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PubMed2006

Effects of different anesthetic techniques on serum leptin, C-reactive protein, and cortisol concentrations in anorectal surgery.

AIM: To compare the effects of intratracheal general anesthesia (ITGA) and regional (saddle block) anesthesia on leptin, C-reactive protein (CRP), and cortisol blood concentrations during anorectal surgery. METHODS: Fifty-eight patients suffering from hemorrhoidal disease, pilonidal sinus, anal fissure, or anal fistula were included the study. Patients were randomly assigned into one of the two groups (n=29). Patients in one group received ITGA. After thiopental and fentanyl induction, vecuronium was used as a muscle relaxant. Anesthesia was maintained with sevoflurane. In the other group we applied saddle block, injecting hyperbaric bupivacaine into the subarachnoid space, through the L3-L4 intervertebral space, in the sitting position. Blood samples were collected for leptin, CRP, and cortisol analysis before the induction of anesthesia at 3 and 24 hours postoperatively. RESULTS: Preoperative leptin, CRP, and cortisol concentrations were comparable between the groups. There was no significant difference in postoperative levels of leptin and CRP in both groups. Although not significant, leptin and CRP concentrations were lower in the saddle block group at three hours postoperatively (mean-/+SD, 6.95-/+8.59 and 6.02-/+12.25, respectively) than in the ITGA group (mean-/+SD, 9.04-/+9.89 and 8.40-/+15.75, respectively). During early postoperative period, cortisol increased slightly in the ITGA group and remained at similar level in the saddle block group, but later decreased in both groups. Cortisol levels in the saddle block group were significantly lower than in the ITGA group at 3 hours postoperatively (343.7-/+329.6 vs 611.4-/+569.8; P=0.034). CONCLUSION: Saddle block, a regional anesthetic technique, may attenuate stress response in patients undergoing anorectal surgery, by blocking afferent neural input during early postoperative period.

Adult↗
PubMed1991

Glomus tumor of the coccyx. A curable cause of coccygodynia.

A 30-year-old woman presented with recurrent severe coccygodynia. She underwent exploration for a possible pilonidal sinus and was found to have a precoccygeal glomus tumor that also involved bony trabeculae of the coccyx. To our knowledge, a glomus tumor involving the coccygeal bone has not been previously documented. In view of the relief of this patient's pain following the surgical excision of coccyx and tumor, a causal role is suggested.

Adult↗
PubMed1989

Carcinoma cuniculatum of the buttock. An unusual case with an inverted growth.

A rare case of carcinoma cuniculatum involving the buttock in a 56-year-old male is presented. This case is uncommon in that the tumor was largely subcutaneous, while the usual carcinoma cuniculatum is an exophytic growth. Although carcinoma cuniculatum has a wide clinical and histological spectrum, to our knowledge there has been only 1 case with similar histological features, located in a pilonidal sinus, and another case located on the buttock.

Buttocks↗
PubMed1978

Bilateral femoral dysgenesis syndrome: a case report.

This paper reports a child with the Bilateral femoral dysgenesis--unusual facies syndrome (BFD-UF). The child has, in addition to previously reported findings, a ventricular septal defect with valvar and infundibular pulmonic stenosis, absence of the labia majora, bilateral syndactyly of the second and third toes, bifid great right toe and a pilonidal sinus. The similarity to cases of Caudal Regression Syndrome (phocomelic diabetic embryopathy) is noted.

Abnormalities, Multiple↗
PubMed1978

Diphenylhydantoin teratogenicity in man.

A case is presented of fetal teratogenic damage from an unusually high maternal dosage of diphenylhydantoin, 600 mg daily, to a 40-kg woman throughout pregnancy. The anomalies included narrowed ends of the fingers and toes; aplasia of the nails on the other fingers and toes; aplasia of the distal phalanges of the fingers and toes; a broad, depressed nasal bridge; anteverted nostrils; prominent upper lip; coarse, profuse scalp hair; pilonidal sinus; and simian crease of the left hand. At the age of 7 months, ossification of the distal phalanges of both middle fingers appeared, the anterior fontanel was small, brain development was retarded, cranial asymmetry was marked, and the fingertips showed a pattern of low arch dermal ridges.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[The Dubowitz syndrome].

A 27-month-old girl with Dubowitz syndrome, a rare autosomal recessive disorder, is presented. The diagnosis was established by a series of symptoms typical for this syndrome: intrauterine and postnatal growth retardation, microcephaly, recurrent diarrhea and respiratory infections, characteristic craniofacial anomalies such as epicanthus, nasal dysplasia with broad nasal bridge in line with forehead, thin hair, micrognathia, large mouth, dysplastic ears, brachyclinodactyly, pectus excavatum and pilonidal sinus. Hyperactivity in behaviour was obvious, and she had a very high pitched voice. Sacral cleft and wide opened frontal fontanelle found in our patient could be new signs, not yet seen in this syndrome. Necessity of regular follow-up of these patients is stressed due to the rather high incidence of malignant diseases and diseases of the hematopoetic system, respectively.

Abnormalities, Multiple↗
PubMed1993

[The dose-response study of sparfloxacin against skin and soft tissue structure infections in the field of surgery].

Sparfloxacin (SPFX), a new oral quinolone antimicrobial, was evaluated for the clinical efficacy against skin/soft tissue structural and osteomyelitic infections. SPFX was administered to a total of 101 patients with various infections such as infected atheroma, periproctal abscess, subcutaneous abscess, wound infections, felon, cellulitis, furuncle, pilonidal sinus, sappurative mastitis, lymphangitis, hemorrhoidal fistula, osteomyelitis. The clinical efficacy in the evaluable 101 cases was assessed by the physician in charge as excellent in 19 cases, good in 64, fair in 11 and poor in 7, the efficacy rate being 82.2%. In contrast, the clinical efficacy in 101 evaluable cases by the criteria of the committee as excellent in 36 cases, good in 45, fair in 8, and poor in 12, the efficacy rate being 80.2%. Clinical efficacy rating was not significantly difference between 200 mg/day group and 300 mg/day group. The bacteriological eradication rate was 86.5% in 53 cases with monomicrobial infection and 90.3% in 33 cases with polymicrobial infections. Of 18 cases whose infections were previously intractable with other drugs and treated thereafter with SPFX, 15 were judged in the efficacy as excellent or good. The side effects observed in 2 cases during the treatment were epigastralgia and nausea which were tolerable and did not require withdrawal of SPFX. No abnormal laboratory value was found in the several required tests. The MIC values measured for 108 strains (90.0%) of 120 clinical isolated of 35 species were lower than 0.78 microgram/ml.

Administration, Oral↗
PubMed1996

[Acute abdomen in abdominal actinomycosis].

The case of a female patient aged 34 suffering from abdominal actinomycosis is reported. She underwent emergency surgery for an abscess-forming tumour infiltrating the lateral abdominal wall and giving rise to the clinical picture of acute abdomen. The casuistry is complemented by two further case histories of actinomyces infections in patients with fistulas of the anal region and pilonidal sinus respectively. Abdominal actinomycosis presents itself as a rare chronic bacterial inflammation, usually located in the right lower abdomen, with local abscess or fistula formation as well as tumour-like infiltration of the surrounding tissues. Exceptionally, the diagnosis is ascertained prior to surgery. Postoperative antibiotic therapy with penicillin for several months ist essential.

Abdomen, Acute↗
PubMed1997

Carney complex: report of a kindred with predominantly cutaneous manifestations.

We report a four-generation kindred with the complex of myxomas, spotty pigmentation and endocrine overactivity. This kindred demonstrates a relatively limited phenotypic expression with predominance of cutaneous features. Male-to-male transmission confirms the autosomal dominant nature of the condition. We propose that pilonidal sinus may be an associated manifestation in this kindred.

Adult↗
PubMed2001

Management of sacrococcygeal pilonidal disease.

OBJECTIVE: Many techniques have been described for the treatment of patients with sacrococcygeal pilonidal disease. No data exists, in relation to this disease within the Kingdom of Saudi Arabia. The aim of this paper is to evaluate our technique retrospectively for management of pilonidial disease with regard to cure and recurrence rates. METHODS: All patients treated at King Faisal Specialist Hospital with either pilonidal abscess or sinus between 1990 and 1998 were identified from the colorectal database and details concerning their presentation, surgery and follow-up were obtained from the patients charts. Both patients with pilonidal sinus and abscess were managed by laying open. Patients were followed until their wounds had healed. RESULTS: Ninety-eight patients, 12 females and 86 males were treated for pilonidal disease in an 8-year period. All patients were managed by laying open. Thirty-one had had previous surgery. Seventy-one presented with pilonidal sinus and 27 presented with pilonidal abscess. The mean length of history prior to presentation was 25 months. Thirty-one patients had an average of 1.6 operations prior to surgery at King Faisal Specialist Hospital. The mean hospital stay was 5.4 days. The average time for healing following laying open was 2.4 months. Five patients developed recurrence following surgery at King Faisal Specialist Hospital 6%. Of the 67 patients who had their primary surgery at King Faisal Specialist Hospital, 2 patients developed recurrence 3%. The mean period of follow up was 6 months range (3-50 months). CONCLUSION: "Laying open" should be the treatment of choice for patients with sacrococcygeal pilonidal disease irrespective of whether the patient presents acutely or electively. Cure rates are high and recurrence rates are low. There is no longer any place for the 2 stage management of pilonidal abscess.

Abscess↗
PubMed1980

Postanal sinus.

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Humans↗