Cases reported "Rectal Fistula"

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1/23. Ileo-rectal fistula complicating advanced ovarian carcinoma.

    Fistula between the bowels and an ovarian carcinoma is recognized but rare complication. Internal malignant fistula of the gastrointestinal tract involving two or more loops of different segments of the bowel and genitourinary structure are rare. The colon is frequently one of the participating loops. In reviewing the literature, however, we were unable to find a previous report of ileo-rectal fistula as a complication of an ovarian carcinoma. A case report and review of the English medical literature are presented with emphasis on the cause, clinical presentation, and management of advanced ovarian cancer with ileo-rectal involvement.
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ranking = 1
keywords = cancer
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2/23. Unusual 'recurrence' sites for colorectal cancer.

    Five patients are reported. Four underwent major 'curative' restorative colorectal resections and developed perineal 'recurrence', 2 developed 'recurrence' in the distal ends of previously identified fistulae in ano and 2 developed 'recurrence' at the site of a previously performed haemorrhoidectomy. The fifth patient developed metastasis to a fistula track prior to surgical intervention. The danger of implantation of exfoliated tumour cells in patients with distally situated 'raw' mucosal sites is recognized and anorectal procedures should not be performed prior to resection. Minor anorectal procedures should not be performed at the same time as colorectal resections for carcinoma in these patients either. Some 'recurrences', such as those described in this paper, may be inevitable and in fact really represent preoperative metastases. Routine flexible sigmoidoscopy prior to the performance of any anorectal procedure might identify patients at risk of such 'recurrences' but this may not be cost-effective.
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ranking = 4
keywords = cancer
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3/23. A case of cancerous familial adenomatous polyposis in urinary bladder due to migration of colonic mucosa through rectovesical fistula.

    The patient was a 50-yr-old man who had undergone low anterior resection for rectal cancer at the age of 24 yr in 1966. At that time, gastric and colonic polyposis were indicated. Postoperative anastomotic dehiscence occurred and, by 1985, a rectovesical fistula had formed. In 1986, when the patient was 44 yr old, he was examined at our hospital for constriction of the rectum due to the rectovesical fistula. Abdominoperineal excision of rectum and surgical closure of the fistula were performed, and the patient was kept under observation because of a diagnosis of familial adenomatous polyposis. In 1988, when the patient was 46 yr old, early ascending colon cancer was discovered and total colectomy was performed. Then, in December, 1991, gross hematuria was found. Further examination revealed a tumor on the posterior wall of the urinary bladder lumen, and biopsy showed adenocarcinoma. Pelvic recurrence of the rectal cancer was diagnosed, and total pelvic exenteration was performed. There were no distant metastases; histologically, the tumor of the bladder was thought to be due to colonic mucosa of familial adenomatous polyposis that had migrated to the bladder lumen via the rectovesical fistula and had become cancerous.
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ranking = 8
keywords = cancer
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4/23. Rectourethral fistula and massive rectal bleeding from iodine-125 prostate brachytherapy: a case report.

    iodine-125 brachytherapy is an effective well-tolerated treatment for localized prostate cancer. Gastrointestinal complications of brachytherapy (minor rectal bleeding or tenesmus) are uncommon. Rectal ulceration or rectourethral fistulas after prostate brachytherapy are rare. We present a case of massive refractory rectal bleeding and rectourethral fistula, a complication of prostate brachytherapy never before reported. As a result of the patient's life-threatening symptoms aggressive surgical therapy was necessary.
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ranking = 1
keywords = cancer
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5/23. Tailgut cyst invaded by rectal cancer through an anal fistula: report of a case.

    Rectal cancer accompanying or developing in a tailgut cyst has been reported. However, there have been no reports of cases such as the present one, a tailgut cyst invaded by a rectal cancer.
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ranking = 6
keywords = cancer
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6/23. Rectal cancer in anorectal malformation with rectovestibular fistula: sphincter-restoring surgery by anterior resection and dynamic vaginoanograciloplasty.

    PURPOSE: The aim of this study was to describe and discuss the anosphincter-restoring procedure adopted in an adult patient with rectal cancer, affected by anorectal atresia and rectovestibular fistula not previously treated. methods: After anterior resection and transverse dissection of the rectovaginal septum, a straight double-staple low colorectal anastomosis was performed. A subcutaneous tunnel was extended from the inter-rectovaginal space, surrounding the pseudoanal orifice. The tunnel housed a left gracilis muscle arranged counter-clockwise and connected to an implanted stimulator. The vaginal and anorectal flaps were sutured longitudinally, thereby spacing out the two orifices and creating an anorectal angle. A temporary loop right colostomy was performed. RESULTS: The postoperative course was uneventful. After continuous electrostimulation training and colostomy takedown, the patient had improved continence (stimulator on) and normal defecation (stimulator off). CONCLUSIONS: The solution described seemed a suitable alternative to a pull-through procedure, which would have involved a colocutaneous anastomosis and the loss of the anorectal sensory function. Any previous anal transposition or pull-through procedures would have prevented the saving of the pre-existing "anus," because of the interruption of the residual mesenteric vascular supply to the anorectal remnant secondary to mesorectal excision.
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ranking = 5
keywords = cancer
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7/23. clostridium septicum and malignancy.

    BACKGROUND: clostridium septicum is known to be associated with malignancy or immunosuppression. It has a variable clinical presentation and is associated with a high mortality. The aim of the present study was to review the experience at St George Hospital, Sydney, over a 10-year period, with particular reference to the association of this condition with colorectal cancer. methods: The records of five patients with blood culture-proven clostridium septicum infection, among a larger group of 31 patients with clostridial infections, presenting to St George Hospital between 1990 and 2000 were reviewed. RESULTS: Associated malignancy was found in four (80%) of the patients with clostridium septicum infection. Two infections were related to colorectal cancer, two to haematological malignancies and one to radiation-induced recto-urethral fistula. Those patients who had colorectal cancer presented with septicaemia and vague abdominal symptoms. CONCLUSIONS: clostridium septicum infections have a strong association with malignancy. When this infection occurs without an obvious underlying aetiology there should be a high index of suspicion about associated malignancy. In the absence of haematological malignancy a colonoscopy is warranted. early diagnosis and aggressive treatment is essential in order to improve prognosis.
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ranking = 47.661792826789
keywords = radiation-induced, cancer
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8/23. Implantation of rectal cancer cells in a fistula in ano: report of a case.

    We report a case of implantation of tumor cells within a fistula in ano. A 36-year-old man with a 16-year history of an anal fistula underwent an operation for rectal carcinoma. Three weeks later, the anal fistula was resected. A histological examination of the specimen showed atypical cells; moreover, rectal carcinoma had proliferated in the granulation tissue lying underneath the intact squamous epithelium. Because there was no continuity to the rectal carcinoma or the anal glands, we diagnosed implantation of rectal cancer cells in a fistula in ano.
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ranking = 5
keywords = cancer
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9/23. Palliative treatment of an enterorectal fistula with a covered metallic stent.

    In patients with recurrent colorectal cancer, the development of fistulae presents a difficult therapeutic problem. The traditional surgical approach of resection and intestinal diversion may not always be appropriate in those with disseminated or terminal disease. We present the successful use of a covered esophageal stent to occlude an enterorectal rectal fistula in a patient with recurrent inoperable colonic carcinoma.
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ranking = 1
keywords = cancer
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10/23. Anal lesion resulting from implantation of viable tumour cells in a pre-existing anal fistula. A case report.

    Colorectal cancer exfoliates cancer cells into the lumen of the bowel, and possibly, raw bowel mucosa should provide a good medium for the exfoliated cancer cells. We report an extremely rare case of a sigmoid carcinoma metastasizing to a low fistula in ano. The patient was operated on for a fistula in ano. biopsy demonstrated a moderate differentiated adenocarcinoma. Thereafter, sigmoidoscopy revealed an intraluminal mass at the sigmoid colon. The patient subsequently underwent abdominoperineal resection of the sigmoid colon and rectum. In conclusion, surgeons should be aware of the possibility of cancer spread incidence, distally beyond the initial site by exfoliated cancer cells into the lumen of the bowel.
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ranking = 5
keywords = cancer
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