Chronic ischemic colitis in the elderly: clinicopathological study

Twenty four subjects presenting with colonic manifestations above 50 years old were studied. By proper integration of the clinical picture, colonoscopic, Ba-enema and duplex scanning, chronic colonic ischemia was detected in 17 cases [71%]. Cardiac disease was associated in 8 cases [47%] and diabetes mellitus in also 8 cases. Eight cases [47%] were found to run chronic stationary course while 5 patients [30%], presented with acute episodic form of ischemia. Four cases needed to be operated upon for resection of colonic segment undergoing infarction

Peri-anal suppuration in pediatric age group

Twenty-eight cases of perianal fistula [PAF] below eight years of age were studied and managed surgically. It was found that children above two years of age showed pattern of the disease very close the adult condition. Infants below two years of age, showed an exclusive male predominance and in many cases have deep anal crypts as an underlying anatomical predisposing factor. Healing was complete in all cases as meticulous primary fistulotomy was adopted as a routine procedure even in acute suppurating lesions. It was concluded that careful diagnosis, prompt surgical management of perianal suppuration in pediatric age group can bring perfect cure to the child provided that surgeon is experienced enough in the field to remember that the case is not just a miniature of an adult one

Evaluation of intra-rectal ultrasonography in pre-operative staging of cancer rectum.

Intra-rectal ultrasonography was used in the preoperative staging of 20 patients with rectal cancer, using a 4 MHz radial scanner. The results of ultrasonic staging were compared with clinical examination including EUA, operative and subsequent histological staging. The lesion could not be felt by digital examination in 6 patients. In the remaining 14 patients ultrasound examination matched the digital examination and EUA and was sometimes superior to it. As regards the degree of invasion of the rectal wall layers, ultrasonography corresponded with the histopathologic findings in 10 of the resected 11 tumors [accuracy rate 90.9%]. Concerning regional lymph node infiltration, the accuracy rate of endorectal sonography was 85% with only one false positive and two false negative cases. Intra-rectal ultrasonography is a highly accurate preoperative staging tool for rectal cancers both in delineating the depth of tumor invasion and subsequently its resectability, and in assessing regional lymph nodes. It is particularly valuable in tumors non reachable by the examining finger