Cases reported "Rectal Diseases"

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1/8. Rectal stricture associated with the long-term use of ibuprofen suppositories.

    Here, we report the case of a 64-year-old woman who suffered from chronic lower backache for which she received ibuprofen suppositories. The patient was admitted to the hospital with a suspected rectal tumor. Clinical examination did not reveal any abnormal finding apart from a mild, bilateral peritibial edema. On rectal examination, an area of stenosis was detected approximately 7 cm above the anal verge. All laboratory parameters, including different tumor markers, were within normal range. Pelvic CT scan and colonoscopy revealed a circular rectal stenosis with severe destruction of the rectal mucosa. The rectal biopsy taken during endoscopy showed severe acute and chronic ulceration, chronic granulation and fibrosis with lymphocytic infiltration. After exclusion of sexually transmitted diseases such as syphilis and lymphogranuloma venerium or exposure to drugs as a possible cause of rectal stenosis, the history in this particular case suggests that the prolonged use of the cyclooxygenase (COX) inhibitor "ibuprofen" as a suppository is the cause of mucosal destruction and rectal stenosis.
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ranking = 1
keywords = lymphogranuloma
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2/8. Saxophone penis revisited.

    Saxophone deformity of the penis is commonly secondary to diseases causing chronic lymphatic obstruction. lymphogranuloma venereum (LGV) is an important cause for this deformity. A case of LGV in genito-anorectal syndrome with a saxophone penis is reported along with the contrast-enhanced computed tomography (CECT) findings of anorectal involvement, and a probable hypothesis for this typical appearance of the penis.
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ranking = 0.063784313622739
keywords = venereum
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3/8. Anorectal lymphogranuloma venereum in a Melbourne man.

    We report the first case of anorectal lymphogranuloma venereum (LGV) in a man who has sex with men (MSM) in australia in the setting of the recent emergence of LGV among MSM in europe and the USA. A 33-year-old man presented with a 2 month history of mild external anal discomfort. He gave a history of unprotected receptive and insertive anal intercourse with one partner in europe during the preceding 6 months. No symptoms suggested proctitis and examination revealed two small anal fissures. An anal swab was positive for chlamydia trachomatis; investigation for other STIs including hiv were negative. On review 6 days later, he was investigated and treated presumptively for LGV. The LGV diagnosis was confirmed by identifying the L2 serovar of C. trachomatis using a genotype test on the original anal specimen. This case is in keeping with the more recent reports of LGV from europe, and has demonstrated the need for a high index of suspicion for asymptomatic or minimally symptomatic anorectal LGV.
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ranking = 8.189215681137
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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4/8. Rectal lymphogranuloma venereum in a bisexual patient.

    Rectal lymphogranuloma venereum (LGV) due to chlamydia trachomatis (Ct) serotype L2 is reported. LGV was isolated from the lymph node biopsy of a bisexual male and was cultured on McCoy cycloheximide treated-cells. Serological tests such as the Micro-immunofluorescent test and the indirect immunoperoxidase assay for chlamydia trachomatis done on the patient's serum were positive with a titer of 1/200 and 1/256 respectively. Smears taken from the rectal discharge were stained by the direct immunoperoxidase assay and showed inclusion bodies with positive staining. The search for the origin source of infection as well as the diagnostic and follow-up strategy in the male and female partners is also discussed.
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ranking = 6.6151568585323
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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5/8. lymphogranuloma venereum of the rectum in a homosexual man. Case report.

    A male homosexual presented initially with bloody diarrhoea and a swelling in the left groin, which was unsuccessfully treated with erythromycin. Examination in hospital showed a rectal mass and an abscess in the left groin. Histological examination of the rectal mass and a positive lymphogranuloma complement fixation test result confirmed the diagnosis of lymphogranuloma venereum. This disease, although rare, should not be forgotten in the differential diagnosis of rectal problems in male homosexuals.
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ranking = 2.8929803907184
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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6/8. Rectal lymphogranuloma venereum in association with rectal adenocarcinoma.

    Rectal involvement in lymphogranuloma venereum (LGV) is more common in women. Inguinal bubo is often absent and the patient seeks medical attention only at a late stage when rectal stricture has developed. LGV rectal stricture resembles and is known to predispose to rectal cancer. Hence it is necessary to rule out rectal malignancy in patients with LGV stricture. We report a case of rectal LGV associated with rectal adenocarcinoma.
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ranking = 8.189215681137
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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7/8. The gay bowel syndrome: clinico-pathologic correlation in 260 cases.

    The clinical and pathological findings in a group of 260 homosexual men comprising 10% of a private proctologic practice are reviewed. A clinical pattern of anorectal and colon diseases encountered with unusual frequency in these homosexual patients is termed the gay bowel syndrome. The clinical diagnoses in decreasing order of frequency include condyloma acuminata, hemorrhoids, nonspecific proctitis, anal fistula, perirectal abscess, anal fissure, amebiasis, benign polyps, viral hepatitis, gonorrhea, syphilis, anorectal trauma and foreign bodies, shigellosis, rectal ulcers and lymphogranuloma venereum. 60 anorectal and sigmoid biopsies from 51 patients failed to disclose evidence of specific infection other than condyloma acuminata. Of 21 patients with biopsy diagnosis of nonspecific proctitis, 8 had a specific infection which was detected by other means,--5 cases of shigellosis and one case each of gonorrheal proctitis, amebiasis and lymphogranuloma venereum. In evaluating proctologic problems in the gay male, all of the known sexually transmitted diseases should be considered. Shigellosis, amebiasis and viral hepatitis should be included. Microbiological evaluation is essential. Concurrent infections with 2 or more pathogens should be anticipated. chlamydia trachomatis, an important cause of nonspecific urethritis in the general population, is high on the list of possible causes of the nonspecific proctitis present in 31 of the 260 patients.
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ranking = 3.2756862724548
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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8/8. lymphogranuloma venereum as a cause of rectal strictures.

    Rectal strictures are uncommon in young patients without a history of malignancy, inflammatory bowel disease or previous surgery. lymphogranuloma venereum of the rectum has been described as a rare cause of rectal strictures in the western world, mainly in homosexual men and in blacks. It presents with nonspecific symptoms, rectal ulcer, proctitis, anal fissures, abscesses and rectal strictures. Clinical and endoscopic findings as well as histology resemble Crohn's disease, which may be misdiagnosed. serology is often positive for chlamydia trachomatis but negative serology is not uncommon. We present two young black women who suffered from chronic diarrhoea, abdominal pain and weight loss. There was no previous history and investigations showed in both cases a long rectal stricture. serology was positive in one patient. They were treated with erythromycin and azithromycin and they both underwent an anterior resection of the rectum. Postoperative histology confirmed the presence of lymphogranuloma venereum of the rectum. We conclude that rectal lymphogranuloma venereum is a rare cause of rectal strictures but surgeons should be aware of its existence and include it in the differential diagnosis of unexplained strictures in high-risk patients.
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ranking = 3.5946078405685
keywords = lymphogranuloma, lymphogranuloma venereum, venereum
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