- Structured versus narrative reporting of pelvic MRI in perianal fistulizing disease: impact on clarity, completeness, and surgical planning. [Journal Article]
- ARAbdom Radiol (NY) 2018 Dec 05
- CONCLUSIONS: Structured MRI reports in patients with perianal fistulizing disease miss fewer key features than narrative reports. Moreover, structured reports were described as more complete and clear, and more helpful for treatment planning.
- Anal Adenocarcinoma Can Masquerade as Chronic Anal Fistula in Asians. [Journal Article]
- ACAnn Coloproctol 2018 Dec 03
- CONCLUSIONS: A high index of suspicion is required to make a clinical diagnosis of an anal adenocarcinoma arising from a chronic fistula. Histologic diagnosis must be achieved to confirm the diagnosis. Multimodal therapy with neoadjuvant chemoradiotherapy followed by abdominoperineal resection is the treatment of choice.
- Structured reporting of MRI for perianal fistula. [Review]
- ARAbdom Radiol (NY) 2018 Nov 24
- CONCLUSIONS: MRI is invaluable for the assessment of perianal fistulas. A systematic report can help communicate the anatomy of complex fistulising disease to assist with optimal management.
- First Aid Toolkit for Anal Fistulas, a Detailed Treatise for Trainees (Video Vignette ESCP Trainee Video). [Letter]
- CDColorectal Dis 2018 Nov 24
- Fistula surgery is often performed by trainees. However, an inexperienced trainee may lay open a fistula that could be treated by a more conservative approach. There is considerable national and inte...
Fistula surgery is often performed by trainees. However, an inexperienced trainee may lay open a fistula that could be treated by a more conservative approach. There is considerable national and international variation and the present video will not attempt to define superior methods, but rather highlight matters of debate. This article is protected by copyright. All rights reserved.
- Treatment of Perianal Sepsis, a Detailed Treatise for Trainees (Video Vignette ESCP Trainee Video). [Letter]
- CDColorectal Dis 2018 Nov 24
- For many surgeons, the drainage of a perianal abscess is the first operation they perform unsupervised. However, this risks an adverse outcome if the young surgeon has not been well trained. Most sur...
For many surgeons, the drainage of a perianal abscess is the first operation they perform unsupervised. However, this risks an adverse outcome if the young surgeon has not been well trained. Most surgeons believe perianal sepsis is caused by cryptoglandular infection. Even though this theory is convenient and likely, contrary evidence also exists. This article is protected by copyright. All rights reserved.
- Long-term outcomes following restorative proctocolectomy ileal pouch-anal anastomosis in pediatric ulcerative colitis patients: Multicenter national study in Japan. [Journal Article]
- AGAnn Gastroenterol Surg 2018; 2(6):428-433
- CONCLUSIONS: To avoid pouch failure following an IPAA procedure, it is important to recognize that pouchitis or an anal fistula may lead to this condition in pediatric UC patients.
- Efficacy of irrigation tubes in the management of para rectal cavities associated with complex fistula-in-ano. [Journal Article]
- BSBMC Surg 2018 Nov 09; 18(1):95
- CONCLUSIONS: Irrigation in the management of pararectal cavities yielded satisfactory results. A case control trial with larger numbers and assessment of cavity size pre and post procedure by 3D-EAUS/MRI evaluation would be necessary for more objective evaluation of the efficacy of this novel intervention.
- Loss of tolerance to glycoprotein 2 isoforms 1 and 4 is associated with Crohn's disease of the pouch. [Journal Article]
- APAliment Pharmacol Ther 2018; 48(11-12):1251-1259
- CONCLUSIONS: The novel anti-GP21 and GP24 antibodies are associated with Crohn's disease of the pouch in ulcerative colitis patients after IPAA. Serological anti-GP2 antibodies could aid in diagnosis of Crohn's disease of the pouch.
- Type I AV fistula of the thoracic spinal cord. [Journal Article]
- AJAm J Emerg Med 2018 Oct 21
- Type I AV fistulas of the spinal cord are exceedingly rare. The average age at diagnosis is 50. Clinical presentation is often very non-specific, and sensory deficits and sphincter dysfunction may al...
Type I AV fistulas of the spinal cord are exceedingly rare. The average age at diagnosis is 50. Clinical presentation is often very non-specific, and sensory deficits and sphincter dysfunction may also occur. Neurological deterioration is generally gradual. Thus, failure to diagnosis frequently results in permanent disability. A 22-year-old female complained of a "muscle spasm" in the midline thoracic area with no history of trauma or prior occurrence. She also experienced bilateral lower extremity weakness/numbness and perianal anesthesia. She is a healthy female with no medical problems. Exam revealed lower extremity motor function of 1/5 as well as diminished sensation. A foley catheter was placed for urinary retention. The remainder of the neurological exam was normal. MRI demonstrated a lesion at the fourth thoracic level with significant cord compression. The patient was taken emergently to the operating room by neurosurgery. This case demonstrates a rare disorder occurring in a 22-year old female, far younger than the typical 50-year old patient. Moreover, the lesion was located in the thoracic rather than the typical lumbar cord. Symptoms may be misinterpreted as a peripheral nerve lesion and delay time to diagnosis. Early diagnosis remains critical to prevent permanent neurologic sequelae. AV fistula should remain high on the differential of patients presenting with back pain and focal neurologic complaints.
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- [Definition, epidemiology and risk factors of obstetric anal sphincter injuries: CNGOF Perineal Prevention and Protection in Obstetrics Guidelines]. [Journal Article]
- GOGynecol Obstet Fertil Senol 2018 Oct 29
- CONCLUSIONS: It is necessary to use a consensus definition of the OASIS to be able to better detect and treat them.