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At least 865 records · Page 48Linked to original sources
PubMed2004

Outpatient adolescent surgical problems.

There are several conditions for which adolescents seek surgical opinion. Many of these necessitate the performance of an office procedure. This article gave perspective on those relatively common and superficial lesions in an office setting.

Adolescent↗
PubMed2005

Infrared and Raman microspectroscopy of foreign materials in tissue specimens.

Infrared and Raman spectra of materials found in tissue specimens submitted for histopathologic diagnosis have been recorded. These foreign materials range in size from approximately 5 to 50 microm, and the vibrational spectra have been used to identify them. Examples include cholesterol and polytetrafluoroethylene (PTFE) in an implant case, polyethylene terephthalate (PET) and polyacrylonitrile (PAN) in a pilonidal cyst, and carbenicillin in a skin biopsy. In some instances, either the infrared or Raman spectra were sufficient to make a definitive identification, while in other cases both were necessary. Because some of the samples fluoresced with visible excitation at 532 nm, FT-Raman spectra with 1064-nm excitation were also recorded. The flexibility of sampling for vibrational microspectroscopy and the value of the recorded data in assisting pathologists render medical diagnoses in the examples cited and other cases are discussed.

Acrylic Resins↗
PubMed1986

Sacrococcygeal myxopapillary ependymomas and ependymal rests in infants and children.

The occurrence of sacrococcygeal myxopapillary ependymal tissue appears to be exceedingly rare. We report on five cases of this lesion in infants, four of which occurred in the first year of life. These cases, the youngest on record, should be added to the thirteen cases previously reported. The lesions were completely removed, and the patients have been followed without recurrence for five months to six years. These lesions arise from the coccygeal medullary vestige, which corresponds to the original site of the final closure of the posterior neuropore. The unique embryology of this region can account for the presence of sacrococcygeal teratomas, lipomas, chordomas, as well as the above described lesion. The presence of ependymal rests, as described by Bale, in most patients with postanal dimples, suggests that the incidence of this lesion should be greater. This lesion has a potential for lymph node and pulmonary metastasis and when clinically palpable, should be completely excised.

Child, Preschool↗
PubMed1987

Extraspinal ependymoma.

Two cases of extraspinal ependymoma are described. This is a low-grade tumor that recurs locally unless wide local excision is performed. It does metastasize, mainly to lymph nodes and lung. Its origin is likely from heterotopic ependymal cells called the coccygeal medullary vestige.

Adolescent↗
PubMed1999

Anorectal miscellany: pilonidal disease, anal cancer, Bowen's and Paget's diseases, foreign bodies, and hidradenitis suppurativa.

Pilonidal disease commonly is seen by all primary care practitioners, and guidelines for office management and referral are provided. Less commonly seen entities, such as hidradenitis suppurativa, anal cancer, and Bowen's and Paget's diseases, also may affect this anatomic area. Knowledge that they may be encountered here helps guide the practitioner to the proper diagnosis and management. Lastly, foreign bodies are sometimes seen in the anorectal area, and information about appropriate steps to take are outlined.

Anus Neoplasms↗
PubMed1979

Self-administered nitrous oxide: an adjunct analgesic.

In a pilot study of 26 patients, a mixture of 50% nitrous oxide and 50% oxygen (N2O-O2) appeared to be an effective and safe analgesic for the incision and drainage of closed-space infections. The analgesic effect of N2O-O2, as measured by a Mean Analgesic Index, is augmented by both amnesic and dissociative effects, ie, patients remembered experiencing significantly less pain than they complained of during the procedure (p less than .01) and reported significantly more pain than they appeared to be having, as recorded by an observer (p less than .01). The patient's recollected pain, however, correlated well (r = .68) with the observer's assessment. Forty-two percent of patients had undergone a similar or identical procedure in the past without the benefit of N2O-O2 and made uniformly favorable comparative statement concerning the analgesic effect of the gas.

Abscess↗
PubMed2002

Efficacy of Rhizophora mangle aqueous bark extract in the healing of open surgical wounds.

Thirty-seven patients with open wounds from surgical intervention of pilonidal cyst (14; 37.8%) or pilonidal fistula (23; 62.2%) were enrolled on a voluntary basis in a comparative blinded clinical trial and randomly assigned to a topical treatment with a Rhizophora mangle aqueous bark extract once a day or twice a day or mercurocrome twice a day. The efficacy of the treatments was evaluated weekly from day 10 to 12 until 6 weeks after surgery by measuring the area of the wounds by image digital planimetry and the tolerability by recording adverse effects. The initial size of the wounds was taken in consideration as covariable in the Generalized Lineal Model used. A thin dark red colored film covering the wound was observed in all the cases treated with the extract. The wound areas of the groups treated with the extract once or twice per day showed a greater reduction (P < 0.05) compared to the group treated with mercurocrome. No differences between the two regimes of application of the extract of R. mangle were observed. No subject showed any sign of adverse effects and no secondary infections were observed.

Adolescent↗
PubMed2003

Local anesthesia and midazolam versus spinal anesthesia in ambulatory pilonidal surgery.

STUDY OBJECTIVE: To evaluate two anesthetic techniques, namely, local anesthesia with sedation, and spinal anesthesia, with respect to recovery times, postoperative side effects, pain scores, patient satisfaction, and hospital costs for ambulatory pilonidal disease surgery. DESIGN: Prospective, randomized study. SETTING: University Hospital of Pamukkale. PATIENTS: 60 consenting patients scheduled for pilonidal disease operation with Limberg flap technique. INTERVENTION: Patients were randomly allocated into two groups: Group 1 (n = 30) received spinal anesthesia with hyperbaric bupivacaine 1.5 mL 0.5%, and Group 2 (n = 30) received local infiltration with a 50-mL mixture containing 10 mL bupivacaine 0.5%, 10 mL prilocaine HCl 2%, and 30 mL isotonic solution with 1:200,000 epinephrine in combination with intravenous (i.v.) midazolam sedation. MEASUREMENTS: Perioperative and postoperative side effects, patient satisfaction, preoperative visual analog scale (VAS) pain scores, and VAS scores from the fourth hour postoperatively until the seventh day were assessed. Anesthesia, operation, surgery, and total hospital time, and costs (drug, resources, and labor) were recorded. MAIN RESULTS: No difference was found between groups in the frequency of side effects. Urinary retention was diagnosed in two patients in the spinal anesthesia group. There was no statistical significant difference seen in satisfaction scores between groups. No statistical significance in VAS pain scores between groups was noted except for the fourth postoperative hour values. The average time spent in the operating room (OR) was greater in the spinal anesthesia group. All Group 2 patients achieved fast-tracking criteria in the OR and were able to bypass the postanesthesia care unit (PACU). Total hospital time and total cost were significantly higher in the spinal anesthesia group than local anesthesia-sedation group (p < 0.05). CONCLUSION: The use of local anesthesia-sedation for ambulatory anorectal surgery resulted in a shorter hospital time, lower hospital costs, and no side effects compared with spinal anesthesia.

Adult↗
PubMed2003

Retrorectal cyst: a rare tumor frequently misdiagnosed.

BACKGROUND: The rarity of retrorectal cysts and their nonspecific clinical presentations often lead to misdiagnoses and inappropriate operations. In recent years, several such patients have been referred to our institutions for evaluation and treatment of misdiagnosed retrorectal cysts. A review of these patients is presented. STUDY DESIGN: Medical records of the colorectal surgery divisions at two institutions were reviewed. Patients found to have previously misdiagnosed retrorectal cysts were identified. Preliminary diagnoses, radiologic examinations, operative procedures, and final diagnoses were obtained. RESULTS: Seven patients with retrorectal cysts who had been misdiagnosed before referral were identified. These patients had been treated for fistulae in ano, pilonidal cysts, perianal abscesses; psychogenic, lower back, posttraumatic, or postpartum pain, and proctalgia fugax before the correct diagnosis was made. Patients underwent an average of 4.1 operative procedures. Physical examination in combination with CT scanning made the correct diagnosis in all patients. All patients underwent successful resection through a parasacrococcygeal approach, and six of seven did not require coccygectomy. The resected tumors included four hamartomas, two epidermoid cysts, and one enteric duplication cyst. CONCLUSIONS: Retrorectal cysts are a rare entity that can be difficult to diagnose without a high index of clinical suspicion. A history of multiple unsuccessful procedures should alert the clinician to the diagnosis of retrorectal cyst. Once suspected, the correct diagnosis can be made with physical examination and a CT scan before a definitive surgical procedure.

Abscess↗