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Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alberta, Canada. Electronic address:

Background: Treatment of anorectal abscesses continues to revolve around early surgical drainage and control of perianal sepsis. Yet even with prompt drainage, abscess recurrence and postoperative fistula formation rates are as high as 40% within 12 months. These complications are thought to be associated with inadequate drainage, elevated bacterial load, or a noncryptoglandular etiology of disease. Read More

J Crohns Colitis 2019 Feb 14. Epub 2019 Feb 14.

Institute of Gastroenterology and Liver Diseases, Department of Medicine, Hadassah - Hebrew University Medical Center, Jerusalem, Israel.

Background And Aims: A majority of acutely-ill Crohn's disease (CD) patients who present to Emergency Department (ED) will undergo an abdominal CT to rule out disease complications. We aimed to generate a simple non-invasive scoring model to predict the presence of an intra-abdominal abscess in CD patients in the ED.

Methods: We performed a retrospective case control study at four Israeli hospitals from January-1 st-2010 to May-30 th-2018. Read More

Gan To Kagaku Ryoho 2019 Jan;46(1):88-90

Dept. of Surgery, Yao Tokushukai General Hospital.

An 81-year old man with a perirectal abscess was referred in May 2017 by another hospital. We observed swelling in the anal region at the 4 o'clock position and performed incisional drainage. Although this alleviated the pain and inflammation in the anal region, the irritation recurred in early June. Read More

Turk J Med Sci 2019 Feb 11;49(1):42-49. Epub 2019 Feb 11.

Background/aim: Differentiating intestinal Behçet’s disease (BD) from Crohn’s disease (CD) is highly challenging, as they often mimic each other in terms of clinical manifestations. Endoscopy is an important modality for distinguishing bowel lesions. The study was designed to identify clinical manifestations that are easily confused and to evaluate the efficacy of endoscopy for distinguishing intestinal BD from CD by several overlapping signs. Read More

Asian J Surg 2019 Feb 6. Epub 2019 Feb 6.

General surgery department, Cairo University, Egypt.

Perianal sepsis and fistula is a troublesome disease in the field of colorectal surgery in term of recurrence and fecal incontinence. The aim of our study is to evaluate the role of 'one stage complex anal fistula excision with reconstruction of anal sphincter without stool diversion' regarding fecal incontinence and recurrence. This was prospective cohort study on 175 patients of complex high peri-anal fistulae, the patients were subjected to fistulectomy and reconstruction (primary suture repair) of anal sphincter without stool diversion, the patients were followed up 1 year postoperatively after complete healing of the wound regarding their continence to stool and gases using Wexner score and recurrence of the fistula which is examined clinically and radio-logically using MRI. Read More

Ultrasound Int Open 2019 Jan 5;5(1):E34-E51. Epub 2019 Feb 5.

Department of Surgery, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway.

This article represents part 3 of the EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound (GIUS). It provides an overview of the examination techniques recommended by experts in the field of endorectal/endoanal ultrasound (ERUS/EAUS), as well as perineal ultrasound (PNUS). The most important indications are rectal tumors and inflammatory diseases like fistula and abscesses in patients with or without inflammatory bowel disease (IBD). Read More

Adv Emerg Nurs J 2019 Jan/Mar;41(1):33-38

Georgetown University, Washington, District of Columbia.

Fournier's gangrene is a rare disease with a significant mortality rate. The potentially fatal disease stems from both aerobic and anaerobic bacteria and primarily occurs in men. The majority of Fournier's gangrene cases are idiopathic or derived from perineal and genital skin infections. Read More

Oxf Med Case Reports 2019 Jan 24;2019(1):omy116. Epub 2019 Jan 24.

Emergency Medicine Physician, Beaumont Hospital, Teaching Hospital of Michigan State University, Department of Emergency Medicine, Farmington Hills, MI, USA.

An anorectal abscess, specifically a perianal abscess, is a relatively uncommon infection in children. It is a purulent fluid collection under the soft tissue outside the anus. Some of these abscesses may spontaneously drain and heal by themselves, while others may result in sepsis and require surgical intervention. Read More

Chirurg 2019 Jan 25. Epub 2019 Jan 25.

Abteilung für Proktologie, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Str. 86, 93049, Regensburg, Deutschland.

Anal fistulas are a common anorectal disease and are frequently associated with a perianal abscess. The etiology is based on a cryptoglandular infection in the intersphincteric space. Surgery remains the only definitive therapy. Read More

Ir J Med Sci 2019 Jan 23. Epub 2019 Jan 23.

Department of Surgery, Cork University Hospital, Wilton Road, Cork, Ireland.

Purpose: Management of anorectal abscess is traditionally by incision and drainage with packing. This study assessed the use of mushroom catheters compared with packing of anorectal abscess after incision and drainage in adults. Placement of a mushroom catheter to allow ongoing drainage of the cavity may have advantages by eliminating the need for painful dressing changes. Read More

Gastroenterol Res Pract 2018 23;2018:5249087. Epub 2018 Dec 23.

Policlinico Tor Vergata, Department of Surgery, University Tor Vergata, Viale Oxford 81, 00133 Rome, Italy.

Background: One-third of Crohn's disease (CD) patients present perianal fistula. The gold standard in the diagnosis and treatment of symptomatic perianal disease (PAD) in CD is the exploration of the anal canal and distal rectum under anesthesia (EUA). This procedure is mainly conducted as a day case surgery. Read More

IDCases 2019 7;15:e00488. Epub 2019 Jan 7.

Department of Medicine, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Rua Dr. Eduardo Torres, 4464-513, Matosinhos, Portugal.

is a ubiquitous, rapidly growing, gram-positive bacterium causing infections in humans and animals. It is responsible for a variety of symptoms depending on the infection site and the integrity of the host's immune system. Case reports of skin and soft tissues infections by Listeria are rare. Read More

Int J Colorectal Dis 2019 Jan 15. Epub 2019 Jan 15.

Department of Radiology, "S. Maria dei Battuti" Hospital, Via Brigata Bisagno 4, 31015, Conegliano, TV, Italy.

Aim: The aim of this retrospective study is to evaluate the preliminary results of a mini-invasive procedure for the treatment of supralevator abscesses (SLA) of cryptoglandular origin by extrasphincteric extension.

Method: In this clinical study, an innovative two-stage procedure was tested for the surgical treatment of SLA. As first step and as a preparation for surgery, the interventional radiologist positioned a CT-guided percutaneous perianal guidewire inside the abscess cavity under local anesthesia. Read More

Vaccine 2019 Jan 7;37(5):751-754. Epub 2019 Jan 7.

School of Social Development and Public Policy, Beijing Normal University, China. Electronic address:

A 16 week newborn vaccinated with bOPV 4 weeks after his first routine IPV vaccination. Nineteen days later, asymmetrical paralysis was developed on his legs, and it was diagnosed to be VAPP. Perianal abscess is suspected to be a risk factor based on some limited results of retrospective studies in China. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2018 Dec;21(12):1337-1346

Surgeon Committee of Gastrointestinal Fistula of Chinese College of Surgeons, Email:

Crohn disease (CD) is a chronic inflammatory disease involving the entire digestive tract and non-perianal fistula is the most serious surgical complication of CD. The goal of treatment is to cure intestinal fistula and intra-abdominal infection, restore the continuity of digestive tract, reduce postoperative recurrence, and improve the quality of life. Evaluation of nutritional status, especially during perioperative period, is important and nutrition support for malnutritional CD patients is necessary. Read More

Case Rep Surg 2018 21;2018:9021289. Epub 2018 Nov 21.

Department of Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA.

Basal cell carcinoma (BCC), a common malignancy, arises most often in sun-exposed areas but does rarely occur in non-sun-exposed sites. Prior tissue injury, especially sharp trauma and chronic inflammation, increases the risk of BCC. We describe a 66-year-old male patient with recurrent perianal abscesses who was found to have a large pigmented basal cell carcinoma. Read More

Inflamm Bowel Dis 2018 Dec 20. Epub 2018 Dec 20.

The Gastro Unit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.

Background: Perianal complications in patients with Crohn's disease are common and have a negative impact on the patients' quality of life. Data about the long-term disease course of perianal Crohn's disease in the era of biological treatment are limited. In this population-based cohort study, we sought to investigate the occurrence, clinical risk factors, and disease course of perianal disease. Read More

Clin Exp Immunol 2018 Dec 15. Epub 2018 Dec 15.

IBD Unit, Presidio Columbus, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Rome, Italy.

Collaboration between gastroenterologists and rheumatologists is recommended for the correct management of patients with associated spondyloarthritis (SpA) and inflammatory bowel disease (IBD). We aimed to establish the appropriateness of several red flags for a prompt specialist referral. A systematic review of the literature was performed using the GRADE method to describe the prevalence of co-existing IBD-SpA and the diagnostic accuracy of red flags proposed by a steering committee. Read More

J Crohns Colitis 2018 Dec 13. Epub 2018 Dec 13.

Department of Gastroenterology, Sandwell and West Birmingham Hospitals NHS Trust, UK.

Background: Perianal abscess (PA) is associated with inflammatory bowel disease (IBD). The incidence of IBD after a diagnosis of PA and potential predictors of a future diagnosis of IBD are unknown.

Methods: The Health Improvement Network (THIN) is a primary care database representative of the UK population. Read More

Tech Coloproctol 2018 12 12;22(12):947-953. Epub 2018 Dec 12.

Department of Surgery, Ålborg University Hospital, Ålborg, Denmark.

Background: The aim of the present multicenter study was to analyze the incidence and risk factors associated with postoperative morbidity in patients who had colorectal resection for colonic Crohn's disease.

Methods: Consecutive patients undergoing colorectal resection for colonic Crohn's disease at seven surgical units in 1992-2017 were included. Exclusion criteria were: proctectomy for perianal disease, surgery for cancer, previous colectomies, surgery before 1998. Read More

J Immunol Res 2018 12;2018:9084759. Epub 2018 Nov 12.

Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.

Objective: To evaluate the efficacy and safety of rituximab in multiple sclerosis in a clinical practice setting.

Methods: Clinical data for all adult patients with multiple sclerosis (MS) treated with off-label rituximab at a single MS center in Lebanon between March 2008 and April 2017 were retrospectively collected from medical charts. The main efficacy outcomes assessed were annualized relapse rate (ARR) and proportion of patients free from relapses, disability progression, or magnetic resonance imaging (MRI) activity. Read More

J Pediatr Surg 2018 Nov 7. Epub 2018 Nov 7.

Children's Hospital, Section of Pediatric Surgery, University of Helsinki, Finland.

Background And Aim: We describe a series of three successive patients with perianal rhabdomyosarcoma (PRMS) from 2014 to 2017 managed with combined chemotherapy, radical surgery, and radiotherapy.

Methods: Ethical consent was obtained. Data including tumor presentation, treatment, and survival was collected from hospital reports. Read More

Colorectal Dis 2019 Feb 15;21(2):244. Epub 2018 Dec 15.

ETZ Hospital, Tilburg, The Netherlands.

Colorectal Dis 2019 Feb 15;21(2):243. Epub 2018 Dec 15.

ETZ Hospital, Tilburg, the Netherlands.

Surg Infect (Larchmt) 2019 Jan 7;20(1):78-82. Epub 2018 Nov 7.

Faculty of Medicine, Department of General Surgery, Kirikkale University , Kirikkale, Turkey .

Background: The objective of this study was to determine the clinical and laboratory features affecting mortality in Fournier gangrene.

Patients And Methods: This retrospective case control study was designed to evaluate patients treated for Fournier gangrene in our center between 2010 and 2018. Those patients were divided into two groups: discharged patients (group 1) and deceased patients (group 2). Read More

Pan Afr Med J 2018 20;30:147. Epub 2018 Jun 20.

Service d'Hépato-gastroentérologie, Faculté de Médecine et de Pharmacie de Fès, Université Sidi Mohammed Ben Abdellah, Fès, Maroc.

Many disorders of the digestive tract cause cutaneous manifestations that may be an indication of an underlying condition; hence dermatologist plays a key role in recommending that the patient see a gastroenterologist. Conversely, gastroenterologist often sees patients with mucocutaneous lesions suggesting possible association with well-known digestive disorders. Chronic inflammatory bowel diseases are the typical example of this essential collaboration between the two specialities. Read More

ANZ J Surg 2018 Oct 25. Epub 2018 Oct 25.

Department of Colorectal and Anal Surgery, Jinhua Municipal Central Hospital, Jinhua, China.

Background: To investigate the role of interleukin (IL)-17 in tissue and peripheral blood of perianal abscess and anal fistula.

Methods: Patients with primary perianal abscess (n = 50) admitted to Jinhua Municipal Central Hospital between March 2003 and August 2004 were enrolled. Fifty patients with mixed haemorrhoids, who showed no perianal abscess or anal fistula, were also recruited as the control. Read More

J Med Imaging Radiat Oncol 2018 Oct;62 Suppl 1:81

Department of Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.

Clin Gastroenterol Hepatol 2018 Oct 4. Epub 2018 Oct 4.

Robarts Clinical Trials, Inc, London, Ontario, Canada; Department of Medicine, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada. Electronic address:

Fistulizing complications develop in approximately one third of patients with Crohn's disease (CD), resulting in morbidity and impaired quality of life. Sites of fistulae most commonly include perianal fistulae, but also enterocutaneous, enteroenteric, enterovesical, and rectovaginal. Its management requires combined medical and surgical strategies to prevent abscess formation and induce healing. Read More

Diagn Interv Radiol 2018 Nov;24(6):321-327

Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey.

Purpose: Anal fistula is an abnormal tract or cavity between the anal canal and perianal skin. Surgical treatment of anal fistulas requires the identification of the course of the primary and secondary tracts and their relation with the sphincter musculature in order to appropriately manage them and drain any abscess. Physical examination alone is not as accurate as imaging modalities in detecting these features of the fistula, and recurrences are usually due to missed or inadequately managed infective components. Read More

Surg Infect (Larchmt) 2019 Jan 20;20(1):31-34. Epub 2018 Sep 20.

3 Department of Microbiology, Faculty of Medicine, Kuwait University , Jabriya, Kuwait .

Background: We conducted a clinical and microbiologic analysis of patients presenting with anorectal abscess.

Methods: A total of 505 adult patients presenting from January 2011 to December 2017 were analyzed retrospectively. Microbiologic data were available for 211 patients. Read More

Pak J Med Sci 2018 Jul-Aug;34(4):1027-1029

Mehmet Oguz Sahin, M.D. Department of Urology, Manisa State Hospital, Manisa, Turkey.

Fournier's gangrene (FG) is a life-threatening, rapidly progressing acute necrotizing fasciitis of perianal, genitourinary and perineal areas. The most common isolated pathogens are , and in tissue and abscess cultures. However we present the first Rhizobium radiobacter FG in this case. Read More

Rev Med Liege 2018 Sep;73(9):468-473

Service de Dermatologie,CHU Sart Tilman, Liège, Belgique.

Hidradenitis suppurativa (HS), also known as Verneuil's disease and acne inversa, is a chronic inflammatory skin disease characterized by a dysfunction of the pilosebaceous structures resulting in occlusion and inflammation. The disease usually starts after puberty, on average between twenty and thirty years, with subcutaneous painful inflammatory nodules, abscess collections, fistulization and scars mainly in the axillary, inguinal, sub-mammary, perineal and perianal regions. It is a multifactorial disease with the most commonly cited risk factors or aggravating factors being smoking, obesity, and HS family history. Read More

Arch Dis Child Educ Pract Ed 2018 Sep 3. Epub 2018 Sep 3.

Department of Paediatric Education and Simulation, Royal Belfast Hospital for Sick Children, Belfast, UK.

QUESTION 1: Which procedure may have been most appropriate to offer an initial clue to her diagnosis? Abdominal X-ray. Digital rectal examination. Perianal swab for streptococcal infection. Read More

J Pediatric Infect Dis Soc 2018 Aug 24. Epub 2018 Aug 24.

Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Canada.

Among 235 children with acute myeloid leukemia, 17 experienced 19 perianal infections. Among 12 episodes with definite abscess, 75% were severely neutropenic. Sixteen diagnostic imaging evaluations were performed; diagnostic yield was similar between computerized tomography of pelvis (5 of 10) and ultrasound (3 of 5). Read More

J Crohns Colitis 2018 Nov;12(12):1392-1398

Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Science, The Chinese University of Hong Kong, Hong Kong.

Background: The presence of perianal fistulas in Crohn's disease [CD] denotes increased disease aggressiveness. We studied the epidemiology and clinical outcomes of perianal CD [PCD] using the Hong Kong territory-wide IBD Registry [HKIBDR].

Methods: Consecutive patients with PCD were identified from the HKIBDR, and disease characteristics, treatments, and outcomes were analysed. Read More

Abdom Radiol (NY) 2018 Aug 29. Epub 2018 Aug 29.

Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, White 270, Boston, MA, 02114, USA.

Purpose: To evaluate the diagnostic efficacy between pre- and post-contrast MRI sequences in perianal fistulas using intra-operative findings as the gold standard.

Materials And Methods: Retrospective analysis of 50 patients with a history of perianal fistula and MRI performed between January 2006 and January 2018 was performed. The inclusion criteria were patients who underwent MRI prior to surgery and had a detailed surgical report available. Read More

Gastroenterol Rep (Oxf) 2018 Aug 18;6(3):221-224. Epub 2018 Jan 18.

Department of Colorectal Surgery, The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

Objective: The aim of this study was to evaluate the safety and efficacy of three-cavity clearance (TCC) used for the treatment of perianal abscess.

Methods: A case-control study of patients with perianal abscess was conducted at the Second and Third Affiliated Hospitals of Nanjing University of Chinese Medicine from June 2013 to March 2016. Clinical data from 46 patients who had TCC were analysed. Read More

Adv Surg 2018 Sep 19;52(1):179-204. Epub 2018 Jun 19.

Department of Surgery, Southern Illinois University School of Medicine, 701 North First Street, Suite D-333, Springfield, IL 62781-0001, USA. Electronic address:

Dis Colon Rectum 2018 09;61(9):1102-1107

Surgical Anatomy Unit, Anatomy and Embryology Department, University of Valencia, Valencia, Spain.

Background: Most perianal abscesses have a cryptoglandular origin, following the pathogenesis described by Parks in 1961. Supralevator abscesses have the most uncommon location. Nevertheless, such pathology results in a high morbidity because of their difficult diagnosis and treatment. Read More

Gut Liver 2018 09;12(5):544-554

Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Background/aims: The disease course and factors associated with poor prognosis in Korean patients with Crohn's disease (CD) have not been fully determined. The aim of this study was to explore potential associations between the clinical characteristics and long-term outcomes of CD and perianal fistulas in a Korean population.

Methods: The retrospective Crohn's Disease Clinical Network and Cohort (CONNECT) study enrolled patients diagnosed with CD between July 1982 and December 2008 from 32 hospitals. Read More

Ann Coloproctol 2018 Jun 30;34(3):138-143. Epub 2018 Jun 30.

Department of Surgery, Daehang Hospital, Seoul, Korea.

Purpose: While perianal disease (PAD) is a characteristic of patients with Crohn disease, it has been overlooked in patients with ulcerative colitis (UC). Thus, our study aimed to analyze the incidence and the clinical features of PAD in patients with UC.

Methods: We reviewed the data on 944 patients with an initial diagnosis of UC from October 2003 to October 2015. Read More

Int Wound J 2018 Oct 27;15(5):840-844. Epub 2018 Jun 27.

Acibadem University Medical Faculty, Department of Pediatric Surgery, Istanbul, Turkey.

Pilonidal sinus disease (PSD) is associated with a complex disease process in children, and its management remains controversial. There are a few published studies on PSD in the paediatric literature; therefore, we present our experience of conservatively treating PSD in children. This study involved a retrospective review with telephone follow up. Read More

J Med Case Rep 2018 Jun 27;12(1):193. Epub 2018 Jun 27.

Department of Urological Surgery, Chang Gung Memorial Hospital, 123 Avenue Xiafei, Xiamen, 361028, Fujian, China.

Background: Fournier's gangrene is an acute surgical emergency characterized by high mortality rates ranging from approximately 13% to 45%. Therefore, aggressive multidisciplinary management is necessary.

Case Presentation: A 29-year-old Asian man who had undergone surgical debridement at another hospital to treat a perianal abscess 5 days earlier was admitted to our hospital for severe scrotal and perianal pain, swelling, and high fever. Read More

Dis Colon Rectum 2018 08;61(8):931-937

Department of Clinical Medicine and Surgery, Surgical Coloproctology Unit, University of Naples "Federico II," Naples, Italy.

Background: Perianal fistulizing Crohn's disease is a challenging clinical situation that requires proper management. Some features seen on the endoanal ultrasound can be helpful in discriminating between cryptoglandular and Crohn's disease fistulas.

Objective: The aim of this study was to define the diagnostic accuracy of 3-dimensional endoanal ultrasound in differentiating between Crohn's disease and cryptogenic fistulas. Read More

Zhonghua Er Ke Za Zhi 2018 Jun;56(6):440-444

Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai 201102, China.

To explore the relationship between genotype and phenotype of ABCB11 deficiency. Clinical data of two siblings with ABCB11 deficiency were retrospectively analyzed. Related literature from PubMed, CNKI and Wangfang databases was reviewed to date (up to August 2017) with 'ABCB11 gene' or 'bile salt export pump', 'cholestasis' and 'child' as key words. Read More

An Pediatr (Barc) 2018 06 4. Epub 2018 Jun 4.

Department of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University, Ankara, Turquía.

Introduction: There are limited data on the aetiology and management of perianal abscesses (PAs). The aim of this retrospective study was to define the characteristics of children with PAs; describe our experience with PA from the perspective of paediatric infectious medicine and determine the factors that influence clinical outcomes.

Methods: We performed a retrospective review of cases of PA in children with no underlying disease managed in a tertiary referral hospital between January 2005 and July 2015. Read More

Front Pediatr 2018 16;6:143. Epub 2018 May 16.

Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, United States.

Perianal abscess and fistula-in-ano are well-described in the pediatric population. They are most common in infants less than 1 year of age and often resolve with oral antibiotics; occasionally they require drainage or fistulotomy. The etiology is commonly associated with cryptoglandular obstruction and subsequent infection, however alternative diagnoses should be considered in cases of recurrent abscesses and fistulae that are refractory to standard treatments. Read More

Int J Colorectal Dis 2018 Nov 29;33(11):1589-1594. Epub 2018 May 29.

Deutsches End- und Dickdarmzentrum, Mannheim, Germany.

Purpose: Proximal intersphincteric fistulas with proximal extension causing supralevatoric, retrorectal abscesses are a rare disease. There is only very limited experience, with small groups, and the limited published literature confirms the complexity of diagnostics and treatment. The aim of this study was to evaluate transrectal internal abscess drainage as planned definitive treatment. Read More

Colorectal Dis 2018 Jul 17;20(7):640-641. Epub 2018 May 17.

Salford Royal NHS Trust, Manchester, UK.