1/25. 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) |
2/25. In utero repair of rectal atresia after complete resection of a sacrococcygeal teratoma.PURPOSE: A case of a fetus with a prenatally diagnosed sacrococcygeal teratoma that produced high-output cardiac failure, hydrops, rectal atresia, and urinary tract obstruction is presented. The unique prenatal surgical management along with the embryogenesis of tumor-related rectal atresia is discussed. CASE REPORT: A large fetal sacrococcygeal teratoma with a significant intrapelvic component was detected at routine ultrasound in a 35-year-old gravida 3 para 2. Fetal hydrops developed rapidly due to high-output cardiac failure from the vascular 'steal' by the growing tumor. The urinary tract was obstructed due to the intrapelvic tumors mass. At 27 weeks' gestation, the female fetus underwent hysterotomy, resection of the entire mass and urinary diversion via bilateral flank ureterostomies. The rectum was found to be completely atretic due to apparent encasement by the tumor. Pull-through anorectoplasty was carried out concurrently. At 30 weeks' gestation, the mother developed preterm labor and a 1.8-kg was delivered by cesarean section. The baby did very well for 3 days but had a cardiac arrest and died due to an atrial perforation by a transfemoral venous catheter. CONCLUSIONS: To our knowledge this is the first report of a complete prenatal resection of a sacrococcygeal teratoma with concomitant pull-through anorectoplasty for rectal atresia.- - - - - - - - - - ranking = 1.462331234784keywords = atresia (Clic here for more details about this article) |
3/25. 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 = 1keywords = anus (Clic here for more details about this article) |
4/25. 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) |
5/25. 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) |
6/25. 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) |
7/25. 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) |
8/25. A case of rectal atresia associated with recto-bulbar urethral fistula.Rectal atresia is a rare condition in which the anus and sphincter muscles are normally developed, with usually no fistulous communication with the urinary tract. An unusual case of rectal atresia associated with recto-bulbar urethral fistula treated by a combination of colo-anal anastomosis and mucosal proctectomy via a posterior sagittal approach is reported for the first time.- - - - - - - - - - ranking = 2.253426772672keywords = anus, atresia (Clic here for more details about this article) |
9/25. Laparoscopically assisted anterior rectal wall resection and reanastomosis for deeply infiltrating endometriosis.A 28-year-old woman, presented with a history of long-standing, severe pelvic and bowel endometriosis. Pronounced cul-de-sac tenderness and nodularity were noted on pelvic examination. Videolaseroscopy was undertaken, the rectum was mobilized, and the tumor was prolapsed to the level of the anus. Anterior rectal wall resection and reanastomosis were performed; the colon was returned to the pelvis under direct visualization via laparoscope.- - - - - - - - - - ranking = 1keywords = anus (Clic here for more details about this article) |
10/25. Posterior sagittal anorectoplasty for adults. A sphincter-saving operation.We performed posterior sagittal anorectoplasty to treat two adult patients. One patient had an idiopathic stricture extending from the proximal sigmoid colon to the anus. The second patient was born with a high imperforate anus and, following a pull-through procedure as an infant, remained totally incontinent of feces. Both patients now have excellent fecal continence following this operation. The posterior sagittal anorectoplasty may be used to preserve rectal continence in selected adults.- - - - - - - - - - ranking = 2keywords = anus (Clic here for more details about this article) |
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