnostic problems due to the paucity of Michaelis-Guttman bodies. One case mimicked a retroperitoneal malignant fibrous histiocytoma and the other a common perianal abcess.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
8/25. Congenital anal fistula with normal anus.Three patients with a congenital anovestibular/perineal fistula were treated at the Montreal Children's Hospital. Two females (one of East Indian and the other of Japanese origin) had anovestibular fistulae that became symptomatic in the first few months of life. The third patient, a boy of Korean descent, presented at 9 months of age with a chronically draining perineal fistula. During surgery, a small fistula tract was easily dissected out and excised. Microscopic examination showed a well-preserved rectal mucosa throughout the tract. Most male patients described to date had anourethral fistulae, often accompanied by other major anomalies such as esophageal atresia or renal malformations. We believe our patient is the first male to be described with a congenital perineal fistula; this suggests that some fistula-in-ano in male infants may be due to a congenital sinus that secondarily becomes infected and drains to the skin.- - - - - - - - - - ranking = 4.0019061229354keywords = anus, atresia (Clic here for more details about this article) |
9/25. Use of hydrogen peroxide to identify internal opening of anal fistula and perianal abscess.hydrogen peroxide injected into a fistula or perianal abscess produces a jet of white bubbles from the internal orifice on the dentate line. This technique has been helpful in locating this often elusive ostium. Failure to produce such an efflux warns one that the pathology was different from what was expected. Confidence to abandon the search in the absence of an efflux is developing, provided the dictates of gravity are respected in positioning the patient so that the anus lies above the abscess.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
10/25. Xanthogranulomatous abscess of a mullerian duct remnant. A rare lesion of the rectum and anus.A rare example of xanthogranulomatous inflammatory mass and abscess of a Mullerian duct remnant involving the anorectal area is reported. A barium enema showed a bilobed precoccygeal mass of moderate size involving the posterior aspect of the distal rectum. Computed tomography (CT) showed two nonfatty, round masses, one of which contained a small central cystic area. The other mass had a homogeneous appearance and was believed to be in the wall of the rectum. The pathologic specimen showed organizing abscesses and a chronic xanthogranulomatous inflammation in tissue compatible with urogenital tissue, presumably a Mullerian duct remnant. This is the first documented report of anorectal xanthogranulomatous abscess in a Mullerian duct remnant with radiologic findings and histopathologic correlation. Though rare, this lesion should be considered in the differential diagnosis of extrinsic and intramural rectal masses seen on barium enema and CT examinations.- - - - - - - - - - ranking = 4keywords = anus (Clic here for more details about this article) |
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