Clinical Characteristics and Incidence of Perianal Diseases in Patients With Ulcerative Colitis

PURPOSE: While perianal disease (PAD) is a characteristic of patients with Crohn disease, it has been overlooked in patients with ulcerative colitis (UC). Thus, our study aimed to analyze the incidence and the clinical features of PAD in patients with UC. METHODS: We reviewed the data on 944 patients with an initial diagnosis of UC from October 2003 to October 2015. PAD was categorized as hemorrhoids, anal fissures, abscesses, and fistulae after anoscopic examination by experienced proctologists. Data on patients’ demographics, incidence and types of PAD, medications, surgical therapies, and clinical course were analyzed. RESULTS: The median follow-up period was 58 months (range, 12–142 months). Of the 944 UC patients, the cumulative incidence rates of PAD were 8.1% and 16.0% at 5 and 10 years, respectively. The incidence rates of bleeding hemorrhoids, anal fissures, abscesses, and fistulae at 10 years were 6.7%, 5.3%, 2.6%, and 3.4%, respectively. The cumulative incidence rates of perianal sepsis (abscess or fistula) were 2.2% and 4.5% at 5 and 10 years, respectively. In the multivariate analyses, male sex (risk ratio [RR], 4.6; 95% confidence interval [CI], 1.7–12.5) and extensive disease (RR, 4.2; 95% CI, 1.6–10.9) were significantly associated with the development of perianal sepsis. CONCLUSION: Although the clinical course of PAD in patients with UC is not serious, in clinical practice, PAD is not rare in such patients. Therefore, careful examination and appropriate management for PAD is needed if the quality of life for patients with UC is to be improved.

Primary Hepatic Tumors in Children

Primary liver tumors are uncommon in childhood, with a relative frequency of 3% of childhood tumors. Seventy three cases of pediatric primary liver tumors which were operated on at single institution between 1986 and 2002 were reviewed. There were 37 cases of hepatoblastoma, 11 hepatocellular carcinomas, 6 undifferentiated (embryonal) sarcomas, and 1 mixed germ-cell tumor in malignancies. Benign tumors constitute only 24.6% of liver tumors, including 7 hemangioendotheliomas, 5 mesenchymal hamartomas, 3 congenital cysts, and one each with focal nodular hyperplasia and hemangioma. The common presenting clinical features were abdominal mass or abdominal distension. Anatomical hepatic resections were carried out in 38 cases, and non anatomical resections in 34 cases. One patient died of a direct result of hepatic resection(1.4%), and complication rate was 16.4%.