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At least 1,441 records · Page 80Linked to original sources
PubMed2001

Clinical application of continent anal plug in bedridden patients with intractable diarrhea.

PURPOSE: Some patients bedridden from various causes such as stroke or spinal cord injury experience poor control of bowel movement. This causes fecal leakage and diarrhea, increases the risk of perianal excoriation and bed sores, and is a burden on caregivers. To evaluate the efficacy of fecal evacuation and the prevention and treatment of skin complications in intractable diarrhea patients using a new device. METHODS: A continent anal plug (US Patent No. 5 569 216) comprises an inner balloon surrounded by an outer balloon, both of which are mounted on a silicone tube containing a pair of air passages and an enema fluid inlet. The tube is secured in place in the rectum by the inflatable outer balloon and is designed to drain fecal matter through a thin collapsible hose situated in the anal canal. Thirty-two patients (21 male; median age 61 (range, 28-76) years) were evaluated after fully informed consent. Median duration was 12 (range, 3-37) days. RESULTS: The continent anal plug evacuated efficiently in those patients with loose or watery stools who only required irrigation once daily or not at all. Skin excoriations improved in three to seven days. Minimal leakage was seen around the anus. There was no anorectal mucosal injury noted over 37 days. CONCLUSIONS: The continent anal plug is an efficient method of treating patients with loss of bowel control and incontinence because it enables controlled fecal evacuation and helps reduce skin complications without causing anorectal mucosal injury.

Adult↗
PubMed1999

Management of idiopathic ulcer of the anal canal by excision in HIV-positive patients.

PURPOSE: The aim of this article is to show our results from the surgical treatment of idiopathic anal ulcers. METHODS: We present 33 patients with acquired immunodeficiency syndrome and idiopathic perianal ulcers. They presented with anal pain that failed to improve with medical treatment. Evaluation under anesthesia typically showed an irregular ulcer in the anal canal and an intersphincteric abscess. Surgical treatment consisted of an incision around the ulcer, its excision including margins but not its base, and abscess drainage. RESULTS: All patients experienced significant immediate postoperative pain relief. Biopsies of the ulcer showed chronic inflammation, and no specific agents appeared in cultures. CONCLUSIONS: These lesions seem to have the same cryptogenic origin as perianal abscesses, and we recommend surgical treatment to provide symptom relief.

Abscess↗
PubMed2000

Tuberculous anal sepsis: report of clinical features in 20 cases.

INTRODUCTION: Tuberculosis is a neglected cause of anal sepsis, often is not recognized, and therefore is not treated properly. METHOD: All patients were reviewed who had tuberculous anal sepsis diagnosed by histology reports of fistulectomy specimens or abscess scrapings from January 1990 to April 1999. RESULTS: Twenty patients (median age, 53 years; 18 males) with anal tuberculous sepsis were identified. They presented with abscesses (n = 2), abscesses and fistulas (n = 6), or fistulas (n = 12). All patients had a long history of anal complaints (3 months to 20 years), for which 15 patients were operated on previously. Nearly all fistulas (17/18) were complex, and secondary tracks or additional complicating features were common, even at first presentation. Eight patients had active concurrent pulmonary tuberculosis, and six showed evidence of previous pulmonary tuberculosis. Six patients had no signs of concurrent or previous tuberculosis elsewhere. Recurrence was observed only in cases where tuberculosis was initially not recognized, and antitubercular treatment therefore was not started. CONCLUSION: Contrary to views held previously, anal tubercular sepsis seems to have characteristic clinical features. It should be considered in cases of known pulmonary or extrapulmonary tuberculosis or if anal sepsis is persistent, recurrent, or complex in nature.

Adult↗
PubMed2000

Tuberculosis presenting as a perirectal mass: report of a case.

The epidemic of acquired immunodeficiency syndrome has caused a worldwide resurgence of tuberculosis. A case of acute tuberculosis with anorectal involvement presenting at an urban American hospital is discussed. Although anorectal involvement by tuberculosis is not uncommon, the diagnosis is usually initially missed.

Acute Disease↗
PubMed1980

The incidence and prevalence of inflammatory bowel disease in North Tees Health District.

The experience with inflammatory bowel disease in a stable, defined population in northeast England is described. In this population, the incidence of inflammatory bowel disease was higher than expected. In particular, a high incidence of colorectal and anal Crohn's disease was found. The literature is reviewed in order to identify some of the factors responsible for this unusual prevalence of inflammatory bowel disease in the study population. No explanation for our unexpected findings can be advanced.

Adolescent↗
PubMedDate not supplied

Anal lesions in hematologic diseases.

Of 514 patients hospitalized for miscellaneous hematologic diseases, 31 had severe anal lesions (5 per cent); these complications were most commonly observed in agranulocytosis, acute myeloid leukemia, and medullar aplasia. They included infiltration of the perianal area, ulceration, and abscesses. In 20 per cent of the 31 patients, the anal lesion was the first manifestation of the hematologic disease. In all instances, the prognosis of the condition was closely related to the type and severity of the underlying hematologic disease. Surgical therapy, which was applied to the majority of the abscesses, was followed in all instances by rapid symptomatic improvement and was never associated with local or general complications.

Abscess↗
PubMedDate not supplied

Management of inflammatory bowel disease: an effective and concise approach.

Experience in treating 100 patients with inflammatory bowel disease, for periods ranging from one to 15 years, is reviewed. A concise clinical classification of inflammatory bowel disease, correlated with a method of management, is presented. Relative rates of operation appear to be reduced over previously reported series: among chronic ulcerative colitis patients, 11 per cent had major precedures; for Crohn's disease, 36 per cent.

Adrenocorticotropic Hormone↗
PubMed1980

Irradiation injuries of the large intestine.

A series of 15 patients suffering from irradiation injuries to the large bowel is reviewed. Ten patients required surgical intervention, initially a diverting stoma in eight; intestinal continuity was re-established in three patients. Loop ileostomy may be preferable to loop transverse colostomy for fecal diversion, as the former is easier for the patient to manage, and ensures that there is no interference with blood supply to the colon should an abdomino-anal pull-through procedure be indicated later to restore continuity. As only three of the patients developed recurrent carcinoma, the initial operation for irradiation injury to the large bowel should be carefully planned so that the patient is not ultimately cured of carcinoma but left with a permanent stoma.

Aged↗
PubMed1976

Fistula-in-Ano: perineal fistula of intra-abdominal or intrapelvic origin simulating fistula-in-ano--report of seven cases.

Fistulas manifesting in the perianal region but originating in the abdomen often have their true origin not recognized for extended periods. Examples of seven such complex cases are presented and discussed. Removal of the abdominal abnormality is mandatory before any cure can be effected; the perianal portion usually heals without any special local treatment.

Abscess↗
PubMed1976

Fistula-in-ano: a ten-year follow-up study of horseshoe-abscess fistula-in-ano.

A preliminary report in 1965 described a conservative surgical procedure for the management of acute and chronic horseshoe anal fistulas. The operation has been used exclusively at the Ochsner Clinic for this problem since 1963. Forty-one patients were treated from 1963 to 1973. The paper reviews the pathology of acute and chronic horseshoe anal fistulas and describes the surgical procedure for both acute and chronic horseshoe abscess anal fistulas with accompanying illustrations. The excellent results with minimal deformity of the anus and anal canal are attributed to avoidance of severing the superficial external sphincter between its coccygeal origin and the anus. Of the 41 patients treated in the period from 1963 to 1973, healing was good, and there has been no recurrence.

Abscess↗