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Phil Tozer - One of the best experts on this subject based on the ideXlab platform.

Kenzo Yanagita - One of the best experts on this subject based on the ideXlab platform.

  • microbiological analysis and endoanal ultrasonography for diagnosis of anal fistula in acute Anorectal sepsis
    International Journal of Colorectal Disease, 2006
    Co-Authors: Takayuki Toyonaga, Makoto Matsushima, Yoshiaki Tanaka, Yasuhiro Shimojima, Naomi Matsumura, Hiroki Kannyama, Makiko Nozawa, Tomoaki Hatakeyama, Kazunori Suzuki, Kenzo Yanagita
    Abstract:

    Background and aims: Treatment of Anorectal sepsis requires prompt surgical drainage, but it is important to identify any associated anal fistula for preventing recurrence. We evaluated whether microbiologi- cal analysis and/or endoanal ultraso- nography could be used to predict anal fistula in patients with acute Anorectal sepsis. Methods: Five hundred fourteen consecutive patients with acute Anorectal sepsis were studied. Clinical data, digital exami- nation findings, endosonographic findings, and results of microbiolog- ical analysis were compared with definitive surgical findings of the presence or absence of anal fistula. Results: Anorectal Abscess with anal fistula was found in 418 patients, and Anorectal Abscess without anal fistula was found in 96 patients. Microbio- logical examination showed that Es- cherichia coli, Bacteroides, Bacillus, and Klebsiella species were signifi- cantly more prevalent in patients with fistula (P<0.01), and coagulase-nega- tive Staphylococci and Peptostrepto- coccus species were significantly more prevalent in patients without fistula (P<0.01). Results of endoanal ultrasonography were concordant with the definitive surgical diagnosis in 421 (94%) of 448 patients studied. Conclusion: Acute Anorectal sepsis due to colonization of "gut-derived" microorganisms rather than "skin- derived" organisms is more likely to be associated with anal fistula. When the microbiological analysis yields gut-derived bacteria, but no fistula has been found in the initial drainage operation, repeat examinations during a period of quiescence, including careful digital assessment and metic- ulous endosonography, are warranted to identify a potentially missed anal fistula.

Alexander Sá Rolim - One of the best experts on this subject based on the ideXlab platform.

  • Perianal Abscess: a descriptive analysis of cases treated at the Hospital Santa Marcelina, São Paulo
    Sociedade Brasileira de Coloproctologia, 2016
    Co-Authors: Neto,isaac José Felippe Corrêa, Cecchinni,angelo Rossi Silva, Lopes,eduardo Augusto, Watté,hugo Henriques, Souza,rogério Freitas Lino, Alexander Sá Rolim
    Abstract:

    Abstract Introduction Perianal suppurations have an incidence of 1–2:10,000 inhabitants per year and represent about 5% of proctology consultations, more frequently in males, being rare in childhood. Although perianal or Anorectal Abscess is an entity of relatively simple diagnosis and treatment, in a considerable percentage of patients difficulties will be found, especially considering that the initial treatment of these patients is performed by non-specialist physicians. Objective This is a retrospective survey of cases of perianal and Anorectal Abscess operated in Santa Marcelina Hospital between October 2011 and December 2014. Patients and methods A retrospective study of patients operated on an emergency basis for perianal and/or Anorectal Abscess in Santa Marcelina Hospital between October 2011 and December 2014, being excluded patients with inflammatory bowel disease. Data of gender, age, clinical presentation, the season of the year in which the Abscess occurred, time of progression of symptoms, comorbidities, signs of Systemic Inflammatory Response Syndrome (SIRS) on admission, surgeries carried out, reoperations and clinical outcome were analyzed. Results Electronic medical records of 52 patients (73.1% male) who underwent surgical treatment of Anorectal and perianal Abscess were analyzed. The mean overall age was 43.03 years, and all patients reported pain as the main symptom, with a mean time of symptoms of 6.5 days. As for the season of the year of onset and diagnosis of perianal Abscess, 61.5% of patients had this pathology in the summer and spring months. Conclusion In our study, it can be observed a higher incidence of perianal Abscess in males and in the warmer months; furthermore, just over half of the patients developed perianal fistula in their progression

  • Perianal Abscess: a descriptive analysis of cases treated at the Hospital Santa Marcelina, São Paulo
    Elsevier, 2016
    Co-Authors: Isaac José Felippe Corrêa Neto, Alexander Sá Rolim, Janaína Wercka, Angelo Rossi Silva Cecchinni, Eduardo Augusto Lopes, Hugo Henriques Watté, Rogério Freitas Lino Souza, Laercio Robles
    Abstract:

    Introduction: Perianal suppurations have an incidence of 1–2:10,000 inhabitants per year and represent about 5% of proctology consultations, more frequently in males, being rare in childhood. Although perianal or Anorectal Abscess is an entity of relatively simple diagnosis and treatment, in a considerable percentage of patients difficulties will be found, especially considering that the initial treatment of these patients is performed by non-specialist physicians. Objective: This is a retrospective survey of cases of perianal and Anorectal Abscess operated in Santa Marcelina Hospital between October 2011 and December 2014. Patients and methods: A retrospective study of patients operated on an emergency basis for perianal and/or Anorectal Abscess in Santa Marcelina Hospital between October 2011 and December 2014, being excluded patients with inflammatory bowel disease. Data of gender, age, clinical presentation, the season of the year in which the Abscess occurred, time of progression of symptoms, comorbidities, signs of Systemic Inflammatory Response Syndrome (SIRS) on admission, surgeries carried out, reoperations and clinical outcome were analyzed. Results: Electronic medical records of 52 patients (73.1% male) who underwent surgical treatment of Anorectal and perianal Abscess were analyzed. The mean overall age was 43.03 years, and all patients reported pain as the main symptom, with a mean time of symptoms of 6.5 days. As for the season of the year of onset and diagnosis of perianal Abscess, 61.5% of patients had this pathology in the summer and spring months. Conclusion: In our study, it can be observed a higher incidence of perianal Abscess in males and in the warmer months; furthermore, just over half of the patients developed perianal fistula in their progression. Resumo: Introdução: As supurações perianais apresentam uma incidência de 1-2:10000 habitantes por ano e representam cerca de 5% das consultas proctológicas, com maior frequência no sexo masculino, sendo raras na infância. Embora o Abscesso perianal ou anorretal seja de diagnóstico e tratamento relativamente simples, uma percentagem considerável representa maior dificuldade para tal, notadamente pelo fato do atendimento inicial desses pacientes ser realizado por médicos não especialistas. Objetivo: Levantamento retrospectivo dos casos de Abscesso perianal e anorretal operados no Hospital Santa Marcelina entre outubro de 2011 e dezembro de 2014. Casuística e método: Estudo retrospectivo de pacientes operados em caráter de urgência por Abscesso perianal e/ou anorretal no Hospital Santa Marcelina entre outubro de 2011 e dezembro de 2014, excluídos portadores de doença inflamatória intestinal. Analisaram-se dados de sexo, idade, quadro clínico, época do ano da ocorrência do Abscesso, tempo de evolução dos sintomas, comorbidades, sinais de Síndrome da Resposta Inflamatória Sistêmica (SIRS) na admissão, cirurgias realizadas, reoperações e desfecho clínico. Resultados: Foram analisados prontuários eletrônicos de 52 pacientes submetidos à tratamento cirúrgico de Abscesso anorretal e perianal, dos quais 73,1% pertenciam ao sexo masculino. A média de idade geral foi de 43,03 anos e todos os pacientes relataram dor como sintoma principal com média de tempo de sintomatologia de 6,5 dias. Quanto à época do ano do aparecimento e diagnóstico do Abscesso perianal, 61,5% dos pacientes apresentaram a patologia nos meses de verão e primavera. Conclusão: Em nosso trabalho, pode-se observar maior incidência de Abscesso perianal no sexo masculino e nos meses mais quentes e que pouco mais da metade dos pacientes desenvolveram fístula perianal na evolução. Keywords: Perianal Abscess, Medical history, Signs of syndrome of systemic inflammatory response, Surgery, Seasonality, Palavras-chave: Abscesso perianal, História clínica, Sinais de síndrome da resposta inflamatória sistêmica, Cirurgia, Sazonalidad

K Sahnan - One of the best experts on this subject based on the ideXlab platform.

Misawa Kazuhito - One of the best experts on this subject based on the ideXlab platform.

  • Midline extraperitoneal approach for bilateral widespread retroperitoneal Abscess originating from Anorectal infection
    The Authors. Published by Elsevier Ltd., 2016
    Co-Authors: Okuda Koji, Oshima Yuka, Saito Kentaro, Uesaka Takahiro, Terasaki Yasunobu, Kasai Hironori, Minagawa Nozomi, Oshima Takahiro, Okawa Yumi, Misawa Kazuhito
    Abstract:

    AbstractIntroductionAnorectal Abscess is one of the most common Anorectal conditions encountered in practice. However, such Abscesses may rarely extend upward and cause life-threatening medical conditions.Presentation of caseA 53-year-old woman presented with symptoms of Anorectal Abscess and evidence of severe inflammatory response and acute kidney injury. Computed tomography revealed a widespread Abscess extending to the bilateral retroperitoneal spaces. Surgical drainage was performed via a totally extraperitoneal approach through a lower midline abdominal incision, and the patient had a rapid and uncomplicated recovery.DiscussionAlthough retroperitoneal Abscesses originating from the Anorectal region are rare, they are life-threating events that require immediate treatment. Percutaneous Abscess drainage has been recently evolved; however, surgical drainage is required sometimes that may be challenging, particularly in the case of widespread Abscesses, as in our case.ConclusionThe midline extraperitoneal approach reported here might be an effective surgical option for patients with bilateral widespread retroperitoneal Abscesses