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J Surg Case Rep 2021 Jun 4;2021(6):rjab222. Epub 2021 Jun 4.

Department of Surgery, Saint Yared General Hospital, Addis Ababa, Ethiopia.

Necrotizing fasciitis (NF) is a life-threatening infection, which requires immediate debridement and broad-spectrum antibiotic treatment. Delay in prompt diagnosis and operative debridement is associated with significant morbidity and mortality. Retroperitoneal NF is a rare condition whereby the infection within the pelvis or retroperitoneum rapidly expands over the fascial planes to involve the anterior abdominal wall (AW), the thighs and the buttocks. Read More

Am J Case Rep 2021 Jun 8;22:e930698. Epub 2021 Jun 8.

Department of Gastroenterology, Deaconess Gateway Hospital, Evansville, IN, USA.

BACKGROUND Crohn disease (CD) is an idiopathic chronic inflammatory disease that can present in the perianal area as perianal CD (pCD), which can present as fistulizing or non-fistulizing. Perirectal abscesses are common complications that are strongly associated with fistula formation. Draining an abscess and not treating the associated fistula leads to a high risk of disease recurrence. Read More

Tech Coloproctol 2021 May 24. Epub 2021 May 24.

General and Digestive Surgery Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain.

SAGE Open Med Case Rep 2021 29;9:2050313X211009717. Epub 2021 Apr 29.

Department of Surgery, The Wollongong Hospital, Wollongong, NSW 2500, Australia.

Behcet's syndrome is a systemic inflammatory disorder that involves several organ systems and is exceptionally rare in the Western world. The diagnosis is frequently difficult as it resembles several other disease processes. A 23-year-old male with a previous presumptive diagnosis of Crohn's disease presented to our unit with genital ulceration. Read More

World J Emerg Surg 2021 May 11;16(1):23. Epub 2021 May 11.

Department of Surgical Sciences, Policlinico Sant'Orsola Malpighi, Bologna, Italy.

Background: Despite the current therapeutic options for the treatment of inflammatory bowel disease, surgery is still frequently required in the emergency setting, although the number of cases performed seems to have decreased in recent years. The World Society of Emergency Surgery decided to debate in a consensus conference of experts, the main pertinent issues around the management of inflammatory bowel disease in the emergent situation, with the need to provide focused guidelines for acute care and emergency surgeons.

Method: A group of experienced surgeons and gastroenterologists were nominated to develop the topics assigned and answer the questions addressed by the Steering Committee of the project. Read More

World J Emerg Surg 2021 05 7;16(1):22. Epub 2021 May 7.

Emergency and Trauma Surgery, Maggiore Hospital, Parma, Italy.

Background: The COVID-19 pandemic caused a rise in healthcare demands leading to significant restructuring of hospital emergency departments worldwide. The aim of the present study is twofold: firstly, to discern any differences in regard to reason for surgical emergency department (SED) attendance and hospital admission during the pandemic and pre-pandemic eras in Greece, and secondly, to assess the impact of the lockdown measures implemented during the pandemic on SED patient attendance.

Methods: Since the beginning of the COVID-19 pandemic in Greece (1 March 2020) and up to 15 December 2020, the charts of all adult patients arriving at the SED of the third surgical department of the "Attikon" University Hospital (a tertiary referral center for surgical and COVID-19 cases) were retrospectively reviewed and broken down in four periods reflecting two nationwide lockdown (period A 1/3/2020 to 30/4/2020 and period D 16/10/2020 to 15/12/2020) and two interim (period B 1/5/2020 to 15/6/2020 and period C 15/9/2020 to 30/10/2020) periods. Read More

J Indian Assoc Pediatr Surg 2021 Jan-Feb;26(1):16-22. Epub 2021 Jan 11.

Department of Pediatric Surgery, Cairo University Specialized Pediatric Hospital, Cairo, Egypt.

Background: Hirschsprung's disease (HD) has been traditionally treated from infancy onward and different techniques have been used including Swenson, Soave, and Duhamel procedures. The purpose of this study was to evaluate the transanal Swenson's procedure for classical rectosigmoid HD in neonates.

Patient And Methods: This was a prospective study in which neonates diagnosed with HD were recruited from January 2017 to December 2018. Read More

J Dig Dis 2021 May 4. Epub 2021 May 4.

Department of Gastroenterology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.

Objective: Treating perianal fistula in cases of Crohn's disease (CD) remains challenging and the postoperative recurrence rate of perianal fistula is 22%-28%. This study aimed to identify the predictive risk factors for reoperation in Korean CD patients with perianal fistula.

Methods: Medical records of the patients with clinically and pathologically confirmed CD who underwent surgical treatment for perianal fistulas at four referral centers in Korea between March 2010 and February 2020 were retrospectively reviewed. Read More

Eur J Trauma Emerg Surg 2021 Jun 4;47(3):677-682. Epub 2021 May 4.

General and Emergency Surgery Division, Robotic and Emergency Surgery Department, A. Manzoni Hospital, ASST Lecco, Lecco, Italy.

Purpose: To evaluate and analyze the impact of lockdown strategy due to coronavirus disease 2019 (COVID-19) on emergency general surgery (EGS) in the Milan area at the beginning of pandemic outbreak.

Methods: A survey was distributed to 14 different hospitals of the Milan area to analyze the variation of EGS procedures. Each hospital reported the number of EGS procedures in the same time frame comparing 2019 and 2020. Read More

Cureus 2021 Mar 29;13(3):e14181. Epub 2021 Mar 29.

Surgery, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND.

Sacrococcygeal teratoma (SCT) in adults is very rare with only a few cases reported in the literature. Its presentation in the adult is asymptomatic to a slow-growing cystic tumor with a 1-2% chance for malignant transformation and may attain a huge size causing pressure effect on pelvic and intra-abdominal organs. It can present unusually as a perianal abscess which needs to be evaluated radiologically. Read More

JGH Open 2021 Apr 26;5(4):420-427. Epub 2021 Mar 26.

Department of Gastroenterology All India Institute of Medical Sciences New Delhi India.

Background: Unlike perianal fistula, long-term outcomes of nonperianal fistulae (NPF) in Crohn's disease (CD) are not clear. We aimed to compare the outcomes of medical and surgical therapies in patients with NPF.

Methods: We retrospectively analyzed the records of patients of CD with NPF who were prospectively followed from January 2005 to December 2018. Read More

BMC Gastroenterol 2021 Apr 13;21(1):167. Epub 2021 Apr 13.

Department of Gastroenterology, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.

Background: Defects in interleukin 10 (IL10) and its receptors are particularly involved in very early onset inflammatory bowel disease (VEOIBD). However, large fragment deletions of IL10 receptor A (IL10RA) are rare.

Methods: VEOIBD patients with confirmed mutations in the IL10RA gene were enrolled from January 1, 2019 to June 30, 2020. Read More

Turk J Surg 2020 Sep 28;36(3):264-270. Epub 2020 Sep 28.

Sisli Hamidiye Etfal Training And Research Hospital, General Surgery, Istanbul, Turkey.

Objectives: Anal fissure is a common health problem that affects the quality of life of young patients. The aim of our study was to benchmark results of lateral internal sphincterotomy (LIS) and botulinum toxin injection in the treatment of chronic anal fissure.

Material And Methods: This multi-center, retrospective study used data from 135 chronic anal fissure patients. Read More

J Surg Case Rep 2021 Mar 22;2021(3):rjab084. Epub 2021 Mar 22.

Department of Surgery, Sanda City Hospital, Hyogo, Japan.

Few articles have reported cases of perianal abscess due to ingested foreign bodies. Herein, we report a case of perianal abscess due to a long fish bone. A 72-year-old man who was toothless and wore a denture had a chief complaint of anal pain. Read More

ANZ J Surg 2021 Jun 22;91(6):1131-1137. Epub 2021 Mar 22.

Department of Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Background: Readiness for practice is an ongoing concern in surgery. Surgeons who have completed general surgery training are expected to be proficient in performing common emergency procedures. The aim of this study was to assess the experience and autonomy of general surgery trainees in New Zealand in 10 emergency general surgery procedures, and identify factors associated with reaching primary operator (PO) thresholds. Read More

Surgery 2021 Jun 18;169(6):1563. Epub 2021 Mar 18.

Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya, Turkey.

Curr Opin Gastroenterol 2021 Jul;37(4):320-327

IBD Outpatient Clinics, Colorectal Surgery Unit, Pontificia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.

Purpose Of Review: Despite advances in medical and surgical therapy in inflammatory bowel disease (IBD) management, intestinal stomas can be needed in a significant proportion of patients. The impact of stomas in patients' lives is significant, and the topic is still challenging for different specialties involved in IBD care.

Recent Findings: Indications for intestinal ostomies in IBD can occur in elective (malnutrition, anemia, or previous steroids) or emergency (perforation, abdominal abscess, obstruction) settings. Read More

Colorectal Dis 2021 Feb 17. Epub 2021 Feb 17.

Department of Gastroenterology and Hepatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

Aim: Even with optimal medical and surgical therapy, perianal fistulas in patients with Crohn's disease (CD) have low closure rates. As a new therapeutic option, administration of local mesenchymal stem cells (MSCs) has proved to be an innovative option after failure of treatment with immunosuppressive or immunomodulatory agents. The aim of this work is to share our first experience with MSC administration and demonstrate its efficacy, safety and feasibility outside a clinical trial. Read More

J Endourol 2021 04 31;35(4):518-524. Epub 2021 Mar 31.

Departments of Urology, Kaiser Permanente Orange County, and Riverside, California, USA.

We present our series of free-hand transperineal prostate biopsy (fTP-Bx) using a novel coaxial needle introducer guide. All cases were performed in the office under local anesthesia (LA) without sedation. The majority received no prophylactic antibiotics. Read More

Ann R Coll Surg Engl 2021 Feb;103(2):e59-e64

Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, UK.

Aggressive angiomyxoma is a rare mesenchymal tumour, primarily arising in the soft tissue of the pelvis and perineum in women of reproductive age. There is a paucity of evidence on optimal management because of the rarity of these tumours, but the consensus has been for surgical excision. We present the case of a 65-year-old woman who was admitted with left-sided buttock pain and initially diagnosed with a perianal abscess. Read More

Dis Colon Rectum 2021 Mar;64(3):328-334

Hospital Civil de Guadalajara Dr Juan I Menchaca, Guadalajara, Jalisco, Mexico.

Background: Anal fistula treatment aims to eradicate the fistula, preserve the sphincter, prevent recurrence, and allow an early return to daily activities for the patient. Because of the difficulty of achieving these goals, stem cell-based therapy has emerged for the treatment of complex perianal fistula with promising results.

Objective: The objective of this study was to evaluate the safety of allogeneic mesenchymal stem cells in the treatment of complex anal fistula in patients without Crohn's disease. Read More

BMJ Case Rep 2021 Feb 1;14(2). Epub 2021 Feb 1.

Clinical Pharmacy Department, Winchester District Memorial Hospital, Winchester, Ontario, Canada.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors, which are used for treatment of type 2 diabetes, are associated with risk of urogenital infections. FDA issued a black box warning about multiple case reports of Fournier's gangrene (FG) observed in patients taking SGLT2 inhibitors. FG is a type of necrotising fasciitis that occurs in the anogenital area. Read More

BMC Surg 2021 Jan 30;21(1):66. Epub 2021 Jan 30.

The Sixth Affiliated Hospital, Sun Yat-Sen University, 26 Yuancun Erheng Road, Tianhe District, Guangzhou, 510655, People's Republic of China.

Background: Perianal/perineal rhabdomyosarcomas (PRMS) are easily misdiagnosed soft tissue tumours with a poor prognosis. This study was designed to analyze the clinical, diagnostic, pathological and prognostic features of PRMS, and to explore currently available therapeutic modalities.

Methods: Clinical data of PRMS patients admitted to the Sixth Affiliated Hospital and the Cancer Center of Sun Yat-sen University and from related Chinese literature published from 1987 to 2018 were collected and analyzed. Read More

Int J Colorectal Dis 2021 Mar 15;36(3):581-588. Epub 2021 Jan 15.

Research Unit for Surgery, Odense University Hospital, J.B. Winsløws Vej 4, 5000, Odense C, Denmark.

Purpose: Needle aspiration of an acute simple perianal abscess may be an alternative to conventional incision drainage with potential advantages in wound healing, functional outcome, and quality of life. The aim and objectives of the study are to compare the outcome of needle aspiration and postoperative antibiotics with that of conventional surgical incision drainage of acute perianal abscess. The primary outcome was abscess recurrence. Read More

Cureus 2020 Dec 3;12(12):e11882. Epub 2020 Dec 3.

Surgical Oncology, Cancer Treatment Centers of America, Tulsa, USA.

Crohn's disease (CD) is a transmural inflammatory bowel disease (IBD) that can affect any part of the gastrointestinal (GI) tract. With the disease's progression, adhesions and transmural fissuring, intra-abdominal abscesses, and fistula tracts may develop. An anal fistula (or fistula-in-ano) is a chronic abnormal epithelial lined tract communicating the anorectal lumen (internal opening) to the perineal or buttock skin (external opening). Read More

J Clin Med 2020 Dec 31;10(1). Epub 2020 Dec 31.

Department of Internal Medicine, Hanyang University College of Medicine, Guri 11923, Korea.

In Crohn's disease (CD), intra-abdominal abscess (IA) and intestinal free-wall perforation (IP) have a common mechanism of transmural inflammation; however, their manifestation is different. This study aimed to investigate differences in the clinical features between IA and IP in Korean patients with Crohn's disease. : A retrospective cohort study. Read More

Case Rep Surg 2020 18;2020:1798543. Epub 2020 Dec 18.

Plastic and Reconstructive Surgery Unit, Department of Surgery, UKM Medical Centre, Kuala Lumpur, Malaysia.

Mucinous adenocarcinoma of the perianal region is an oncologic rarity posing a diagnostic and therapeutic dilemma for treating oncologists. This is due to the low number of reported cases, compounded by the lack of definitive therapeutic guidelines. It accounts for 2% to 3% of all gastrointestinal malignancies and is historically known to arise from chronic anal fistulas and ischiorectal or perianal abscesses. Read More

J Ultrason 2020 Nov 28;20(82):e222-e225. Epub 2020 Sep 28.

Department of Pediatric Radiology, Medical University of Lublin, Lublin, Poland.

Primary symptoms of Crohn's disease usually include, among others, abdominal pain and cramping, recurrent diarrhea, fever and weight loss. The aim of this study was to show the effectiveness of ultrasound in the diagnosis and assessment of the extent of perianal complications in Crohn's disease. Five patients (four boys and one girl) aged from 13 to 16 years, with prolonged pain in the perianal area, which worsened when sitting, were admitted to the Department of Pediatric Gastroenterology between 2017 and 2019. Read More

Clin Case Rep 2020 Dec 2;8(12):3557-3558. Epub 2020 Aug 2.

Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical School Tokyo Japan.

Perianal abscesses exist in various forms depending on the location. Clinical examination and endorectal ultrasound (EUS) may be useful for the diagnosis of anal tumor. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2020 Dec;23(12):1123-1130

Anal fistula is one of the most common diseases in colorectal and anal surgery. Most of them are formed after the abscess of perianal space reptures. Due to the complexity and diversity of pathological changes, the clinical efficacy of some patients is not optimistic, and there may even be serious surgical complications, including delayed healing of anal fistula or varying degrees of fecal incontinence, which significantly affect the quality of life of patients and even lead to disability. Read More