Pub Date : 2019-01-09DOI: 10.30476/ACRR.2019.45967
R. Houshyar, R. Bennett, B. Yadegari, M. Helmy, C. Bennett
Poster: "ECR 2019 / C-1919 / What Makes You Tic: Comprehensive Review of GI Tract Diverticular Disease " by: "R. houshyar1, R. Bennett 1, B. F. Yadegari2, M. Helmy3, C. Bennett4; 1Orange/US, 2Orange, California/US, 3Orange, CA/US, 4Chicago/US"
海报:“ECR 2019 / C-1919 /什么让你Tic:胃肠道憩室疾病综合综述”，作者:R. houshyar1, R. Bennett 1, B. F. Yadegari2, M. Helmy3, C. Bennett4;1Orange/US, 2Orange, California/US, 3Orange, CA/US, 4Chicago/US”
{"title":"What Makes You Tic: Comprehensive Review of GI Tract Diverticular Disease","authors":"R. Houshyar, R. Bennett, B. Yadegari, M. Helmy, C. Bennett","doi":"10.30476/ACRR.2019.45967","DOIUrl":"https://doi.org/10.30476/ACRR.2019.45967","url":null,"abstract":"Poster: \"ECR 2019 / C-1919 / What Makes You Tic: Comprehensive Review of GI Tract Diverticular Disease \" by: \"R. houshyar1, R. Bennett 1, B. F. Yadegari2, M. Helmy3, C. Bennett4; 1Orange/US, 2Orange, California/US, 3Orange, CA/US, 4Chicago/US\"","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"28 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2019-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85710963","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}
Background: Hemorrhoids are normal anatomical structures, present in individuals from birth and recognisable even in intrauterine life. When we talk about haemorrhoids in actual fact we refer to the symptoms caused by haemorrhoids. Currently surgery is considered the gold standard in the treatment of hemorrhoids. Objectives: In our work we propose the application of an alternative, outpatient and painless treatment of hemorrhoids using intraluminal injection of sclerosing foam (EndoTHeF), demonstrating the safety and feseability of this procedure. Methods: We enrolled 615 patients from may 2008 to september 2018 with proctorragy from second and third degree hemorrhoids. Regular 3-week control examinations for all patients were scheduled. A total of 1427 procedures were carried out, with an average of 2.32 sessions per patient. Results: Four hundred seventy six patients were available for follow-up, which lasted on average 12 months. In 83% of the cases proctorragy disappeared as early as after the first session. The analysis of a validity score concerning bleeding, pain level and sense of discomfort reported by patients showed a statistically significant difference (P < 0.0015) between before and after procedure. Conclusions: Hemorrhoidal endosclerosis with foam seems to be an effective and safe method to cure hemorrhoidal pathologies and seems to offer good results in the short-middle term with acceptable results in terms of patient comfort and overall cost to society.
{"title":"EndoTHeF: Endoluminal Treatment of Hemorrhoids with Foam","authors":"M. Ronconi, S. Casiraghi, M. Schieppati","doi":"10.5812/ACR.86297","DOIUrl":"https://doi.org/10.5812/ACR.86297","url":null,"abstract":"Background: Hemorrhoids are normal anatomical structures, present in individuals from birth and recognisable even in intrauterine life. When we talk about haemorrhoids in actual fact we refer to the symptoms caused by haemorrhoids. Currently surgery is considered the gold standard in the treatment of hemorrhoids. Objectives: In our work we propose the application of an alternative, outpatient and painless treatment of hemorrhoids using intraluminal injection of sclerosing foam (EndoTHeF), demonstrating the safety and feseability of this procedure. Methods: We enrolled 615 patients from may 2008 to september 2018 with proctorragy from second and third degree hemorrhoids. Regular 3-week control examinations for all patients were scheduled. A total of 1427 procedures were carried out, with an average of 2.32 sessions per patient. Results: Four hundred seventy six patients were available for follow-up, which lasted on average 12 months. In 83% of the cases proctorragy disappeared as early as after the first session. The analysis of a validity score concerning bleeding, pain level and sense of discomfort reported by patients showed a statistically significant difference (P < 0.0015) between before and after procedure. Conclusions: Hemorrhoidal endosclerosis with foam seems to be an effective and safe method to cure hemorrhoidal pathologies and seems to offer good results in the short-middle term with acceptable results in terms of patient comfort and overall cost to society.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89722129","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}
Colonoscopy is the preferred method for colorectal cancer screening. However, despite significant advances, the examination remains subject to limitations and variability amongst different practitioners. This calls for the need for objective quality indicators to ensure the optimal use of the modality. Three major priority quality measures have been identified that include adenoma detection rate (ADR), cecal intubation, and adherence to surveillance guidelines. ADR is the best-studied metric correlating with outcomes including post-colonoscopy colon cancer, but has inherent limitations such as the potential for corruptibility. Other important quality indicators include the quality of bowel preparation and colonoscopy withdrawal time. All these quality measures are interrelated and an improvement in any of them would help in increasing the power of colonoscopy as a screening tool, as well as decreasing its economic burden and potentially improving adherence to screening guidelines.
{"title":"Quality Metrics and Indicators in Colonoscopy","authors":"Halim Bou Daher, A. Sharara","doi":"10.5812/ACR.84901","DOIUrl":"https://doi.org/10.5812/ACR.84901","url":null,"abstract":"Colonoscopy is the preferred method for colorectal cancer screening. However, despite significant advances, the examination remains subject to limitations and variability amongst different practitioners. This calls for the need for objective quality indicators to ensure the optimal use of the modality. Three major priority quality measures have been identified that include adenoma detection rate (ADR), cecal intubation, and adherence to surveillance guidelines. ADR is the best-studied metric correlating with outcomes including post-colonoscopy colon cancer, but has inherent limitations such as the potential for corruptibility. Other important quality indicators include the quality of bowel preparation and colonoscopy withdrawal time. All these quality measures are interrelated and an improvement in any of them would help in increasing the power of colonoscopy as a screening tool, as well as decreasing its economic burden and potentially improving adherence to screening guidelines.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73218995","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}
S. Mandalà, A. Mirabella, M. Lupo, M. Branca, C. Barbera, Carlo Szokoll, V. Mandalà
Internal hernia (IH) is an infrequent cause of small bowel obstruction, and paracecal hernia (PH) is very rare. The etiology is related to congenital or acquired causes. The current report was on the case of a 67-year-old male admitted to surgical emergency department for a small bowel obstruction due to a PH. The patient was taken to theatre and underwent a laparoscopic-assisted procedure of small bowel resection for strangulation. The postoperative course was uneventful. As demonstrated in literature, the most important diagnostic tool is contrast-enhanced computed tomography (CT) (when possible with reformatted images). Early diagnosis and prompt surgical intervention is paramount to achieve a good outcome. Laparoscopic approach seems to have an interesting role in such conditions. A further review of literature was performed to highlight the current “state of art” in diagnostic and therapeutic management, especially with regard to laparoscopic approach, of this rare disease.
{"title":"Strangulated Small Bowel Obstruction in Paracecal Hernia and Laparoscopic Approach: A Case Report and Review of Literature","authors":"S. Mandalà, A. Mirabella, M. Lupo, M. Branca, C. Barbera, Carlo Szokoll, V. Mandalà","doi":"10.5812/acr.83539","DOIUrl":"https://doi.org/10.5812/acr.83539","url":null,"abstract":"Internal hernia (IH) is an infrequent cause of small bowel obstruction, and paracecal hernia (PH) is very rare. The etiology is related to congenital or acquired causes. The current report was on the case of a 67-year-old male admitted to surgical emergency department for a small bowel obstruction due to a PH. The patient was taken to theatre and underwent a laparoscopic-assisted procedure of small bowel resection for strangulation. The postoperative course was uneventful. As demonstrated in literature, the most important diagnostic tool is contrast-enhanced computed tomography (CT) (when possible with reformatted images). Early diagnosis and prompt surgical intervention is paramount to achieve a good outcome. Laparoscopic approach seems to have an interesting role in such conditions. A further review of literature was performed to highlight the current “state of art” in diagnostic and therapeutic management, especially with regard to laparoscopic approach, of this rare disease.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"49 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78073057","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}
F. Ferrara, P. Rigamonti, G. Damiani, M. Cariati, M. Stella
Introduction: Procedure for prolapsed hemorrhoids (PPH) or hemorrhoidopexy is not free from complications, some of which have been described as serious, such as bleeding. This study describes a case of a female patient with post-operative huge pelvic hematoma, successfully treated with percutaneous angioembolization. Case Presentation: A 76-year-old female underwent PPH, with no intraoperative complications. Few hours later, the patient showed signs of acute abdomen. No external rectal bleeding was identified and vital signs were normal. A computerized tomography (CT)scan showed a giant peri-rectal and retroperitoneal pelvic hematoma, with signs of active bleeding. A subsequent selective arteriography showed huge bleeding from superior hemorrhoidal artery, treated with super-selective embolization. The procedure was successful and the patient showed a symptomatic improvement. The subsequent hospital stay was uneventful and she was discharged on the ninth post-operative day, with no complications. At the 30-day post-discharge follow-up, the patient was completely pain free with no signs of pelvic discomfort. Control CT scan revealed regression of the pelvic hematoma. Conclusions: Severe complications may occur after PPH and one of the most important is local bleeding. In the current case, no signs of external active bleeding were noted. Prompt diagnosis with CT scan allowed efficacious non-operative treatment with angioembolization, avoiding the need of reoperation for a potential serious complication.
{"title":"A Rare Complication of Stapled Hemorrhoidopexy: Giant Pelvic Hematoma Treated with Super-Selective Percutaneous Angioembolization","authors":"F. Ferrara, P. Rigamonti, G. Damiani, M. Cariati, M. Stella","doi":"10.5812/acr.83005","DOIUrl":"https://doi.org/10.5812/acr.83005","url":null,"abstract":"Introduction: Procedure for prolapsed hemorrhoids (PPH) or hemorrhoidopexy is not free from complications, some of which have been described as serious, such as bleeding. This study describes a case of a female patient with post-operative huge pelvic hematoma, successfully treated with percutaneous angioembolization. Case Presentation: A 76-year-old female underwent PPH, with no intraoperative complications. Few hours later, the patient showed signs of acute abdomen. No external rectal bleeding was identified and vital signs were normal. A computerized tomography (CT)scan showed a giant peri-rectal and retroperitoneal pelvic hematoma, with signs of active bleeding. A subsequent selective arteriography showed huge bleeding from superior hemorrhoidal artery, treated with super-selective embolization. The procedure was successful and the patient showed a symptomatic improvement. The subsequent hospital stay was uneventful and she was discharged on the ninth post-operative day, with no complications. At the 30-day post-discharge follow-up, the patient was completely pain free with no signs of pelvic discomfort. Control CT scan revealed regression of the pelvic hematoma. Conclusions: Severe complications may occur after PPH and one of the most important is local bleeding. In the current case, no signs of external active bleeding were noted. Prompt diagnosis with CT scan allowed efficacious non-operative treatment with angioembolization, avoiding the need of reoperation for a potential serious complication.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81357593","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}
An osseous metaplasia in colonic tissue is extremely rare. The current report presents a case of osseous metaplasia in a hamartomatous rectal polyp in a four-year-old boy, who presented with intermittent rectal bleeding. Though this condition has minimum adverse effects on the prognosis of the patient, awareness of this rare histological variant is of utmost importance.
{"title":"Rectal Polyp with Osseous Metaplasia: A Case Report and Review of the Literature","authors":"N. Gaikwad, Sudhir Gupta, Kirti Jaiswal","doi":"10.5812/ACR.84950","DOIUrl":"https://doi.org/10.5812/ACR.84950","url":null,"abstract":"An osseous metaplasia in colonic tissue is extremely rare. The current report presents a case of osseous metaplasia in a hamartomatous rectal polyp in a four-year-old boy, who presented with intermittent rectal bleeding. Though this condition has minimum adverse effects on the prognosis of the patient, awareness of this rare histological variant is of utmost importance.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91108310","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}
M. Aghaei-Afshar, F. Mahmoudikordi, M. Rezazadehkermani
Preoperative bowel preparation was previously strictly done for all patient undergoing colorectal surgeries. With advances in the surgical techniques and patient care, the role of bowel preparation in surgical complications is questioned. In this study we describe a non-randomized retrospective analysis of 193 patients who underwent left colon and rectal resections in two different hospitals, the preoperative bowel preparation regimens were different in two hospitals. Both regimens contain mechanical preparation with polyethylene glycol, however, one hospital administered erythromycin and neomycin and the other hospital did not. From 74 patients receiving oral antibiotic eight (10.8%) one developed wound infection and from 119 patients who did not receive oral antibiotic three (2.5%) patient developed wound infection. This difference was statistically significant. Regarding literature review, it is suggested to omit oral antibiotic from preoperative bowel preparation regimens elective colorectal resections.
{"title":"Preoperative Bowel Preparation with Oral Antibiotics Might Increase Wound Infection in Elective Colorectal Resections","authors":"M. Aghaei-Afshar, F. Mahmoudikordi, M. Rezazadehkermani","doi":"10.5812/acr.81775","DOIUrl":"https://doi.org/10.5812/acr.81775","url":null,"abstract":"Preoperative bowel preparation was previously strictly done for all patient undergoing colorectal surgeries. With advances in the surgical techniques and patient care, the role of bowel preparation in surgical complications is questioned. In this study we describe a non-randomized retrospective analysis of 193 patients who underwent left colon and rectal resections in two different hospitals, the preoperative bowel preparation regimens were different in two hospitals. Both regimens contain mechanical preparation with polyethylene glycol, however, one hospital administered erythromycin and neomycin and the other hospital did not. From 74 patients receiving oral antibiotic eight (10.8%) one developed wound infection and from 119 patients who did not receive oral antibiotic three (2.5%) patient developed wound infection. This difference was statistically significant. Regarding literature review, it is suggested to omit oral antibiotic from preoperative bowel preparation regimens elective colorectal resections.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87474504","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}
Improved results following liver transplantation (LT) over the past 20 years have led clinicians to push boundaries and expand its indications. LT in non-resectable colorectal liver metastases (NCRLM) is being revisited with an aim to radically improve survival. By utilizing new tools for preoperative patient selection, modern operative techniques for LT and an aggressive attitude against metastases, long-term survival, and even cure could be expected. This paper reviews the current status of liver transplantation for NCRLM with an eye on the future.
{"title":"Liver Transplantation for Non-Resectable Colorectal Liver Metastases","authors":"A. Rammohan","doi":"10.5812/ACR.83855","DOIUrl":"https://doi.org/10.5812/ACR.83855","url":null,"abstract":"Improved results following liver transplantation (LT) over the past 20 years have led clinicians to push boundaries and expand its indications. LT in non-resectable colorectal liver metastases (NCRLM) is being revisited with an aim to radically improve survival. By utilizing new tools for preoperative patient selection, modern operative techniques for LT and an aggressive attitude against metastases, long-term survival, and even cure could be expected. This paper reviews the current status of liver transplantation for NCRLM with an eye on the future.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78712203","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}
Objectives: Major vascular injuries contribute significantly to the mortality of pancreatic and duodenal trauma. We hypothesized that in the setting of penetrating trauma to the pancreas and/or duodenum, independent predictors of mortality associated with vascular injuries could be identified. Our objectives in this study were to describe the national profile of major vascular injuries as well as to identify predictors of morbidity and mortality. Methods: Using the abbreviated injury scale 2005 and ICD-9-CM E-codes, we identified 597 penetrating pancreatic, duodenal, and pancreaticoduodenal trauma patients with major vascular injuries from the NTDB between 2010 and 2014. We controlled patientlevel covariates of age, biological sex, systolic blood pressure (SBP), Glasgow coma score (GCS), pulse, injury severity score (ISS), and organ injury scale (OIS) grade. We estimated multivariable generalized linear mixed models to account for the nesting of patients within trauma centers. Results: Our results indicated an overall mortality rate of 26.1%. Approximately 19% of patients died within 24 hours of admission, and of those, 78% died in the first 6 hours. The inferior vena cava was the most commonly injured vessel. The average number of associated injuries was 4.9 in pancreatic or duodenal trauma and 5.4 in pancreaticoduodenal. Statistically significant independent predictors of mortality were firearm mechanism, SBP, GCS, and pulse. Specifically, odds of death were decreased with a 10-mmHg higher admission SBP (7.7% decreased odds), one-point higher GCS (12.8%), and a 10-beat lower pulse (11.6%). Conclusions: This study is the first to examine the effect of major vascular injuries in the setting of penetrating trauma to the pancreas and/or duodenum utilizing the NTDB. We have identified patterns of injury and statistically significant independent predictors of morbidity and mortality.
{"title":"The Effect of Associated Vascular Injuries in Penetrating Trauma to the Duodenum and Pancreas","authors":"B. Phillips, L. Turco, S. Aurit, R. Walters","doi":"10.5812/ACR.83130","DOIUrl":"https://doi.org/10.5812/ACR.83130","url":null,"abstract":"Objectives: Major vascular injuries contribute significantly to the mortality of pancreatic and duodenal trauma. We hypothesized that in the setting of penetrating trauma to the pancreas and/or duodenum, independent predictors of mortality associated with vascular injuries could be identified. Our objectives in this study were to describe the national profile of major vascular injuries as well as to identify predictors of morbidity and mortality. Methods: Using the abbreviated injury scale 2005 and ICD-9-CM E-codes, we identified 597 penetrating pancreatic, duodenal, and pancreaticoduodenal trauma patients with major vascular injuries from the NTDB between 2010 and 2014. We controlled patientlevel covariates of age, biological sex, systolic blood pressure (SBP), Glasgow coma score (GCS), pulse, injury severity score (ISS), and organ injury scale (OIS) grade. We estimated multivariable generalized linear mixed models to account for the nesting of patients within trauma centers. Results: Our results indicated an overall mortality rate of 26.1%. Approximately 19% of patients died within 24 hours of admission, and of those, 78% died in the first 6 hours. The inferior vena cava was the most commonly injured vessel. The average number of associated injuries was 4.9 in pancreatic or duodenal trauma and 5.4 in pancreaticoduodenal. Statistically significant independent predictors of mortality were firearm mechanism, SBP, GCS, and pulse. Specifically, odds of death were decreased with a 10-mmHg higher admission SBP (7.7% decreased odds), one-point higher GCS (12.8%), and a 10-beat lower pulse (11.6%). Conclusions: This study is the first to examine the effect of major vascular injuries in the setting of penetrating trauma to the pancreas and/or duodenum utilizing the NTDB. We have identified patterns of injury and statistically significant independent predictors of morbidity and mortality.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76614941","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}
Christopher J. Buzas, Anju Gupta, Zong-ming Chen, J. Oxenberg
Introduction: Fibroadenomas are one of the most common benign breast lesions, however they have also been found on rare occasions elsewhere. These lesions usually arise from mammary-like glands (MLG) of the anogenital region which were first described by van der Putte. Methods: This case is about a 51-year-old female who presents with symptomatic hemorrhoids and a 5 cm nodular lesion external to the anal verge. These were removed and examined histo-pathologically. Results: Pathology revealed three hemorrhoidal specimens and the nodular lesion which was consistent with a fibroadenoma. Histologically, the nodular lesion demonstrated a benign process with ductal proliferation and estrogen receptors. Conclusions: Fibroadenomas in anatomic locations other than the breast are very uncommon. Other sites noted in prior case reports include gallbladder, prostate, arm, eyelid and anogenital region. Most of the anogenital lesions have been found on the vulva, with only six documented cases in the anal region, making this pathology exceedingly rare.
纤维腺瘤是最常见的乳腺良性病变之一，但在其他地方也有罕见的发现。这些病变通常来自于肛门生殖器区域的乳腺样腺(MLG)，由van der Putte首次描述。方法:本病例为51岁女性，有症状性痔疮，肛缘外有5cm结节状病变。将其切除并进行病理组织学检查。结果:病理显示三个痔疮标本，结节状病变与纤维腺瘤一致。组织学上，结节状病变表现为良性过程，伴导管增生和雌激素受体。结论:纤维腺瘤在除乳房以外的解剖部位是非常罕见的。先前病例报告中提到的其他部位包括胆囊、前列腺、手臂、眼睑和肛门生殖器区域。大多数的肛门生殖器病变都是在外阴发现的，只有六个记录的病例在肛门区域，使得这种病理非常罕见。
{"title":"Rare Fibroadenoma of the Anal Region","authors":"Christopher J. Buzas, Anju Gupta, Zong-ming Chen, J. Oxenberg","doi":"10.5812/acr.66886","DOIUrl":"https://doi.org/10.5812/acr.66886","url":null,"abstract":"Introduction: Fibroadenomas are one of the most common benign breast lesions, however they have also been found on rare occasions elsewhere. These lesions usually arise from mammary-like glands (MLG) of the anogenital region which were first described by van der Putte. Methods: This case is about a 51-year-old female who presents with symptomatic hemorrhoids and a 5 cm nodular lesion external to the anal verge. These were removed and examined histo-pathologically. Results: Pathology revealed three hemorrhoidal specimens and the nodular lesion which was consistent with a fibroadenoma. Histologically, the nodular lesion demonstrated a benign process with ductal proliferation and estrogen receptors. Conclusions: Fibroadenomas in anatomic locations other than the breast are very uncommon. Other sites noted in prior case reports include gallbladder, prostate, arm, eyelid and anogenital region. Most of the anogenital lesions have been found on the vulva, with only six documented cases in the anal region, making this pathology exceedingly rare.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"196 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75584710","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}
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