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[Endoscopic dilatation of benign colon and rectum stenosis].

AIM: To determine the usefulness of endoscopic dilatation in dealing with benign stenosis of the anus, rectum and colon. PATIENTS AND METHODS USED: Thirty six (36) patients with stenosis, anus (8), rectum (22) and colon (6) were given endoscopic treatment using hydroneumatic balloons, electro incision (radiated cuts) or a combination of both. Rigid equipment (metal) was used for distal stenosis. Age ranged between 30 and 82 years. Twelve (12) patients were male and 24 female. The diameter of the stenosis was less than 13 mm in 18 of the patients and 11 patients carried colostomy. RESULTS: All 36 patients were subjected to a total of 113 dilatation sessions. The average number of sessions per patient for patients with anal stenosis was 2.5 and for patients with colorectal stenosis, 3.32. One patient with rectal stenosis required 21 sessions to achieve final objective. The result achieved was good in 31 patients, less than satisfactory in 3 patients and bad in one patient, who presented a stenosis which was over 5 cm long. We lost track of a patient in the follow up stage. Success in closing the colostomy was achieved in 9 patients, while one presented a complication due to the procedure (cervical emphysema) which remitted with medical attention. CONCLUSIONS: Endoscopic dilatation offers, through its different techniques, a safe and efficient method for the treatment of benign stenosis of the anus, rectum and colon and must be considered as a first class tool for the treatment of this kind of pathologies.

Adult↗

[Amoxiklav in the treatment of acute paraproctitis].

In 38 patients with an acute paraproctitis a new generation antibiotic Amoxiclave, owing broad spectrum of activity, was applied. While observing the wound clearance and healing process, together with clinical parameters, the results of bacteriological investigation were controlled. High efficacy of the preparation was observed as well as expediency of its application in the purulent wound surgery, for an acute paraproctitis in particular.

Acute Disease↗

[Anaerobic paraproctitis].

Anaerobic paraproctitis (AP) was seen in 8.6% of 1057 cases with acute paraproctitis. Severe general condition of the patient, vast damage, fetid wound secretion, extensive detachment and necrosis of tissues were the main AP symptoms. Radical excision of affected tissues with daily revision and sanatation in combination with intensive general therapy permits to reduce mortality to 4.3%. In early postoperative period reversible insufficiency of anal sphincter developed in 16.1% AP patients. It is necessary to close wounds as early as possible. Perforated cutaneous pedicle flap from posterior wall of the scrotum may be successfully used for plastic repair of perineum wound.

Acute Disease↗

[Local sorption-detoxication therapy in combined treatment of acute purulent paraproctitis].

Efficacy of sorption-detoxication therapy (sorbent SUMS-1) in combined treatment of acute purulent paraproctitis was evaluated. Degree of endotoxication, state of postoperative wound, structural and morphological state of mucosous membrane of the rectum (light, electron microscopy, morphometry of biopsies) were studied. It was found that local use of sorbent increases efficacy of treatment of severe paraproctitis: endotoxicosis eliminates, regional hemo- and lympho-circulation improves, wound regeneration activates.

APACHE↗

[Eosinophilic proctocolitis induced by foods. Report of a case].

The food-induced eosinophilic proctocolitis is a major cause of blood-tinged stools and appears in the first two months of life. The infant is generally described as well, but the clinical features and laboratory results are often nonspecific. We present an early infant with fresh blood stools at 50 days. The colonoscopy and biopsy of the rectum and lower sigmoid revealed lymphoid nodular hyperplasia of the submucose and eosinophil infiltration (40 to 50 per high power field) of the lamina propria and intraepithelial. Elimination of the offending protein from the diet, through the use of an extensively hydrolyzed casein-based formula and soy, lead to clinical resolution of bleeding at 48 hours. We made a review of the case.

Colitis↗