فهرست مطالب

Annals of Colorectal Research - Volume:7 Issue:3, 2019
  • Volume:7 Issue:3, 2019
  • تاریخ انتشار: 1398/06/10
  • تعداد عناوین: 8
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  • Beuy Joob *, Viroj Wiwanitkit Page 1
    Context 

    Influenza is an important viral respiratory disease. The disease mainly affects respiratory organ. In severe case, the patient might die. Influenza is still the important problematic infectious disease. The atypical manifestation of influenza is observable in clinical practice. The colorectal presentation of influenza is very interesting. Evidence Acquisition: The authors hereby searched and summarized clinical data from published article in international database regarding colitis in influenza.

    Results

    An important condition is influenza related colitis. Hemorrhagic colitis is a rare but possible clinical complication of influenza. In case with influenza related colitis, the patient might have a lower abdominal pain, bloody diarrhea, and hematochezia. Severe colonic bleeding might occur and hemostatic therapy is required. On the other hand, the antiviral therapy is also a possible cause of colitis. In a patient with influenza receiving oseltamivir, a possible adverse effect of antiviral drug is hemorrhagic colitis. The problem might be acute. The patient usually has abdominal pain, diarrhea, and hematochezia after the first administration of oseltamivir. In addition to hemorrhagic colitis, ischemic colitis due to influenza is also observable . The patient might require colectomy and this condition might lead to death. Another possible colonic complication due to influenza is colonic apoptosis due to influenza related fulminant hemophagocytic lymphohistiocytosis. The patient will have abdominal pain and skin rash.

    Conclusions

    Therefore, it is not impossible that the colonic complication might occur in any patient with influenza. The practitioner should recognize for the possibility that there might be a colorectal manifestation in any patients with influenza.

    Keywords: Colitis, Influenza, Colorectal disorders
  • Joseph Nesambi, Olivier Mukuku *, Prosper Kakudji, Jean, Baptiste Kakoma Page 2
    Background

    In developing countries, fistulae are generally caused by long obstructed labors. Obstetric fistula (OF) is a severe condition which can have devastating consequences for a woman’s life.

    Objective

    Describe the socio-demographic and delivery characteristics of patients with OF in Haut-Katanga province in the DRCongo.

    Methods

    This is a prospective descriptive study of 413 patients with OF in Haut-Katanga province during the period from September 2009 to December 2018.

    Results

    At fistula occurrence, 53.3% of patients were younger than 20 years (mean age: 21.3 ± 6.7 years) and 65.8% were primiparous. More than half had primary education and 39.7% were illiterate; 70.2% of the patients were separated or divorced. Fistula developed after delivery at home in 239 (57.9%) of 413 women. A total of 393 (95.2%) women developed fistula after vaginal delivery. A total of 387 (93.7%) of the 413 women reported that the fetus did not survive the labor during which fistula developed. 92.3% had a vesico-vaginal fistula and the mean age of fistula was 6.5 years. Surgical repair was successful in 82.9%.

    Conclusion

    Obstructed labor remains the most important cause of OF in Haut-Katanga. It is important to prevent OF arising from obstructive causes. The surgical treatment of OF will depend upon the type, size and location of fistula.

    Keywords: Obstetric fistula, Socio-demographic, delivery, Haut-Katanga
  • Marwa Sobhi, Sameh Hany Emile *, Ahmed Abdelmawla, Mohamed Youssef, Sabry Mahmoud Page 3

    Abstract

    Background

    Conservative treatment of chronic anal fissure (CAF) is the first line of treatment. Patients who fail conservative treatment are offered surgical treatment in the form of lateral internal sphincterotomy (LIS) or V-Y anoplasty.

    Objective

    This prospective study aimed to compare LIS and V-Y anoplasty in the treatment of CAF based on the baseline resting anal pressure of patients.

    Methods

    Female patients with CAF were investigated with anal manometry. Patients with elevated resting anal pressure were treated with LIS and patients with normal or low resting anal pressure were treated with V-Y anoplasty. Data about healing of anal fissure, reduction in pain score, continence disturbance, and complications were recorded on follow-up.

    Results

    Twenty-four female patients of a mean age of 37.6 years were included to this study. Sixteen patients underwent LIS (group I) and 8 underwent V-Y flap (group II). Both groups achieved comparable time to complete healing. Both groups showed significant decrease in pain score at 3 months of follow-up (Group I: 6.1±0.85 to 0.93±0.7, p

    Keywords: Chronic anal fissure, Lateral internal sphincterotomy, V-Y, Anoplasty, Manometry
  • Colin Sirr, Siobhan Rooney, Amir Samy, Rishabh Sehgal *, Aisling Hogan Page 4
    Background

    Faecal incontinence (FI) is a debilitating condition associated with social isolation and poor quality of life. The prevalence of FI within the Irish setting has yet to be fully elucidated. The aim of the current study was to provide insights into the prevalence of FI among the population of the West of Ireland.

    Method

    An anonymized questionnaire-based survey was conducted between May and August 2018 in a tertiary referral centre. Staff members and patients above the age of 18yrs were invited to take part in the study. The Rome IV criteria for FI was utilized. Data collected included patient demographics, co-morbidities, FI risk factors, surgical and obstetric history. Severity of faecal incontinence was assessed using the Wexner Continence Scale (WCS).

    Results

    A total of 200 participants (F/M 124/76, median age 47yrs (18-86yrs)) were enrolled into the study. The overall prevalence of FI was 31.5% (63/200). 81 (40.5%) experienced some form of bowel dysfunction in the past. Of the 81, only 45 (55.5%) had discussed their FI symptoms with a healthcare professional. The FI group had 14 individuals (7%) with severe incontinence (Wexner score ≥ 9), 18 (9%) reported moderate incontinence (Wexner 5-8) and 31 (16%) reported mild incontinence (Wexner score 1-4). The FI cohort had a significantly greater incidence of inflammatory bowel disease, irritable bowel syndrome and previous bowel surgery (p

    Keywords: Faecal Incontinence, prevalence, Wexner Continence Scale, Rome IV criteria
  • Ahmad Izadpanah, Habibollah Nikzad Jamnani, Alireza Safarpour *, Ahad Izadpanah, Seyed Mohammad Kazem Tadayon Page 5
    Background

    Inability to manage of stool release, fecal incontinence, is a condition with sever negative effects on the patients’ quality of life. Use of platelet-rich plasma in healing of anal sphincter might improve outcomes. The current study investigated the healing effects of PRP application after surgical repair of sphincter in rabbits as an animal model for human studies.

    Methods

    Twenty-four New Zealand rabbits were randomly allocated into 4 groups based on the time of healing at one and three weeks after sphincteroplasty and using of PRP. Sphincterotomy and then sphincteroplasty were performed in all animals and autologous PRP was prepared and used as dose as 0.5 ml per animal. The healing scores of sphincter were compared between four groups using histological scoring system.

    Results

    The histological healing score in PRP used group was significantly higher than not PRP used group after one week (18.6 ± 0.8 vs. 13.0 ± 1.8 respectively, P = 0.01) but no significant difference was detected between healing score of PRP used and not PRP used groups after three weeks (19.0 ± 0.0 vs. 18.5 ± 0.8 respectively, P = 0.17).

    Conclusion

    Our findings indicated that although PRP had an accelerator role in wound healing of sphincter repair, but it has not significant effects over time especially after 3 weeks.

    Keywords: Anal sphincter, Healing, Platelet-Rich plasma, sphincterotomy, Sphincteroplasty
  • Parveen Kumar *, Rishabh Jain, Arti Khatri Page 6

    CPC is a rare reginal variant as per international Krickenbeck classification, in which colon (partly or complete) is replaced by a pouch like dilatation, opening into urogenital tract via a large fistula. Theassociation of CPC without a fistula with ARM is very rare. Type I: Absent large colon, with ileum opening directly into pouch. Type II: The presence of short segment of caecum which then opens into pouch. Type III: The presence of good length of colon between ileum and pouch. Type IV: The presence of large colon with only sigmoid and rectum converted into pouch A 2-day-old female baby presented with radiological features of pouch colon, which intra-operatively revealed type 4 CPC without fistula. The vestibule had two normal openings, with an external anal marking in perineum with puckering of skin but without any caliber. She underwent excision of pouch with end stoma and awaiting abdomino-perineal pull through at 6 months of age. To best of our knowledge, there is no case reported of CPC without fistula with external anal marking and puckering.

    Keywords: CPC (Congenital Pouch colon), ARM (Anorectal malformation), Fistula
  • Sankal Psingh *, Nishant Lohia, Manoj Prashar, Subramananiam Anand, Sundaram Viswanath, Richa Ranjan Page 7

    The rectum is an unusual and unlikely site for squamous carcinoma of the gastrointestinal tract. The clinicalpresentation of this rare histology though, is similar to adenocarcinoma rectum. Being a rare clinical entity withlimited cases, the etiology, pathogenesis and optimal treatment regimen is still unclear. In this paper, we presenta case of a 55 years old man presenting with complaints of bleeding per rectum for previous six months. Imagingrevealed mass in rectum and the biopsy was suggestive of squamous cell carcinoma. He was treated withabdominoperineal resection followed by adjuvant chemoradiotherapy.The rectum is an unusual and unlikely site for squamous carcinoma of the gastrointestinal tract. The clinicalpresentation of this rare histology though, is similar to adenocarcinoma rectum. Being a rare clinical entity withlimited cases, the etiology, pathogenesis and optimal treatment regimen is still unclear. In this paper, we presenta case of a 55 years old man presenting with complaints of bleeding per rectum for previous six months. Imagingrevealed mass in rectum and the biopsy was suggestive of squamous cell carcinoma. He was treated withabdominoperineal resection followed by adjuvant chemoradiotherapy.

    Keywords: Squamous cell carcinoma, hematochezia, Rectum
  • Masoud Hosseinzadeh, Sahand Mohammadzadeh * Page 8

    Acute appendicitis is usually developing due to obstruction of the appendix and is one of the most common causes of emergency in surgical cases. Many factors are involved in the etiology like fecalith, stricture, foreign body, worm infestation, and neoplasm. Trichobezoars may be seen in the bowels and other parts of the gastrointestinal tract which may present with clinical symptoms like acute abdomen and gastric outlet obstruction. Our case is about a 16-year-old male who had acute appendicitis due to trichobezoar with a past history of psychological disorders. We would like to emphasize the importance of appendicitis due to foreign bodies, and also considering a trichobezoar formation in a patient with gastrointestinal obstruction symptoms, especially in the case with the previous history of trichophagia.

    Keywords: Appendix, Acute Appendicitis, Trichobezoar