20 results on '"Ulcer surgery"'
Search Results
2. Stapled transanal rectal resection in solitary rectal ulcer associated with prolapse of the rectum: a prospective study.
- Author
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Boccasanta P, Venturi M, Calabro G, Maciocco M, and Roviaro GC
- Subjects
- Biofeedback, Psychology, Defecography, Female, Humans, Male, Manometry, Middle Aged, Prospective Studies, Rectal Diseases complications, Rectal Diseases physiopathology, Rectal Prolapse complications, Rectal Prolapse physiopathology, Recurrence, Surveys and Questionnaires, Treatment Outcome, Ulcer complications, Ulcer physiopathology, Digestive System Surgical Procedures methods, Rectal Diseases surgery, Rectal Prolapse surgery, Sutures, Ulcer surgery
- Abstract
Purpose: At present, none of the conventional surgical treatments of solitary rectal ulcer associated with internal rectal prolapse seems to be satisfactory because of the high incidence of recurrence. The stapled transanal rectal resection has been demonstrated to successfully cure patients with internal rectal prolapse associated with rectocele, or prolapsed hemorrhoids. This prospective study was designed to evaluate the short-term and long-term results of stapled transanal rectal resection in patients affected by solitary rectal ulcer associated with internal rectal prolapse and nonresponders to biofeedback therapy., Methods: Fourteen patients were selected on the basis of validated constipation and continence scorings, clinical examination, anorectal manometry, defecography, and colonoscopy and were submitted to biofeedback therapy. Ten nonresponders were operated on and followed up with incidence of failure, defined as no improvement of symptoms and/or recurrence of rectal ulceration, as the primary outcome measure. Operative time, hospital stay, postoperative pain, time to return to normal activity, overall patient satisfaction index, and presence of residual rectal prolapse also were evaluated., Results: At a mean follow-up of 27.2 (range, 24-34) months, symptoms significantly improved, with 80 percent of excellent/good results and none of the ten operated patients showed a recurrence of rectal ulcer. Operative time, hospital stay, and time to return to normal activity were similar to those reported after stapled transanal rectal resection for obstructed defecation, whereas postoperative pain was slightly higher. One patient complained of perineal abscess, requiring surgery., Discussion: The stapled transanal rectal resection is safe and effective in the cure of solitary rectal ulcer associated with internal rectal prolapse, with minimal complications and no recurrences after two years. Randomized trials with sufficient number of patients are necessary to compare the efficacy of stapled transanal rectal resection with the traditional surgical treatments of this rare condition.
- Published
- 2008
- Full Text
- View/download PDF
3. Massive hematochezia from acute hemorrhagic rectal ulcer in patients with severe comorbid illness: rapid control of bleeding by per anal suturing of bleeder using anoretractor.
- Author
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Hung HY, Changchien CR, You JF, Chen JS, Chiang JM, Yeh CY, Fan CW, Tang R, Hsieh PS, and Tasi WS
- Subjects
- Adult, Aged, Aged, 80 and over, Female, Gastrointestinal Hemorrhage etiology, Humans, Male, Middle Aged, Rectal Diseases complications, Retrospective Studies, Suture Techniques, Ulcer complications, Gastrointestinal Hemorrhage surgery, Hemostasis, Surgical instrumentation, Rectal Diseases surgery, Surgical Instruments, Ulcer surgery
- Abstract
Purpose: Massive hematochezia from acute hemorrhagic rectal ulcer can arise in patients with severe comorbid illness who are bedridden for long periods. If the bleeder is not found and treated immediately, the bleeding will cause deterioration of health and even threaten life. The results of the current study show how quickly and safely per anal suturing can treat acute hemorrhagic rectal ulcer., Methods: From January 2003 to December 2003, the records of 26 patients who underwent per anal suturing of acute hemorrhagic rectal ulcer were retrospectively reviewed. The identification of acute hemorrhagic rectal ulcer was confirmed by clinical and anoscopic examination., Results: Most of these patients were elderly and bedridden (14 men; median age 69 years). Main comorbid illnesses existed in all patients and included liver cirrhosis (8 patients, 31 percent), sepsis (13 patients, 50 percent), cerebral vascular accident (15 patients, 58 percent), respiratory failure (13 patients, 50 percent), and malignancy (7 patients, 27 percent). Effective hemostasis was achieved in all patients by direct suture of bleeding ulcer. No complications developed relative to the per anal suturing procedure among any patients. Although 11 patients developed recurrent hematochezia, 9 patients responded to repeated therapy. The risk factors associated with recurrent bleeding were severity of disease and abnormal coagulation., Conclusions: When massive hematochezia occurs in bedridden patients with severe comorbid illness, it is essential to investigate the lower rectum, which often is affected by acute hemorrhagic rectal ulcer. Recognition of this clinical presentation will result in early identification and therapy. Per anal suturing of a bleeder at the bedside provides a quick, safe, and successful management of acute hemorrhagic rectal ulcer.
- Published
- 2006
- Full Text
- View/download PDF
4. Rectal ulceration as a result of prostatic brachytherapy: a new clinical problem: report of three cases.
- Author
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Celebrezze JP Jr and Medich DS
- Subjects
- Aged, Humans, Male, Middle Aged, Rectal Diseases surgery, Ulcer surgery, Brachytherapy adverse effects, Prostatic Neoplasms radiotherapy, Rectal Diseases etiology, Ulcer etiology
- Abstract
Introduction: Prostate cancer is the most common cancer of males in the United States. One treatment modality for localized prostate cancer is brachytherapy, the implantation of radioactive seeds directly into the prostate. Although this is an effective treatment option, significant complications can result. More commonly these complications involve the genitourinary tract, but radiation proctitis is a well-recognized, less common complication. A specific complication of brachytherapy, the development of a rectal ulcer is not well recognized. The clinical course of this complication and results of treatment options are unknown., Methods: Three cases of rectal ulceration as a consequence of prostatic brachyradiotherapy are presented, and the presumed course of disease and treatment options is discussed., Results: Two patients were initially treated with local advancement flaps that both failed. These patients developed rectourethral fistulas. One patient was treated with diverting colostomy and suprapubic urinary diversion. The second underwent proctectomy and coloanal anastomosis. This also failed after multiple attempts to treat perianastomotic fistulas. The third patient was treated endoscopically for bleeding and has had no further interventions., Conclusion: In the small percentage of patients who develop rectal ulcerations from prostatic brachyradiotherapy, local medical or surgical treatments will often result in failure. They also may contribute to the eventual development of rectourethral fistulas, the likely natural progression of this disease. These fistulas should be treated with both urinary and fecal diversion. Earlier stages of ulceration may be treated with rectal resection and reconstruction, but selection criteria for these procedures have yet to be determined.
- Published
- 2003
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5. Connective tissue changes in ileal Crohn's disease: relationship to disease phenotype and ulcer-associated cell lineage.
- Author
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Borley NR, Mortensen NJ, Kettlewell MG, George BD, Jewell DP, and Warren BF
- Subjects
- Cell Division physiology, Collagen ultrastructure, Crohn Disease surgery, Humans, Ileal Diseases surgery, Ileum pathology, Ileum surgery, Image Processing, Computer-Assisted, Immunoenzyme Techniques, Intestinal Mucosa pathology, Intestinal Obstruction pathology, Intestinal Obstruction surgery, Intestinal Perforation pathology, Intestinal Perforation surgery, Risk Factors, Ulcer surgery, Connective Tissue pathology, Crohn Disease pathology, Ileal Diseases pathology, Muscle, Smooth pathology, Ulcer pathology
- Abstract
Purpose: Abnormalities of enteric collagen and smooth-muscle cell content have been documented in Crohn's disease. We studied the relationships among connective tissue changes, disease "type," and other disease features using immunohistochemistry and image analysis., Methods: Twenty consecutive ileal resections for Crohn's disease and ten normal terminal ileal specimens were evaluated using conventional histopathologic examination. Monoclonal antibodies to smooth-muscle actin and Type III collagen fibers were used to determine the percentage area of the submucosa occupied by these constituents using image analysis., Results: There were no significant differences in smooth-muscle content among stenosed, perforated, and ulcerated specimens. There was a significantly increased submucosal Type III collagen content in stenosed vs. other types. The only factor that correlated with smooth-muscle cell content was the amount of ulcer-associated cell lineage present., Conclusions: Increased deposition of Type III collagen fibers rather than smooth-muscle proliferation is associated with a stenotic phenotype. Loss of Type III collagen fibers may play a role in the development of perforating complications. We have found no evidence that smooth-muscle cells are the source of Type III collagen fiber production although there is evidence that ulcer-associated cell lineage may be related to the stimulus leading to submucosal neomuscularization.
- Published
- 2001
- Full Text
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6. Perforated solitary ulcer of the colon. Report of a case.
- Author
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Koçdor MA, Aydin C, Astarcioğlu H, Küpelioğlu A, and Bora S
- Subjects
- Abdomen, Acute surgery, Adult, Colonic Diseases surgery, Emergencies, Female, Humans, Intestinal Perforation surgery, Laparotomy, Ulcer surgery, Colonic Diseases pathology, Intestinal Perforation pathology, Ulcer pathology
- Abstract
Purpose: A patient with a solitary colonic ulcer had sudden onset of crampy abdominal pain, anorexia, fever, and vomiting, with signs of positive peritoneal irritation., Methods: The diagnosis was proved by histopathologic examination of right hemicolectomy material., Results: An emergency laparotomy, with right hemicolectomy and ileotransversostomy, gave complete relief from symptoms. The patient was still asymptomatic at the two-year follow-up, and control colonoscopic examinations performed at 6 and 18 months after the operation were normal., Conclusion: Preoperative diagnosis of perforated solitary colonic ulcers localized at the right hemicolon may mimic acute appendicitis, and intraoperative findings may mimic colonic carcinoma. If the preoperative diagnosis is not certain, right hemicolectomy and ileotransversostomy, with regular colonoscopic controls, is a safe procedure in the treatment and follow-up of these patients.
- Published
- 1998
- Full Text
- View/download PDF
7. Postoperative recurrence in patients with intestinal Behçet's disease.
- Author
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Iida M, Kobayashi H, Matsumoto T, Okada M, Fuchigami T, Yao T, and Fujishima M
- Subjects
- Adult, Barium Sulfate, Behcet Syndrome diagnosis, Behcet Syndrome epidemiology, Behcet Syndrome therapy, Colonoscopy, Combined Modality Therapy, Endoscopy, Gastrointestinal, Enema, Female, Follow-Up Studies, Humans, Ileostomy, Incidence, Intestinal Diseases diagnosis, Intestinal Diseases epidemiology, Intestinal Diseases therapy, Intraoperative Care, Male, Middle Aged, Postoperative Care, Recurrence, Time Factors, Ulcer diagnosis, Ulcer epidemiology, Ulcer surgery, Ulcer therapy, Behcet Syndrome surgery, Intestinal Diseases surgery
- Abstract
Purpose: The postoperative course of intestinal Behçet's disease was studied in nine patients who had undergone a total of 15 operations due to intestinal ulcers., Methods: These patients were followed up for an average of 6.0 years (range, 1 year, 3 months to 13 years, 10 months) after each operation and they were repeatedly examined by double-contrast radiography and/or colonofiberscopy., Results: Recurrence of intestinal ulcers was observed in 12 (80 percent) of the 15 surgical cases. The incidence (50 percent) of postoperative recurrence in six cases in which intraoperative endoscopy revealed no abnormality in the retained intestine was lower than that (100 percent) in nine cases without this examination. Recurrent intestinal lesions in most cases were demonstrated as multiple aphthoid ulcers in the ileum near the ileocolectomy, or as one or two deep ulcers at the ileocolectomy site. The recurrent ulcers were successfully treated by various medical therapies, but the effectiveness of these therapies was only temporary., Conclusion: In the case of this disease, intraoperative endoscopy may be useful for preventing postoperative recurrence and periodic follow-up examination with radiography and endoscopy should be performed, even after surgery.
- Published
- 1994
- Full Text
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8. Sliding mucocutaneous flap for the treatment of anal ulcer
- Author
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Fidel Ruiz-Moreno
- Subjects
medicine.medical_specialty ,Anus Diseases ,Ulcer surgery ,business.industry ,Mucocutaneous zone ,Gastroenterology ,MEDLINE ,Anal Ulcer ,General Medicine ,Skin Transplantation ,Skin transplantation ,Transplantation, Autologous ,Colorectal surgery ,Surgery ,Transplantation ,Surgical oncology ,medicine ,Methods ,Humans ,Fissure in Ano ,business ,Ulcer - Published
- 1968
9. Intestinal involvement in Behçet's disease: review of 136 surgical cases in the Japanese literature.
- Author
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Kasahara Y, Tanaka S, Nishino M, Umemura H, Shiraha S, and Kuyama T
- Subjects
- Adolescent, Adult, Aged, Behcet Syndrome surgery, Child, Crohn Disease pathology, Female, Humans, Intestinal Diseases pathology, Intestinal Diseases surgery, Intestinal Perforation surgery, Japan, Male, Middle Aged, Recurrence, Ulcer pathology, Ulcer surgery, Behcet Syndrome complications, Intestinal Diseases etiology
- Abstract
A survey was prepared of 136 cases of laparotomy in patients with Behçet's disease and intestinal ulcers in Japan. The incidence of the disease is highest in males in the fourth and fifth decades. The ulcers are frequently found in the terminal ileum and the cecum. The ulcers are liable to perforate into the abdominal cavity, so that many patients require emergency operation. Resection of the ileocecal region or right half of the colon is the usual operation in the treatment of this disease. However, it is necessary to search for skip lesions, because multiple ulcers may be present. The incidence of postoperative complications and postoperative recurrence of ulcers is so high that supplementary management is often required.
- Published
- 1981
- Full Text
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10. Radiation-induced solitary rectal ulcer.
- Author
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Crowe J and Stellato TA
- Subjects
- Embolization, Therapeutic, Female, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage therapy, Humans, Middle Aged, Radiation Injuries pathology, Radiation Injuries surgery, Radiotherapy adverse effects, Rectal Diseases pathology, Rectal Diseases surgery, Ulcer etiology, Ulcer pathology, Ulcer surgery, Radiation Injuries etiology, Rectal Diseases etiology, Uterine Neoplasms radiotherapy
- Abstract
A case of radiation-induced solitary rectal ulcer is presented. The unusual posterior location with involvement of the internal iliac artery produced massive lower intestinal hemorrhage. Temporary control was obtained with percutaneous arterial catheter embolization, but definitive control necessitated surgical resection.
- Published
- 1985
- Full Text
- View/download PDF
11. Clinical and manometric features of the solitary rectal ulcer syndrome.
- Author
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Keighley MR and Shouler P
- Subjects
- Adult, Aged, Electromyography, Female, Humans, Male, Manometry, Middle Aged, Pressure, Rectal Diseases physiopathology, Rectal Diseases surgery, Rectal Prolapse physiopathology, Rectal Prolapse surgery, Ulcer etiology, Ulcer physiopathology, Ulcer surgery, Anal Canal physiopathology, Rectal Diseases etiology, Rectal Prolapse complications
- Abstract
We report 33 patients with the solitary rectal ulcer syndrome seen between 1975 and 1982. Twenty-four were women and the median age was 32 years. The principal symptoms were bleeding (89 per cent), chronic constipation (64 per cent), rectal pain (42 per cent), tenesmus (42 per cent), and mucous discharge (45 per cent). Twenty-eight patients gave a history of straining (85 per cent). A full-thickness rectal prolapse was present in six patients, an anterior rectal prolapse was observed in 11, and 12 patients had clinical evidence of perineal descent. Defecation was only possible by digital evaluation in six women, and three male patients were passive homosexuals. Manometric studies were performed on 16 patients; eight patients were unable to tolerate rectal distention with 200 cc of air and impaired rectal sensation was present in two. Rectal distention was associated with bursts of involuntary external sphincter activity in three patients, and the distention reflex was absent in six, despite normal ganglia on rectal biopsy. In only four patients was there electromyographic evidence of contraction of the puborectalis during attempted defecation. Fourteen patients were treated by rectopexy; healing of the ulcer occurred in five of six with a full-thickness prolapse compared with only two of eight without a complete prolapse.
- Published
- 1984
- Full Text
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12. Stercoral perforation of the sigmoid colon: report of two cases.
- Author
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Hakami M, Mosavy SH, and Tadaiion A
- Subjects
- Adult, Colonic Diseases surgery, Colostomy, Fecal Impaction surgery, Female, Humans, Intestinal Perforation surgery, Male, Middle Aged, Ulcer etiology, Ulcer surgery, Colon, Sigmoid, Colonic Diseases etiology, Fecal Impaction complications, Intestinal Perforation etiology
- Published
- 1975
- Full Text
- View/download PDF
13. Nonspecific ulcers of the cecum: report of two cases.
- Author
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Lazarovitch I, Michowitz M, Lowenthal M, and Solowiejczyk M
- Subjects
- Adult, Aged, Air, Cecal Diseases pathology, Cecal Diseases surgery, Colectomy, Diaphragm diagnostic imaging, Female, Humans, Radiography, Ulcer pathology, Ulcer surgery, Cecal Diseases etiology, Ulcer etiology
- Published
- 1974
- Full Text
- View/download PDF
14. Fissurectomy with superficial midline sphincterotomy. A viable alternative for the surgical correction of chronic fissure/ulcer-in-ano.
- Author
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Bode WE, Culp CE, Spencer RJ, and Beart RW Jr
- Subjects
- Chronic Disease, Female, Humans, Male, Methods, Middle Aged, Postoperative Care, Postoperative Complications, Recurrence, Anal Canal surgery, Fissure in Ano surgery, Ulcer surgery
- Abstract
A series of 121 patients with chronic fissure-in-ano who underwent fissurectomy with superficial midline sphincterotomy was studied. The mean follow-up was 8.1 years. Minor problems with anal competence occurred after the operation in 30 patients (25 per cent). Within two months, this problem had resolved in all patients. One patient (0.8 per cent) had a true recurrence. Five patients (4.1 per cent) had recurrent acute anal abrasions as the result of passage of a hard stool. These healed spontaneously. Twelve patients (9.9 per cent) had fragile scars, but this was a significant problem in only five (4.1 per cent). No patient had significant stricture formation, keyhole deformities, or major persistent problems with anal competence. The patients graded their operations with regard to satisfaction: 118 (97.5 per cent) reported satisfactory results and three (2.5 per cent) reported unsatisfactory results. This study shows that fissurectomy with superficial midline sphincterotomy is a viable approach to the surgical management of chronic fissure-in-ano.
- Published
- 1984
- Full Text
- View/download PDF
15. Idiopathic colonic ulcer: report of a case diagnosed preoperatively.
- Author
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Eusebio EB and Kaplan AP
- Subjects
- Biopsy, Colonic Diseases pathology, Colonic Diseases surgery, Endoscopy, Fiber Optic Technology, Humans, Male, Middle Aged, Sigmoidoscopy, Time Factors, Ulcer diagnosis, Ulcer pathology, Ulcer surgery, Colonic Diseases diagnosis
- Published
- 1974
- Full Text
- View/download PDF
16. Stercoral necrosis of the cecum in an incarcerated right inguinal hernia: report of a case.
- Author
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Mehta M, Querubin A, and Islami A
- Subjects
- Aged, Cecal Diseases pathology, Cecal Diseases surgery, Fecal Impaction surgery, Hernia, Inguinal surgery, Humans, Male, Necrosis, Ulcer etiology, Ulcer pathology, Ulcer surgery, Cecal Diseases etiology, Fecal Impaction complications, Hernia, Inguinal complications
- Abstract
A rare case of stercoral ulcers of the cecum in an incarcerated inguinal hernia is described. Local resection was followed by an uneventful recovery.
- Published
- 1975
- Full Text
- View/download PDF
17. Benign cecal ulcers. Spectrum of disease and selective management.
- Author
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Shallman RW, Kuehner M, Williams GH, Sajjad S, and Sautter R
- Subjects
- Adult, Aged, Cecal Diseases etiology, Cecal Diseases surgery, Cecum pathology, Female, Humans, Male, Middle Aged, Ulcer etiology, Ulcer surgery, Cecal Diseases pathology, Ulcer pathology
- Abstract
Benign ulceration of the cecum is an uncommon lesion. Most cases are diagnosed intraoperatively and most authors have advocated right hemicolectomy due to the difficulty in differentiating benign from malignant lesions. Recently colonoscopic diagnosis and conservative treatment have been reported. We describe six cases of cecal ulcer ranging from asymptomatic lesions diagnosed at colonoscopy and healing with conservative management to perforated ulcers with intra-abdominal abscesses requiring right hemicolectomy. A selective approach to patient management is advocated, including stapler wedge cecectomy with frozen section diagnosis to avoid extensive bowel resection and retain the ileocecal valve.
- Published
- 1985
- Full Text
- View/download PDF
18. Successful treatment of a benign solitary rectal ulcer by temporary diverting sigmoidostomy: report of a case.
- Author
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Stavorovsky M, Weintroub S, Ratan J, and Rozen P
- Subjects
- Adult, Female, Humans, Radiography, Rectal Diseases diagnostic imaging, Ulcer diagnostic imaging, Colon, Sigmoid surgery, Colostomy methods, Rectal Diseases drug therapy, Ulcer surgery
- Abstract
A rare case of a solitary benign rectal ulcer in which conservative medical therapy was unsuccessful is described. Diversion of the fecal stream by temporary sigmoidostomy resulted in rapid healing of the ulcer. This entity presents diagnostic and therapeutic problems, which are discussed. The use of temporary sigmoidostomy in such cases is recommended.
- Published
- 1977
- Full Text
- View/download PDF
19. Sliding mucocutaneous flap for the treatment of anal ulcer.
- Author
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Ruiz-Moreno F
- Subjects
- Fissure in Ano surgery, Humans, Methods, Transplantation, Autologous, Ulcer surgery, Anus Diseases surgery, Skin Transplantation
- Published
- 1968
- Full Text
- View/download PDF
20. Preoperative diagnosis of a nonspecific ulcer of the cecum by colonofiberscopy: report of a case.
- Author
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Nagasako K, Ikezawa H, Gyo S, and Takemoto T
- Subjects
- Cecal Diseases surgery, Endoscopy, Fiber Optic Technology, Humans, Male, Melena diagnosis, Methods, Middle Aged, Ulcer surgery, Cecal Diseases diagnosis, Ulcer diagnosis
- Published
- 1972
- Full Text
- View/download PDF
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