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Mil Med 2020 Apr 21. Epub 2020 Apr 21.

Division of General Surgery, Department of Surgery, Uniformed Services University of the Health Sciences (USUHS)/Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889.

Introduction: Anorectal diseases, among the most common surgical conditions, are underrepresented in medical training. The Fundamentals of Anorectal Technical Skills course was developed to provide cost-effective formal training in diagnosis of common anorectal conditions and in commonly performed anorectal procedures using the theories of deliberative practice and perceptual and adaptive learning.

Materials And Methods: First- through third-year general surgery and internal medicine residents and third- and fourth-year medical students participated in a course consisting of didactic instruction and hands on skills stations. Read More

Am Fam Physician 2020 01;101(1):24-33

University of Virginia School of Medicine, Charlottesville, VA, USA.

Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be considered in the differential diagnosis. History and examination, including anoscopy, are usually sufficient for diagnosing these conditions, although additional testing is needed in some situations. Read More

Ann Gastroenterol 2020 Jan-Feb;33(1):9-18. Epub 2019 Nov 29.

Department of General Surgery, Division of Gastrointestinal and General Surgery Portland, Oregon Health and Science University, OR, USA.

Hemorrhoids, anal fissures, and fistulas are common benign anorectal diseases that have a significant impact on patients' lives. They are primarily encountered by primary care providers, including internists, gastroenterologists, pediatricians, gynecologists, and emergency care providers. Most complex anorectal disease cases are referred to colorectal surgeons. Read More

Endosc Int Open 2019 Nov 11;7(11):E1549-E1562. Epub 2019 Nov 11.

Department of Gastroenterology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

 Anal examination and video anoscopy (VA) are rarely performed during colonoscopies. The aim of this study is to demonstrate that anal examination and VA provide important information in all routine colonoscopies.  A cross-sectional study was conducted on 12,151 patients screened by VA which were performed during routine outpatient colonoscopy between 2006 and 2018. Read More

Khirurgiia (Mosk) 2019 (8. Vyp. 2):32-39

Rostov State Medical University, Health Ministry of the Russian Federation, Rostov-on-Don, Russian Federation.

Aim: To objectify the criteria for choosing the method of treatment of anal fissures, to determine the indications for surgery and sphincterotomy.

Material And Methods: The results of treatment of 206 patients with chronic and acute anal fissures between the ages of 17 to 75 years are analyzed. The posterior anal fissure was detected in 175 (84. Read More

J Surg Res 2019 11 25;243:249-254. Epub 2019 Jun 25.

Division of GI and General Surgery, Department of Surgery, Oregon Health & Science University, Portland, Oregon. Electronic address:

Background: Benign anal diseases, including hemorrhoids, fissures, abscesses, fistulas, and anal condylomata, affect 10%-15% of our population. Most patients seen by nonsurgical providers experience delayed treatment. We examined at our institution whether an educational session on anorectal diseases would benefit trainees from medical and surgical specialties. Read More

S Afr Med J 2019 Jan 31;109(2):122-126. Epub 2019 Jan 31.

Department of Surgery, Worcester Hospital and Ukwanda Centre for Rural Health, Stellenbosch University, Cape Town, South Africa.

Background: There are limited published data describing surgical admissions at a regional hospital level in the South African (SA) context.

Objectives: To retrospectively review data from an electronic discharge summary  database at a regional SA hospital from 2012 to 2016 to describe the burden of surgical disease by analysing characteristics of the patients admitted.

Methods: All discharge summary records for the 4-year period were reviewed after extraction from a database created for the surgery department. Read More

J Crohns Colitis 2019 Apr;13(5):572-577

Department of Colorectal Surgery, Beaujon Hospital, University Denis Diderot [Paris VII], Clichy, France.

Background And Aims: Faecal diversion [FD] can be proposed in patients with refractory anoperineal Crohn's disease [APCD]. This study aimed to assess long-term results of this strategy, following the advent of the anti-tumour necrosis factor [TNF] era.

Methods: All patients who underwent FD for refractory APCD between 2005 and 2017 were included, excluding patients with a history of ileal pouch-anal anastomosis. Read More

Int J Surg Pathol 2019 Jun 21;27(4):423-426. Epub 2018 Sep 21.

1 University of Miami, FL, USA.

Background: Epithelioid hemangioendothelioma (EHE) is an uncommon malignant endothelial neoplasm that most commonly arises in soft tissue, bone, lung, and liver. Crohn's disease (CD) is an inflammatory bowel disease of unknown etiology that is frequently associated with complications including strictures, fistulas/fissures, and neoplasms.

Case Description: A 43-year-old woman with a 6-year history of severe CD presented with anal pain and bleeding. Read More

Clin Colon Rectal Surg 2018 Mar 25;31(2):117-120. Epub 2018 Feb 25.

Departments of Surgery and Child Health, University of Arizona College of Medicine, Phoenix, AZ.

Anorectal complaints are not uncommon in pediatric care, but the etiology and management can differ significantly from adults. Age is an important factor when considering etiology and management, distinguishing between infants, children, and adolescents. For all ages, malignancy is rarely a consideration, but a thorough examination of infants and children typically requires deep sedation or general anesthesia. Read More

Internist (Berl) 2017 Oct;58(10):1053-1064

Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig AöR, Leipzig, Deutschland.

In proctology patients can often be helped with very little effort. With knowledge of the most common disease symptoms the treating physician can in many cases correctly recognize the cause of the complaints and initiate the appropriate therapy or arrange referral to a proctological institution. This article aims to briefly and succinctly present the most common diseases in proctology (e. Read More

J Pediatr Gastroenterol Nutr 2017 09;65(3):293-298

*Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Hospital, Petah Tikva, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel †Department of Radiology, Sheba Medical Center, Tel-Hashomer, Israel ‡Department of Diagnostic Imaging, Hospital for Sick Children §Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada ||Pediatric Radiology Unit, Shaare Zedek Medical Center, Jerusalem, Israel ¶Department of Radiology, Hospital Regional Universitario Carlos Haya, Malaga, Spain #Electroradiology Department, Faculty of Health Sciences, Collegium Medicum, Jagiellonian University, Cracow, Poland **Department of Radiology, University of Munich, Munich, Germany ††Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA ‡‡Department of Radiology, Cincinnati Children's Hospital, Cincinnati, OH §§Department of Radiology, Connecticut Children's Medical Center, Hartford, CT ||||Department of Radiology, Schneider Children's Hospital, Petah Tikva, Israel ¶¶Diagnostic Imaging Division, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel ##Division of Gastroenterology, Hospital for Sick Children, Toronto, Ontario, Canada ***Institute of Gastroenterology, Nutrition and Liver Disease, Shaare Zedek Medical Center, Jerusalem, Israel.

Objectives: Data on the outcomes of children with perianal Crohn disease (pCD) are limited, although its presence is often used for justifying early use of biologics. We aimed to assess whether pCD in children is associated with more severe outcomes as found in adults.

Methods: Data were extracted from the ImageKids database, a prospective, multicenter, longitudinal cohort study. Read More

Abdom Radiol (NY) 2017 02;42(2):403-422

Mallinckrodt Institute of Radiology, Washington University in St. Louis, 510 S. Kingshighway, St. Louis, MO, 63110, USA.

Anorectal disorders are a common cause of presentation to the emergency department (ED). While the most frequently encountered anorectal conditions, such as hemorrhoids and anal fissures, are relatively benign and do not require imaging for diagnosis or management, there are multiple potentially life threatening anorectal conditions for which imaging is an important component of evaluation, diagnosis, and management. Although computed tomography (CT) is the most commonly used imaging modality for evaluation of anorectal pathology in the ED, magnetic resonance imaging (MRI) has an increasingly important role in the detection, characterization and management of specific anorectal conditions. Read More

Cir Esp 2016 Dec 20;94(10):588-594. Epub 2016 Oct 20.

Clinic for Anesthesiology and Intensive Care, Military Medical Academy, Belgrado, Serbia.

Introduction: This prospective, observational study evaluated transanal dearterialization (THD) efficacy and safety in grade 2-4 hemorrhoids (HD).

Methods: THD was performed under sedation-locoregional anesthesia in 402 outpatients. Patients had follow-up evaluation 3 days, 2 weeks, 1, 6 and 12 months postoperatively. Read More

Perm J 2016 10;20(4):15-222. Epub 2016 Oct 10.

Board-Certified General Surgeon with a special interest in anal health care at the Los Angeles Medical Center in CA.

Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of the symptoms correctly, then to provide an effective and appropriate treatment strategy. Read More

Ter Arkh 2016;88(7):72-77

National Research Center for Hematology, Ministry of Health of Russia, Moscow, Russian Federation.

Aim: to identify poor prognostic factors for perianal infection (PI) in patients with hemoblastosis and to define an effective tactic for preventive and therapeutic measures.

Subjects And Methods: The prospective study enrolled 72 patients (37 men and 35 women; mean age, 47 years) with hemoblastosis that was complicated by the development of one of the following forms of PI: abscess, infiltrate, multiple ulcers. Different clinical and laboratory characteristics of the patients were examined to identify risk factors for PI. Read More

Prz Gastroenterol 2015 10;10(2):83-8. Epub 2015 Mar 10.

Chair and Department of Gastroenterology, Human Nutrition, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.

Anal fistulas occurring in Crohn's disease (CD) comprise a risk factor of severe course of inflammation. They are frequently intractable due to various factors such as penetration of the anal canal or rectal wall, impaired wound healing, and immunosuppression, among others. Anal fistulas typical to CD develop from fissures or ulcers of the anal canal or rectum. Read More

Clin Ter 2015 ;166(5):194-9

Dipartimenti di Medicina Interna e Specialità Mediche, "Sapienza" Università di Roma, Italia.

Background And Aims: Our experience in colon-proctology showed the need to update the post-surgical complications score we published (1), adding others that may have an impact on outcome of treatment. The aim of this study was to assess the efficacy of a score obtained from the analysis of the quality of life and severity of complications after proctologic surgery.

Materials And Methods: Between January and December 2013, we studied 150 patients undergoing several ano-rectal surgeries for the presence of hemorrhoids of grade III and IV (63 patients), anal fissures (42 patients), anal fistulas (19 patients), rectocele (15 patients) and mucosal prolapse of the rectum (11 patients). Read More

Minerva Gastroenterol Dietol 2015 Dec 7;61(4):223-33. Epub 2015 Oct 7.

General Surgery Unit, University Hospital Tor Vergata, Rome, Italy -

Perianal disease is a common complication of inflammatory bowel disease (IBD). It includes different conditions from more severe and potentially disabling ones, such as abscesses and fistulas, to more benign conditions such as hemorrhoids, skin tags and fissures. Most literature has been focused on anal sepsis and fistulae, as they carry the majority of disease burden and often alter the natural course of the disease. Read More

Ter Arkh 2015 ;87(6):83-87

State Coloproctology Research Center, Ministry of Health of Russia, Moscow, Russia.

Aim: To determine the efficacy of 0.1% tacrolimus ointment in patients with perianal Crohn's disease (CD).

Subjects And Methods: This prospective randomized trial enrolled 20 patients with perianal CD as anal fissures and rectal fistulas. Read More

J Manag Care Spec Pharm 2015 Jul;21(7):559-66

HealthCore, Inc., 123 Justison Ave., Ste. 200, Wilmington, DE 19801.

Background: In recent years, there have been a number of pharmacological innovations for Crohn's disease (CD), a difficult-to-treat condition, including new treatment philosophies (e.g., top-down therapy) and new therapeutic options in terms of the agent and the route of administration. Read More

Chirurg 2015 Aug;86(8):734-40

Kompetenzzentrum für Koloproktologie, End- und Dickdarm-Zentrum Essen, Rüttenscheiderstr. 66, 45130, Essen, Deutschland,

Background: Fistula-in-ano and anal fissures are common proctological diseases. In most cases of anal fissures conservative treatment provides good clinical results, whereas for fistula-in-ano operative treatment is the only option.

Objective: The most important and for the patient most stressful long-term complication is postoperative incontinence, especially as the deliberate severance of the anal sphincter musculature is part of the treatment for many patients. Read More

Ugeskr Laeger 2015 Feb;177(9):V11140623

Center for Perioperativ Optimering, -Kirurgisk Afdeling, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev.

Anal fistulas and fissures are frequent disorders. Affected patients may have significant psychosocial and sexual dysfunction. A few studies have investigated patients with anal fissures and fistulas with regard to sexual dysfunction. Read More

Postgrad Med 2015 Apr 7;127(3):266-72. Epub 2015 Mar 7.

Department of Medicine, Massachusetts General Hospital , Boston, MA , USA.

Perianal involvement in Crohn's disease (CD), which encompasses fistulas, ulcers, abscesses, strictures and cancer, can lead to significant impairment in quality of life. The objective of this article is to review the major perianal complications of CD and the current medical and surgical modalities used to treat them. Antibiotics are commonly used despite a lack of controlled trials to validate their use and should be used as a bridge to maintenance therapy. Read More

Acta Med Hist Adriat 2015 ;13 Suppl 2:29-40

Avicenna (980-1037 AD), also known as Sheikh or-Raeis, was an Muslim philosopher, physician, surgeon, astronomer, politician, encyclopedist, and mathematician. Avicenna's writings comprise of five books, know as the Al-Qanun fi al-Tibb (The Canon of Medicine) and the canon covers a wide variety of medical issues. This canon of medicine was the main reference for medical education in Western countries up until the 16th century and in the Middle East until the 19th century. Read More

World J Gastrointest Pathophysiol 2014 Aug;5(3):239-51

Ricardo Sordo-Mejia, Wolfgang B Gaertner, Division of Colon and Rectal Surgery, Department of Surgery, ABC Medical Center, 01120 Mexico City, Mexico.

Perianal symptoms are common in patients with Crohn's disease and cause considerable morbidity. The etiology of these symptoms include skin tags, ulcers, fissures, abscesses, fistulas or stenoses. Fistula is the most common perianal manifestation. Read More

Dermatol Online J 2014 Apr 16;20(4):22373. Epub 2014 Apr 16.

Weil Cornell Medical College.

This article is dermatological atlas of the morphologic presentations of Hidradenitis Suppurativa (HS). It includes: superficial abscesses (boils, furnucles, carbuncles), abscesses that are subcutaneous and suprafascial, pyogenic granulomas, cysts, painful erythematous papules and plaques, folliculitis, open ulcerations, chronic sinuses, fistulas, sinus tracts, scrotal and genital lyphedema, dermal contractures, keloids (some that are still pitted with follicular ostia), scarring, skin tags, fibrosis, anal fissures, fistulas (i.e. Read More

FP Essent 2014 Apr;419:20-7

University of Oklahoma Department of Family and Preventive Medicine, 900 NE 10th St, Oklahoma City, OK 73104,

Anal fissures are linear splits in the anal mucosa. Acute fissures typically resolve within a few weeks; chronic fissures persist longer than 8 to 12 weeks. Most fissures are posterior and midline and are related to constipation or anal trauma. Read More

J Pediatr Gastroenterol Nutr 2013 Sep;57(3):401-12

Department of Pediatrics, University of Colorado School of Medicine, Children's Hospital Colorado, Denver, CO, USA.

Inflammatory bowel disease is a chronic inflammatory disorder of the gastrointestinal tract that includes both Crohn disease (CD) and ulcerative colitis. Abdominal pain, rectal bleeding, diarrhea, and weight loss characterize both CD and ulcerative colitis. The incidence of IBD in the United States is 70 to 150 cases per 100,000 individuals and, as with other autoimmune diseases, is on the rise. Read More

Ther Umsch 2013 Jul;70(7):417-28

Gastroenterologie und Hepatologie, Stadtspital Triemli, Zürich.

In patients with Crohn's disease, perianal lesions can be found at presentation in 20 - 30 % of all cases and a majority will have fistulas or abscesses. If a fistula is suspected, careful inspection of the perianal region will often confirm the diagnosis. Further investigation should be done by magnet-resonance imaging or anal endosonography to guide preoperative planing and minimize recurrence rates. Read More

Eur J Surg Oncol 2013 Apr 21;39(4):404-7. Epub 2013 Jan 21.

Department of Surgery, King Hussein Cancer Center, P.O.Box 1269, Al-Jubeiha, Amman 11941, Jordan.

Introduction: The aim of this study was to examine the type and frequency of perianal conditions in a contemporary series of febrile neutropenic patients and to examine the risk factors, management options and outcome of septic perianal conditions.

Methods: Medical records of all adult febrile neutropenic patients (933 patients) who were admitted during the period from January, 2009 to December 2011 were retrospectively review. All patients with perianal complaints or conditions were included. Read More

Chirurg 2012 Dec;83(12):1033-9

Klinik für Viszeral-, Thorax- und Gefässchirurgie, Klinikum München Bogenhausen, Städtisches Klinikum München GmbH, Englschalkinger Str. 77, 81925, München, Deutschland.

CRYPTOGLANDULAR ANAL FISTULA: Perianal abscesses are caused by cryptoglandular infections. Not every abscess will end in a fistula. The formation of a fistula is determined by the anatomy of the anal sphincter and perianal fistulas will not heal on their own. Read More

Dis Colon Rectum 2012 Nov;55(11):1145-52

Division of Colon and Rectal Surgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.

Background: Anal complications of Crohn's disease range from painless skin tags to debilitating fistulas that are imperfectly treated with tumor necrosis factor antagonists. The recent discovery of more than 190 single-nucleotide polymorphisms associated with Crohn's disease offers the opportunity to genetically define the severity of anal disease in Crohn's disease and possibly predict prognosis and anti-tumor necrosis factor response.

Objectives: This study aimed to identify single nucleotide polymorphisms associated with anal disease generally, septic anal disease specifically and the responsivity to anti-tumor necrosis factor treatment. Read More

Surgery 2013 Feb 19;153(2):211-8. Epub 2012 Aug 19.

Division of Colon and Rectal Surgery, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan.

Background: Our aim is to report the outcomes of hemorrhoidectomy performed via LigaSure™ with a minimum follow-up of 2 years.

Methods: A total of 666 patients underwent hemorrhoidectomy for symptomatic prolapsed hemorrhoids (grade III and IV) via LigaSure between June 2006 and June 2008. Patient demographic and operative data were collected and analyzed. Read More

Am Fam Physician 2012 Mar;85(6):624-30

Eisenhower Army Medical Center, 300 E. Hospital Rd., Ft. Gordon, GA 30905, USA.

The prevalence of benign anorectal conditions in the primary care setting is high, although evidence of effective therapy is often lacking. In addition to recognizing common benign anorectal disorders, physicians must maintain a high index of suspicion for inflammatory and malignant disorders. Patients with red flags such as increased age, family history, persistent anorectal bleeding despite treatment, weight loss, or iron deficiency anemia should undergo colonoscopy. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2011 Dec;14(12):958-60

Department of Pathology, The Third Affiliated Hospital, Nanjing Traditional Chinese Medical University, Nanjing 210001, China.

Objective: To analyze the infection condition of human papillomavirus (HPV) type 16 and 18 in the squamous cells and columnar cells of patients with common anorecatal lesions.

Methods: Infections of HPV type 16 and 18 were determined with real-time fluorescent quantitative PCR in the wax-embedded surgical specimen of 805 patients with common anorectal diseases.

Results: The overall infection rate among 805 patients with anorecatal lesions was 66. Read More

Surg Innov 2012 Mar 7;19(1):33-6. Epub 2011 Jul 7.

Unit of Proctological and Perineal Surgery, University Hospital of Pisa, Pisa, Italy.

Aim: The purpose of this study was to investigate whether endoanal ultrasonographic findings could better characterize chronic anal fissures, mostly in those patients with persistent and recurrent disease after medical treatment.

Methods: Between January 2004 and April 2010, patients referred to our departments suspected for anal fissure were considered in a database. Physical examination and anoscopy confirmed the diagnosis of anal fissure in 543 patients. Read More

Inflamm Bowel Dis 2012 Jan 23;18(1):43-8. Epub 2011 Feb 23.

Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.

Background: The cumulative incidence of and risk factors for perianal Crohn's disease (CD) for findings other than fistulas are unknown.

Methods: The medical records of 310 incident cases of CD from Olmsted County, Minnesota, diagnosed between 1970 and 2004, were reviewed for evidence of perianal disease findings other than fistulas. Cumulative incidence was estimated using the Kaplan-Meier method, and associations between baseline factors and time to first event were assessed using proportional hazards regression. Read More

Cir Esp 2010 Apr 4;87(4):224-30. Epub 2010 Mar 4.

Unidad de Coloproctología, Centro de Especialidades de Aldaya, Servicio de Cirugía General y Digestiva, Consorcio Hospital General Universitario de Valencia, Valencia, España.

Aim: To assess the value of using smooth muscle relaxants drugs and assess the results of the topical use of 2% diltiazem as an alternative to 0.2% nitroglycerin in the treatment of chronic anal fissure (CAF).

Methods: Review of the CAF contained in a prospectively collected database of anal fissures including one hundred forty-five patients diagnosed with CAF and treated with standard measures (ST) in two consecutive periods. Read More

Dig Dis 2009 4;27(4):565-70. Epub 2009 Nov 4.

Lviv National Medical University, Coloproctology Department, Lviv, Ukraine.

Aim: To construct an algorithm of the treatment tactics which would include modern conservative and surgical methods.

Materials And Methods: Endoscopy under anesthesia, endorectal ultrasonography, histological and radiological examinations, MRT. In the last 22 years, 310 patients with Crohn's disease (CD) have been treated in our clinic of which 144 had perianal complications (60 fissure, 52 fistula, 61 perianal abscess). Read More

Best Pract Res Clin Gastroenterol 2009 ;23(4):575-92

Department of Gastroenterology, University Hospital Vrije Universiteit, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.

Anorectal disorders like haemorrhoids, rectal prolapse, anal fissures, peri-anal fistulae and sexually transmitted diseases are bothersome benign conditions that warrant special attention. They, however, can all be diagnosed by inspection or proctoscopy (sexually transmitted proctitis). Constipation can play an underlying role in haemorrhoids, rectal prolapse and anal fissures, and it is important to treat these conditions in order to avoid recurrences. Read More

World J Gastroenterol 2009 Jul;15(26):3201-9

Anorectal complaints are very common and are caused by a variety of mostly benign anorectal disorders. Many anorectal conditions may be successfully treated by primary care physicians in the outpatient setting, but patients tend not to seek medical attention due to embarrassment or fear of cancer. As a result, patients frequently present with advanced disease after experiencing significant decreases in quality of life. Read More

Colorectal Dis 2010 Aug 30;12(8):792-8. Epub 2009 Jun 30.

Coloproctology Unit, Ars Medica Hospital, Rome, Italy.

Aim: Some benign anorectal diseases may have psychosomatic aetiology, but patients often refuse direct psychological counselling. The Draw-the-Family Test (DFT) is a simple indirect investigation. The aim of this study was to evaluate the DFT in patients with psychological problems undergoing surgery for benign anorectal disease and to correlate the results with surgical outcome. Read More

Anticancer Res 2009 Mar;29(3):927-33

Department of Surgery, Fukuoka University Chikushi Hospital, Chikusino-shi, Fukuoka 818-8502, Japan.

Background: Infliximab has played a central role in the treatment of luminal Crohn's disease (CD) due to its great usefulness. Although the seton placement has been widely used for the treatment of anal fistula in patients with CD, we have used infliximab for severe cases in which improvement was not achievable by the seton placement, or for patients in whom improvement of quality of life (QOL) could be expected.

Patients And Methods: The anal region of 383 patients with CD was examined during the period from July 1985 to December 2005 and the presence of a lesion in the anal region was confirmed in 326 patients. Read More

Aten Primaria 2009 Apr 27;41(4):207-12. Epub 2009 Mar 27.

Servicio de Cirugía General y del Aparato Digestivo, Hospital General de Castellón, Castellón, Spain.

Objective: To analyse the diagnostic performance of the primary care (PC) doctor in benign anal diseases.

Design: Cross-sectional study including patients referred to our clinic from PC with the diagnosis of clinical conditions pertaining to benign anal diseases between 1st June and 31st December 2007. The diagnosis established by the PC doctor was compared with that of 2 medical specialists in general and digestive diseases surgery. Read More

Dis Colon Rectum 2008 Oct 1;51(10):1491-4. Epub 2008 Aug 1.

Emilio Ribas Infectious Diseases Institute, Sao Paulo, Brazil.

Purpose: Highly active antiretroviral therapy has enabled better control over HIV infection. Thus, the immunologic status of such patients has been improving and we believe that changes in their perianal diseases also have been occurring. This study was designed to compare anorectal disease incidence among HIV-positive patients attended in two eras: prehighly active antiretroviral therapy and highly active antiretroviral therapy. Read More

Chirurg 2008 May;79(5):439-43

Klinikum Bogenhausen, Klinik für Visceral-, Thorax- und Gefässchirurgie, Städtisches Klinikum München GmbH, Englschalkinger Strasse 77, 81925 München.

Fissures in ano are linear ulcers situated in the anal canal and extending from the dentate line to the margin of the anus. They cause pain and spasms. Diagnosis is made by the history alone. Read More

Chirurg 2008 May;79(5):430-8

Klinikum Bogenhausen, Klinik für Visceral-, Thorax- und Gefässchirurgie, Städtisches Klinikum München GmbH, Englschalkinger Strasse 77, 81925 München.

Perianal abscesses are caused by cryptoglandular infections at the dentate line between the anal sphincters. Acute therapy will relieve the pain but not the development of perianal fistulas. The challenge in therapy of perianal fistulas balances between the best possible cure and the preservation of continence. Read More

Dakar Med 2006 ;51(3):161-4

Service de gastroentérologie, Hôpital Aristide Le Dantec Dakar.

Introduction: haemorrhoidal disease symptoms lead frequently to medical consultation. The aims of our study were to determine its epidemiological, clinical and endoscopic characteristics in Dakar.

Patients And Methods: we conducted a prospective multicentric study in the hospitals and in the private offices with endoscopic unit in Dakar from November 2nd 2003 to July 31 2004. Read More

Isr Med Assoc J 2007 Mar;9(3):163-8

Department of Surgery, Sheba Medical Center, Tel Hashomer, Israel.

Perianal Crohn's disease refers to the involvement of the anal region in this chronic inflammatory bowel disease. It most commonly presents with the formation of perianal abscesses and fistulas, although other forms of presentations such as fissures and skin tags may also be present. Perianal activity often parallels abdominal disease activity, but may occasionally be the primary site of active disease, and significantly compromises the quality of life in affected patients. Read More