Pub Date : 2021-06-01DOI: 10.30476/ACRR.2021.91493.1105
Vineet Nair
Context- The oral cavity and the colon, though part of the alimentary tract are distantly located anatomically and hence are colonized by totally divergent microbes. The mouth is affected by several pathologies and so is the colon. So it is quite natural to investigate the probable connection between poor oral health and colorectal pathologies. Evidence acquisition- This article is a small attempt to identify the oral microbiota, how they translocate to the colon-rectum area and then how do they create pathology there. Pubmed indexed journals relating to this topic were screened and shortlisted to construct this article. Results- The organisms generally responsible for the oral diseases, namely Fusobacterium nucleatum and Porphyromonas gingivalis among others have been found in colon disorders resulting in intestinal dysbiosis and ultimately leading to colorectal cancer. Conclusions- If the disease pathogenesis is well understood, then it will open new ways on how to prevent or treat colorectal pathologies. However further studies are needed in this arena.
{"title":"ORAL BACTERIA AND COLORECTAL PATHOLOGY","authors":"Vineet Nair","doi":"10.30476/ACRR.2021.91493.1105","DOIUrl":"https://doi.org/10.30476/ACRR.2021.91493.1105","url":null,"abstract":"Context- The oral cavity and the colon, though part of the alimentary tract are distantly located anatomically and hence are colonized by totally divergent microbes. The mouth is affected by several pathologies and so is the colon. So it is quite natural to investigate the probable connection between poor oral health and colorectal pathologies. Evidence acquisition- This article is a small attempt to identify the oral microbiota, how they translocate to the colon-rectum area and then how do they create pathology there. Pubmed indexed journals relating to this topic were screened and shortlisted to construct this article. Results- The organisms generally responsible for the oral diseases, namely Fusobacterium nucleatum and Porphyromonas gingivalis among others have been found in colon disorders resulting in intestinal dysbiosis and ultimately leading to colorectal cancer. Conclusions- If the disease pathogenesis is well understood, then it will open new ways on how to prevent or treat colorectal pathologies. However further studies are needed in this arena.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"46 1","pages":"47-50"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77584434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.30476/ACRR.2021.91373.1102
Mozhdeh Zamani, S. Dastghaib, Mehran Erfani, S. Hosseini, P. Mokarram
BackgroundAutophagy and unfolded protein response (UPR) are mechanisms with dual roles in both maintaining the cellular homeostasis and progression of various diseases such as cancer. Therefore, identification of different molecules and proteins involved in the regulation of these pathways may contribute to find new therapeutic targets. A member of the M28 family of the metallopeptidases, Endoplasmic Reticulum Metallo Protease 1 (ERMP1), is overexpressed in cancers such as colorectal cancer. The role of this protein in the UPR activation was previously reported in breast cancer. We aimed to evaluate the role of ERMP1 in the activation of autophagy and apoptosis in colorectal cancer.MethodsERMP1 Gene silencing was performed using specific small hairpin RNA (shRNA) in HCT-116 colorectal cancer cell line. Then, autophagy associated protein markers including Beclin 1, p62 and LC3II were evaluated using western blot. The effect of ERMP1 knockdown on cellular apoptosis was also assessed by propidium iodide staining flow cytometry analysis. Statistical analysis was performed using SPSS software version 20.ResultsAll three autophagy markers were increased significantly in the ERMP1-silenced HCT116 cell lines compared with negative control cells (P 0.05).ConclusionThe oncogenic protein, ERMP1, activates autophagy in colorectal cancer cell line. Targeting of ERMP1 may be considered as a proper approach in colorectal cancer therapy. Further investigations are required to confirm these results.
{"title":"The Role of endoplasmic reticulum metallo protease 1 on Autophagy Pathway in HCT-116 Colorectal Cancer Cell Line","authors":"Mozhdeh Zamani, S. Dastghaib, Mehran Erfani, S. Hosseini, P. Mokarram","doi":"10.30476/ACRR.2021.91373.1102","DOIUrl":"https://doi.org/10.30476/ACRR.2021.91373.1102","url":null,"abstract":"BackgroundAutophagy and unfolded protein response (UPR) are mechanisms with dual roles in both maintaining the cellular homeostasis and progression of various diseases such as cancer. Therefore, identification of different molecules and proteins involved in the regulation of these pathways may contribute to find new therapeutic targets. A member of the M28 family of the metallopeptidases, Endoplasmic Reticulum Metallo Protease 1 (ERMP1), is overexpressed in cancers such as colorectal cancer. The role of this protein in the UPR activation was previously reported in breast cancer. We aimed to evaluate the role of ERMP1 in the activation of autophagy and apoptosis in colorectal cancer.MethodsERMP1 Gene silencing was performed using specific small hairpin RNA (shRNA) in HCT-116 colorectal cancer cell line. Then, autophagy associated protein markers including Beclin 1, p62 and LC3II were evaluated using western blot. The effect of ERMP1 knockdown on cellular apoptosis was also assessed by propidium iodide staining flow cytometry analysis. Statistical analysis was performed using SPSS software version 20.ResultsAll three autophagy markers were increased significantly in the ERMP1-silenced HCT116 cell lines compared with negative control cells (P 0.05).ConclusionThe oncogenic protein, ERMP1, activates autophagy in colorectal cancer cell line. Targeting of ERMP1 may be considered as a proper approach in colorectal cancer therapy. Further investigations are required to confirm these results.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"38 1","pages":"63-68"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76903544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.30476/ACRR.2021.91296.1100
Ebrahim Mirakhor, June Choe, R. Goodman
IntroductionCollagenous Enteritis (CE) is a less common cause of enteropathy presenting with malabsorption as its cardinal symptom. While historically considered a resistant form of celiac disease, newer evidence supports the interaction between genetic predispositions and environmental triggers as the pathophysiologic basis of CE.Case PresentationHerein we present the case of a 40-year-old woman with two-year history of diarrhea and 32 kg weight loss who was incorrectly diagnosed with celiac disease with refractory symptoms despite adherence to a gluten-free diet. Extensive infectious, inflammatory, secretory, autoimmune workup did not reveal an underlying etiology. Endoscopic evidence of severe villous blunting and biopsy with characteristic patchy enlarged subepithelial collagen layer solidified a diagnosis of CE. Treatment with steroids resulted in resolution of malabsorptive symptoms and gradual weight gain.ConclusionThis case highlights the importance of considering CE in patients presenting with malabsorption especially given significant clinical overlap with other malasbsorptive conditions as well as its therapeutic implications.
{"title":"Collagenous Enteritis – An Alternative Cause of Malabsorptive Enteropathy","authors":"Ebrahim Mirakhor, June Choe, R. Goodman","doi":"10.30476/ACRR.2021.91296.1100","DOIUrl":"https://doi.org/10.30476/ACRR.2021.91296.1100","url":null,"abstract":"IntroductionCollagenous Enteritis (CE) is a less common cause of enteropathy presenting with malabsorption as its cardinal symptom. While historically considered a resistant form of celiac disease, newer evidence supports the interaction between genetic predispositions and environmental triggers as the pathophysiologic basis of CE.Case PresentationHerein we present the case of a 40-year-old woman with two-year history of diarrhea and 32 kg weight loss who was incorrectly diagnosed with celiac disease with refractory symptoms despite adherence to a gluten-free diet. Extensive infectious, inflammatory, secretory, autoimmune workup did not reveal an underlying etiology. Endoscopic evidence of severe villous blunting and biopsy with characteristic patchy enlarged subepithelial collagen layer solidified a diagnosis of CE. Treatment with steroids resulted in resolution of malabsorptive symptoms and gradual weight gain.ConclusionThis case highlights the importance of considering CE in patients presenting with malabsorption especially given significant clinical overlap with other malasbsorptive conditions as well as its therapeutic implications.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"18 1","pages":"78-81"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87860540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.30476/ACRR.2021.89835.1082
M. Khan, N. Chowdri, R. Wani, F. Parray, A. Mehraj, A. Baba, M. Laway
The concept of ghost/Khatith ileostomy is a bridge between covering ileostomy and no-ileostomy (‘Khatith’ meaning ‘hidden’ in Kashmiri language). We performed the pre-stage ghost ileostomy (GI) without parietal wall split. The technique of GI is that after the completion of resection-anastomosis of rectal cancer, a terminal ileal loop at about 20cm from ileocecal junction is identified. Small (10-12F) Ryle’s tube (RT) is passed through a small opening in the mesentery of the identified ileal loop. A small 4-5mm incision is given on abdominal wall at pre-operatively marked proposed stoma site in right iliac fossa region. Haemostatic Kelly’s forceps is introduced through this small incision to get out the two limbs of the RT that has been already looped around the identified ileal loop. These two limbs of the RT are cut short and fixed to each other and to the skin around it with 2-0 silk sutures, taking care to keep the tubing loop loose enough to avoid any tension to the vascular supply of the ileal loop and without causing any luminal compression of the loop to avoid bowel obstruction. In case of AL, the pre-stage GI can be converted into a formal covering stoma under local or spinal anesthesia by gentle pull of the two limbs of the looped RT to extract the isolated ileal loop through an adequate circular incision around the site of GI. In case of uncomplicated postoperative course, the fixing RT is pulled out gently from the abdominal cavity to release down the GI.
{"title":"Technique of Ghost (Khatith) Ileostomy-How I Do It?","authors":"M. Khan, N. Chowdri, R. Wani, F. Parray, A. Mehraj, A. Baba, M. Laway","doi":"10.30476/ACRR.2021.89835.1082","DOIUrl":"https://doi.org/10.30476/ACRR.2021.89835.1082","url":null,"abstract":"The concept of ghost/Khatith ileostomy is a bridge between covering ileostomy and no-ileostomy (‘Khatith’ meaning ‘hidden’ in Kashmiri language). We performed the pre-stage ghost ileostomy (GI) without parietal wall split. The technique of GI is that after the completion of resection-anastomosis of rectal cancer, a terminal ileal loop at about 20cm from ileocecal junction is identified. Small (10-12F) Ryle’s tube (RT) is passed through a small opening in the mesentery of the identified ileal loop. A small 4-5mm incision is given on abdominal wall at pre-operatively marked proposed stoma site in right iliac fossa region. Haemostatic Kelly’s forceps is introduced through this small incision to get out the two limbs of the RT that has been already looped around the identified ileal loop. These two limbs of the RT are cut short and fixed to each other and to the skin around it with 2-0 silk sutures, taking care to keep the tubing loop loose enough to avoid any tension to the vascular supply of the ileal loop and without causing any luminal compression of the loop to avoid bowel obstruction. In case of AL, the pre-stage GI can be converted into a formal covering stoma under local or spinal anesthesia by gentle pull of the two limbs of the looped RT to extract the isolated ileal loop through an adequate circular incision around the site of GI. In case of uncomplicated postoperative course, the fixing RT is pulled out gently from the abdominal cavity to release down the GI.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"29 1","pages":"51-57"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78840789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01DOI: 10.30476/ACRR.2021.89837.1083
S. Devarajan, Benjamin L. Musher, J. Abraham
Introduction Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene cause cystic fibrosis (CF), a disease which affects primarily the respiratory and gastrointestinal (GI) tracts. The lifetime risk of colorectal cancer (CRC) in patients with CF is approximately 5-10 times that of the general population. In 2018, the CF Foundation CRC Screening Task Force recommended initiating CRC screening in adults with CF at age 40. Case Presentations In this case series, we present three cases of females with CF younger than age 40 diagnosed with CRC with variable presentations and stages. We discuss the data supporting current CRC screening guidelines in CF in an effort to raise awareness among clinicians regarding young-onset CRC in this population. Furthermore, we aim for this case series to help drive further investigation into the mechanisms underlying CF-related CRC and to open the door to changes in current screening practices. Conclusion People with CF are at substantially higher risk of development of CRC relative to the general population. While current CRC screening practices advocate for earlier screening in this population compared to average-risk patients, this case series highlights potential limitations to current screening guidelines.
{"title":"Colorectal Cancer in People with Cystic Fibrosis under the Age of 40: A Case Series","authors":"S. Devarajan, Benjamin L. Musher, J. Abraham","doi":"10.30476/ACRR.2021.89837.1083","DOIUrl":"https://doi.org/10.30476/ACRR.2021.89837.1083","url":null,"abstract":"Introduction Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene cause cystic fibrosis (CF), a disease which affects primarily the respiratory and gastrointestinal (GI) tracts. The lifetime risk of colorectal cancer (CRC) in patients with CF is approximately 5-10 times that of the general population. In 2018, the CF Foundation CRC Screening Task Force recommended initiating CRC screening in adults with CF at age 40. Case Presentations In this case series, we present three cases of females with CF younger than age 40 diagnosed with CRC with variable presentations and stages. We discuss the data supporting current CRC screening guidelines in CF in an effort to raise awareness among clinicians regarding young-onset CRC in this population. Furthermore, we aim for this case series to help drive further investigation into the mechanisms underlying CF-related CRC and to open the door to changes in current screening practices. Conclusion People with CF are at substantially higher risk of development of CRC relative to the general population. While current CRC screening practices advocate for earlier screening in this population compared to average-risk patients, this case series highlights potential limitations to current screening guidelines.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"64 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77197921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01DOI: 10.30476/ACRR.2021.90252.1086
R. M. Melo, Pedro Ducatti Oliveira-e-Silva, E. Oliveira
We present a small series of patients who underwent concomitant treatment of external digestive bypass (stoma) and incisional hernia, using the Lazaro da Silva technique - a special method of purely tissue repair. The rational was not to use meshes on contaminated wounds. Initially, five patients were enrolled and all were operated on by the same group. Some demographic data were recorded, but also the time interval between the making of the stoma (or the appearance of the enterocutaneous fistula). Some characteristics of the hernia and data related to surgical procedures were also pointed out. The primary outcome was to verify the rate of hernial recurrence, but also the surgical site occurrences in the first 30 days. Only one patient had superficial wound infection and in none of them was a recurrence detected. Our work raises some questions about the best approach in these more complex cases, such as dissociating or not dissociating the procedures, the use of meshes anyway, and employment of mini-invasive surgery in some steps.
我们介绍了一小部分患者，他们使用Lazaro da Silva技术(一种纯组织修复的特殊方法)接受了外部消化搭桥(造口)和切口疝的同时治疗。合理的做法是不要在污染的伤口上使用网格。最初，5名患者被招募，所有患者都由同一组进行手术。记录了一些人口统计学数据，但也记录了造口(或肠皮瘘的出现)之间的时间间隔。本文还指出了疝的一些特点和与外科手术有关的资料。主要结果是验证疝复发率，以及手术部位在前30天的发生率。仅有1例患者有浅表伤口感染，且均未发现复发。我们的工作提出了一些关于在这些更复杂的情况下的最佳方法的问题，例如分离或不分离手术，无论如何使用网格，以及在某些步骤中使用微创手术。
{"title":"Concomitant enterostomy closure and ventral abdominal wall reconstruction using the Lázaro da Silva technique","authors":"R. M. Melo, Pedro Ducatti Oliveira-e-Silva, E. Oliveira","doi":"10.30476/ACRR.2021.90252.1086","DOIUrl":"https://doi.org/10.30476/ACRR.2021.90252.1086","url":null,"abstract":"We present a small series of patients who underwent concomitant treatment of external digestive bypass (stoma) and incisional hernia, using the Lazaro da Silva technique - a special method of purely tissue repair. The rational was not to use meshes on contaminated wounds. Initially, five patients were enrolled and all were operated on by the same group. Some demographic data were recorded, but also the time interval between the making of the stoma (or the appearance of the enterocutaneous fistula). Some characteristics of the hernia and data related to surgical procedures were also pointed out. The primary outcome was to verify the rate of hernial recurrence, but also the surgical site occurrences in the first 30 days. Only one patient had superficial wound infection and in none of them was a recurrence detected. Our work raises some questions about the best approach in these more complex cases, such as dissociating or not dissociating the procedures, the use of meshes anyway, and employment of mini-invasive surgery in some steps.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"64 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85278744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01DOI: 10.30476/ACRR.2021.89642.1080
P. Mohapatra, D. Mitra, A. Dey, Ishita Biswas
Abstract Introduction- Now a day’s colorectal cancer (CRC) is one of the most deadly cancers in the world. The objective of this investigation was to evaluate the protective effect of gallic acid and pyrogallol in colorectal cancer. Previous reports suggest that there is an association present between some tannase producing bacteria and colorectal cancer. Tannase hydrolyze tannic acid into gallic acid and pyrogallol. Are those compounds have any therapeutic effect on colorectal cancer? This study will help to find those quarries. Methods-The remedial effect of gallic acid and pyrogallol was studied by descriptor properties and molecular docking methods. 100 CRC causing protein structures were docked in this investigation. Results- Lipinski Rule of Five and other descriptor properties of those compounds have showed their nontoxic and therapeutic nature. Molecular docking studies have showed highest score -38.22 KJ/Mol with gallic acid and -33.6 KJ/Mol with pyrogallol. Conclusion- This is the first report on docking investigation of these large numbers of protein. The findings of this research concluded that gallic acid and pyrogallol have a protective effect in colorectal cancer by stopping the effect of those CRC causing protein.
{"title":"Bioactive compounds as a potential inhibitor of colorectal cancer; an insilico study of Gallic acid and Pyrogallol","authors":"P. Mohapatra, D. Mitra, A. Dey, Ishita Biswas","doi":"10.30476/ACRR.2021.89642.1080","DOIUrl":"https://doi.org/10.30476/ACRR.2021.89642.1080","url":null,"abstract":"Abstract Introduction- Now a day’s colorectal cancer (CRC) is one of the most deadly cancers in the world. The objective of this investigation was to evaluate the protective effect of gallic acid and pyrogallol in colorectal cancer. Previous reports suggest that there is an association present between some tannase producing bacteria and colorectal cancer. Tannase hydrolyze tannic acid into gallic acid and pyrogallol. Are those compounds have any therapeutic effect on colorectal cancer? This study will help to find those quarries. Methods-The remedial effect of gallic acid and pyrogallol was studied by descriptor properties and molecular docking methods. 100 CRC causing protein structures were docked in this investigation. Results- Lipinski Rule of Five and other descriptor properties of those compounds have showed their nontoxic and therapeutic nature. Molecular docking studies have showed highest score -38.22 KJ/Mol with gallic acid and -33.6 KJ/Mol with pyrogallol. Conclusion- This is the first report on docking investigation of these large numbers of protein. The findings of this research concluded that gallic acid and pyrogallol have a protective effect in colorectal cancer by stopping the effect of those CRC causing protein.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"9 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78307583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01DOI: 10.30476/ACRR.2021.90332.1090
T. Uuml, Saim Rkoğlu, Adem Yokuş, Fırat Aslan
Perforation Due to Rectal Foreign Body and Radiological Findings Introduction: Rectal foreign bodies have been increasingly seen and cause urgent surgical complications. Diagnosis and treatment of these cases in emergency departments may be difficult. The effective use of radiological imaging techniques can accelerate and facilitate this process. Case presentation: A 65-year-old male patient, who underwent computed tomography with the suspicion of a foreign body in the rectum, was admitted to the emergency outpatient clinic. The patient was a male patient with a psychiatric illness who later underwent emergency surgery. Since the patient had impaired consciousness during the examination, anamnesis could not be obtained, so surgical consultation in the emergency service was first consulted as perforation due to rectal tumoral thickening. In almost all cases, plain radiography is sufficient and can eliminate diagnostic difficulties. However, this is not possible in non-opaque objects. Therefore, CT played an important role in the diagnosis of this patient. A 30cm foreign body, salami, was removed from the abdomen of the patient, who was later taken into emergency surgery. Conlusion: The guiding role of radiological examinations in diagnosis and treatment was discussed, and it was emphasized that CT is a problem-solving tool for rectal foreign body.
{"title":"Perforation Due to Rectal Foreign Body and Radiological Findings","authors":"T. Uuml, Saim Rkoğlu, Adem Yokuş, Fırat Aslan","doi":"10.30476/ACRR.2021.90332.1090","DOIUrl":"https://doi.org/10.30476/ACRR.2021.90332.1090","url":null,"abstract":"Perforation Due to Rectal Foreign Body and Radiological Findings Introduction: Rectal foreign bodies have been increasingly seen and cause urgent surgical complications. Diagnosis and treatment of these cases in emergency departments may be difficult. The effective use of radiological imaging techniques can accelerate and facilitate this process. Case presentation: A 65-year-old male patient, who underwent computed tomography with the suspicion of a foreign body in the rectum, was admitted to the emergency outpatient clinic. The patient was a male patient with a psychiatric illness who later underwent emergency surgery. Since the patient had impaired consciousness during the examination, anamnesis could not be obtained, so surgical consultation in the emergency service was first consulted as perforation due to rectal tumoral thickening. In almost all cases, plain radiography is sufficient and can eliminate diagnostic difficulties. However, this is not possible in non-opaque objects. Therefore, CT played an important role in the diagnosis of this patient. A 30cm foreign body, salami, was removed from the abdomen of the patient, who was later taken into emergency surgery. Conlusion: The guiding role of radiological examinations in diagnosis and treatment was discussed, and it was emphasized that CT is a problem-solving tool for rectal foreign body.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82139323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-01DOI: 10.30476/ACRR.2021.90260.1085
BHUPENDRA KUMAR JAIN, H. Gupta, M. Mohta, Nitasha Sharma, Sanjay Gupta
ABSTRACT PURPOSE: To evaluate (i) acceptability of surgery for simple anal fistula under local anesthesia with conscious sedation by the patients and (ii) accuracy of a set of clinical criteria for diagnosis of simple anal fistula. METHODS: A set of clinical criteria based on physical findings was used to diagnose patients with simple anal fistula. These patients were operated under local anesthesia with conscious sedation. Intravenous paracetamol, diclofenac sodium, and midazolam were administered as adjuvants. Fistulotomy with/without marsupialisation was performed in most patients. Clinical diagnosis was matched with operative findings. RESULTS: Among 193 patients presenting with anal fistula, 61 patients were diagnosed as simple anal fistula and were scheduled for surgery under local anesthesia with conscious sedation. One patient was found to have complex anal fistula during intraoperative assessment and surgery was deferred. Surgery could be completed under local anesthesia with conscious sedation for 58/60 (96.7%) patients. Acceptability of the procedure was assessed with two parameters: the patients’ satisfaction score on visual analogue scale and their willingness to undergo fistula surgery under local anesthesia again, if required. Median (interquartile range) visual analogue scale score for patients’ satisfaction was 10 (9-10). All the patients expressed their willingness to undergo fistula surgery under local anesthesia again, if required. The clinical criteria was successful in diagnosing simple anal fistula in 58/61 (95.1%) patients. The remaining three patients had high intersphincteric fistula (1) and blind sinus (2). CONCLUSIONS: Acceptability of surgery for simple anal fistula under local anesthesia with conscious sedation was excellent. The proposed clinical criteria were highly accurate in diagnosing simple anal fistula.
{"title":"SIMPLE ANAL FISTULA: CLINICAL CRITERIA FOR DIAGNOSIS AND LOCAL ANESTHESIA WITH CONSCIOUS SEDATION FOR SURGERY - AN OBSERVATIONAL STUDY","authors":"BHUPENDRA KUMAR JAIN, H. Gupta, M. Mohta, Nitasha Sharma, Sanjay Gupta","doi":"10.30476/ACRR.2021.90260.1085","DOIUrl":"https://doi.org/10.30476/ACRR.2021.90260.1085","url":null,"abstract":"ABSTRACT PURPOSE: To evaluate (i) acceptability of surgery for simple anal fistula under local anesthesia with conscious sedation by the patients and (ii) accuracy of a set of clinical criteria for diagnosis of simple anal fistula. METHODS: A set of clinical criteria based on physical findings was used to diagnose patients with simple anal fistula. These patients were operated under local anesthesia with conscious sedation. Intravenous paracetamol, diclofenac sodium, and midazolam were administered as adjuvants. Fistulotomy with/without marsupialisation was performed in most patients. Clinical diagnosis was matched with operative findings. RESULTS: Among 193 patients presenting with anal fistula, 61 patients were diagnosed as simple anal fistula and were scheduled for surgery under local anesthesia with conscious sedation. One patient was found to have complex anal fistula during intraoperative assessment and surgery was deferred. Surgery could be completed under local anesthesia with conscious sedation for 58/60 (96.7%) patients. Acceptability of the procedure was assessed with two parameters: the patients’ satisfaction score on visual analogue scale and their willingness to undergo fistula surgery under local anesthesia again, if required. Median (interquartile range) visual analogue scale score for patients’ satisfaction was 10 (9-10). All the patients expressed their willingness to undergo fistula surgery under local anesthesia again, if required. The clinical criteria was successful in diagnosing simple anal fistula in 58/61 (95.1%) patients. The remaining three patients had high intersphincteric fistula (1) and blind sinus (2). CONCLUSIONS: Acceptability of surgery for simple anal fistula under local anesthesia with conscious sedation was excellent. The proposed clinical criteria were highly accurate in diagnosing simple anal fistula.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"665 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76850224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-03-01DOI: 10.30476/ACRR.2021.89658.1081
Warut Boonnithi
Introduction: Sigmoid volvulus is an uncommon cause of colonic obstruction in adults. There have been fewer reports of sigmoid volvulus in Thailand. The aims of this study were to assess characteristics and outcomes of treatment in patients who were diagnosed with sigmoid volvulus at Maharat Nakhon Ratchasima Hospital over a 10-year period. Methods: This retrospective study included 42 sigmoid volvulus patients between 01/2010 and 12/2019. Patients’ characteristics, investigations for diagnosis, operative details and postoperative outcomes were analyzed. Results: From 42 sigmoid volvulus patients, 34 (80%) were males with average age of 64.6 years. Two most common co-morbidities were hypertension (33.3%) and bedridden status (14.2%). Classic “Coffee bean” sign on plain abdominal radiography was found in 33 patients (78.6%). Colonoscopic detorsion was attempted in 17 patients (40.5%) with a success rate of 76.5%. From 13 patients who had successful detorsion, only 5 patients (38.5%) underwent sigmoidectomy with primary anastomosis in the same index admission. Overall 30-day mortality rate was 9.5% and mortality rate was 10.3% for emergency surgery. Conclusions: Sigmoid volvulus usually presents in elderly patients. Endoscopic detorsion should be the initial management of patients without peritonitis. Sigmoidectomy should be done in the same index admission.
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