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At least 1,783 records · Page 99Linked to original sources
PubMed1992

Prognosis of surgically treated radiation-induced damage to the intestine.

A series of 88 patients operated on during 24 years for radiation-induced damage (RID) to the intestinal tract were retrospectively reviewed and clinical and surgical factors were related to the ultimate prognosis by multivariate analysis. The first operation was performed on the small intestine in 47 patients, the large intestine in 32 patients or both in nine patients. Postoperative complications occurred in 35 patients (40%), with fatal outcome in 12 (13%). Thirty-one patients (35%) required further surgery and altogether 19 patients (22%) ultimately died from RID. Negative prognostic factors after the first operation were postoperative intestinal leak (P < 0.05) and operation for fistula or perforation (P < 0.01). The outcome after the last operation was negatively influenced by intestinal leak (P < 0.001) by the choice of bypass as operative procedure (P < 0.01) and by operation for fistula or perforation (P < 0.01). In addition, 43% of the patients in whom the disease had progressed between two explorations died from RID. Thus, the severity of the RID as diagnosed at laparotomy, and progression of the disease between two subsequent explorations were related to the prognosis. Care should be taken to avoid intestinal leak. Resections should be preferred to bypass of injured intestine whenever possible.

Adult↗
PubMed2003

[Application of magnetic therapy in acute paraproctitis].

There were studied the possibilities and perspectives of application of the magnetically liquefied layer as an instrument for better purulent and putrefactive wounds clearance after intervention for an acute paraproctitis. Together with clinical signs the results of bacteriological investigation were controlled as well. There was established high efficacy of the method proposed and expedience of its application.

Acute Disease↗
PubMedDate not supplied

[Hemorrhagic rectitis].

Explore the source record for details and available documents.

Gastrointestinal Hemorrhage↗
PubMed2003

Rectal inflammation as first manifestation of graft-vs-host disease: radiologic-pathologic findings.

Graft-vs-host disease (GVHD) is a common, life-threatening complication of bone marrow transplantation that frequently involves the gastrointestinal tract. Since symptoms are typically nonspecific, radiologic examination is often performed to reach a diagnosis. To the best of our knowledge, this is the first reported radiologic description of a case of rectal involvement as the first manifestation of GVHD. The differential diagnosis of segmental rectal wall thickening in a patient following bone marrow transplantation should include GVHD.

Adult↗
PubMedDate not supplied

Radiation-induced rectal ulcer--prognostic factors and medical treatment.

BACKGROUND/AIMS: We conducted this study in order to investigate prognostic factors, and the difference of efficacy of three medical regimens, in the treatment of radiation-induced rectal ulcer. METHODOLOGY: We enrolled 38 pts, with different ages, the free interval from radiation to the appearance of symptoms, and the rectal ulcer size. Medical regimens were 1) sucralfate enema, 2) salasopyrine + hydrocortisone enemas, 3) combination of regimens. We analyzed the difference of frequency of ulcer healing and the time necessary for ulcer healing, between the patients in the different groups. RESULTS: The patients with late appearance of symptoms had significantly shorter time to ulcer healing than the patients with early appearance of symptoms (p=0.032). The patients who received sucralfate alone significantly more frequently achieved ulcer healing, than the patients with salasopyrine and hydrocortisone (p=0.046), and combination regimen (p=0.003). The patients with sucralfate (p=0.009), and with salasopyrine + hydrocortisone (p=0.0387), demanded significantly shorter time to ulcer healing than the patients who received combination treatment. CONCLUSIONS: The free interval may be an important prognostic factor, in patients with rectal ulcer concerning treatment duration. It seems that treatment with sucralfate alone may be the treatment of choice, for patients with radiation-induced rectal ulcer.

Aged↗
PubMed1992

[Endoscopic sonography of the anorectum in inflammatory rectal diseases].

213 patients, classified in 3 groups, were examined in a prospective trial using endorectal ultrasound. 80 patients (group A) had no anorectal disease, the endorectal ultrasound showed normal structures of the anorectum and the perirectal tissue. 80 patients (group B) suffered from Crohn's disease, 30 of them had no clinical signs, the rest of this group (50 patients) felt pain in the anal/perianal region. 83 patients (group C) had perianal abscesses or fistulas, Crohn's disease could be excluded. In all 64 perianal fistulas and 66 perianal abscesses were diagnosed. The results of the rectal-proctological examination were compared with endorectal ultrasound. 100% of the perianal abscesses could be recognized using endosonography. The digital-proctological examination revealed only 57% of perianal abscesses and 48% of perianal fistulas; the supralevatory abscesses couldn't be detected proctologically at all. By endorectal ultrasonography we obtained useful informations about localization and extension of the inflammatory process. From a therapeutic and prognostic view the endorectal ultrasound is a simple, practicable and useful method to investigate perianal and anorectal diseases.

Abscess↗
PubMed1992

[Surgical treatment of chronic paraproctitis].

The experience with operative treatment of 974 patients with chronic paraproctitis has been summarized. After the operations for intrasphincter fistula, 1% of the patients developed a disease recurrence, 0.5%--incompetence of the anal sphincter; for transsphincteric fistula--2.6 and 1.9%, respectively, for extrasphincteric fistula--5.7 and 5.2%. A fistula excision into the intestinal lumen is an operation of choice in intra- and transsphincteric fistula. In extrasphincteric fistula, fistula excision, plastic transfer of mucosa for closure of its internal opening with preservation of the anal sphincter should be performed. In presence of the extensive scars and purulent leaks, a ligature should be added to fistula excision.

Chronic Disease↗
PubMedDate not supplied

[Colorectal Crohn's disease: indications to surgical treatment].

Colorectal Crohns Disease (CRCD) represents the 25% of all cases of Crohns Disease (CD). Between January 1984 and December 2000 we have operated 68 patients with CRCD, that represent 10.3% of the patients operated for CD. Thirtythree patients (48.5%) were men and 35 (51.5%) were women. The median age at diagnosis was 37.3 +/- 13.1 years, with the highest incidence during the fourth decade. In most cases the disease involved the left colon and rectum (65.9%), while in 6.3% and in 3.8% of cases the right and the transverse colon respectively. In the 27.9% of cases the entire colon was involved. At the time of surgery, the disease behaviour was stenosing in 30.9% of patients, inflammatory in 22.1%, and penetrating in 47% of cases with the presence of fistulae (coloenteric in 6 patients, colo-bladder in 2 cases, rectouretral in 1 case, colo-cutaneous in 4 cases and intramesenteric in 2 cases) and abscesses (23.5% of patients). In three patients the CRCD had led to neoplastic transformation. Fourteen patients had undergone an emergency surgical procedure for severe acute colitis, 2 for toxic megacolon, 1 for an intraabdominal abscess and one for intestinal occlusion. In the segmentary forms we have always practiced a resection of the diseased colonic segment without total colectomy. In the cases with diffuse colonic involvement in which the rectum was free from disease a total colectomy with ileorectal anastomosis was performed. In the cases with rectal disease (26 cases) the sphinteric function was preserved with low rectal resection or with colo-anal anastomosis. In 4 patients with rectal disease and in 4 cases with fistulae, we complited the intervention with a permanent stoma. During the median follow-up of 83.7 months (12-207) the surgical relapse was of 27.3%. We suggest to treat CRCD with resections limited to the diseased segment. Moreover, it is possible to preserve the sphinteric function every time the rectum or the anal canal are normal, without postoperative complications or early relapses.

Acute Disease↗
PubMed1992

[Pelvi-rectal abscesses. Diagnosis, treatment and follow-up by transrectal ultrasonography].

Pelvirectal abscess usually presents with vague symptoms which may delay diagnosis and subsequent treatment. However, it is important to recognize this condition since these abscesses may interfere with the sphincter function or give rise to chronic fistulo-in-ano. We describe two patients in whom transrectal ultrasound was applied for diagnosis, and who were treated for a pelvirectal abscess. Both patients were admitted to our hospital because of tumour of the rectum. There were few symptoms and signs of infection. Transrectal ultrasound examination of the rectum made a significant contribution to early diagnosis. We also point out the advantage of transrectal ultrasound examination during follow-up, mainly because we were able to rule out malignant neoplasm by obtaining an ultrasound-guided specimen for histological examination.

Abscess↗