Subject(s)
Cholecystectomy, Laparoscopic , Gallstones/surgery , Pleural Diseases/etiology , Postoperative Complications/etiology , Subphrenic Abscess/etiology , Aged , Humans , Male , Peritoneum , Pleural Diseases/therapy , Postoperative Complications/therapy , Subcutaneous Tissue , Subphrenic Abscess/therapyABSTRACT
No disponible
Subject(s)
Humans , Male , Adult , Adenomatous Polyposis Coli/pathology , Endoscopy, Gastrointestinal/methods , Adenomatous Polyposis Coli/surgery , Mutation/geneticsABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Subphrenic Abscess/etiology , Cholecystectomy, Laparoscopic/adverse effects , Drainage/methods , Cholecystitis/surgeryABSTRACT
OBJECTIVE: To find out if nuclear morphometry is a useful indicator of prognosis in patients with familial adenomatous polyposis (FAP) before and after treatment with sulindac. DESIGN: Open study. SETTING: Teaching hospital, Spain. SUBJECTS: 29 patients (17 women and 12 men) with FAP who had been treated by colectomy. There were two control groups: 17 people with healthy rectal mucosa and 10 patients with colorectal cancer. INTERVENTIONS: The 29 patients with FAP were treated with sulindac 150 mg orally twice daily for 6 months. MAIN OUTCOME MEASURES: Results of histological examination of biopsy specimens and nuclear morphometry. RESULTS: Before treatment, all patients with FAP had nuclei of cells in the rectal mucosa that were intermediate in size between those in healthy mucosa (small nuclei) and those in cancer (large nuclei). After 6 months' treatment with sulindac the patients with FAP no longer had any polyps and the size of the nuclei was similar to those in healthy mucosa. Only 1 patient failed to respond, and in this patient one of the polyps subsequently became malignant. CONCLUSIONS: Nuclear morphometry may be useful in identifying patients with FAP who are at high risk of malignant degeneration.
Subject(s)
Adenomatous Polyposis Coli/pathology , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Intestinal Mucosa/pathology , Rectum/pathology , Sulindac/therapeutic use , Adenomatous Polyposis Coli/drug therapy , Adenomatous Polyposis Coli/surgery , Adolescent , Adult , Colorectal Neoplasms/pathology , Female , Humans , MaleABSTRACT
Introducción. El incremento de la expectativa de vida en los pacientes con poliposis adenomatosa familiar está permitiendo, entre otras circunstancias, apreciar una mayor variabilidad de formas y localizaciones en las manifestaciones extracolónicas de la enfermedad. A pesar de ser muy escasas las referencias bibliográficas, para algunos autores la prevalencia de masas adrenales en la poliposis adenomatosa familiar es mayor que en el resto de la población. Caso clínico. Se presenta el caso de un paciente al que 10 años antes se le había realizado una colectomía total y anastomosis ileorrectal por poliposis adenomatosa familiar, que fue diagnosticado de un pólipo degenerado en el muñón rectal y una masa adrenal derecha no funcionante simultáneamente. Conclusión. Cuál es la mejor actitud diagnóstica ante estas lesiones y cuál la estrategia terapéutica más adecuada en el contexto de una enfermedad genética, caracterizada por su tendencia a la proliferación celular y la degeneración maligna, son aspectos controvertidos. Por el momento, nada indica que las pautas de diagnóstico, seguimiento y tratamiento de dichas lesiones deban ser diferentes de las empleadas en la población general (AU)
Subject(s)
Adult , Male , Humans , Adenocarcinoma/diagnosis , Adenocarcinoma/epidemiology , Post Disaster Reconstruction/methods , Adenoma/complications , Adenoma/diagnosis , Adenoma/metabolism , Adenomatous Polyposis Coli/complications , Adenomatous Polyposis Coli/diagnosis , Adenomatous Polyposis Coli/epidemiology , Adenomatous Polyposis Coli/etiology , Adenomatous Polyposis Coli/surgery , Colectomy/methods , Colectomy , Anastomosis, Surgical/methods , Anastomosis, Surgical , Biopsy , Ultrasonography/methods , Ultrasonography , Tomography , Neoplasm Metastasis/diagnosisABSTRACT
No disponible
Subject(s)
Adult , Male , Humans , Adenoma , Adenomatous Polyposis Coli , Neoplasms, Multiple Primary , Adrenal Gland NeoplasmsABSTRACT
BACKGROUND: The classic treatment for uncomplicated anal fissure is surgical sphincterotomy, i.e. cutting of the internal anal sphincter, thus eliminating spasm of this muscle and breaking the vicious circle of pain, spasm and inflammation. Recently, however, botulinum toxin has become available for the treatment of muscular dystonias, and thus for anal fissure. In the present study, we investigated the effectiveness of treatment with botulinum toxin in 76 patients with uncomplicated anal fissure. MATERIAL AND METHOD: The 76 patients received an injection of 40 U of botulinum toxin on each side of the fissure. Response was monitored 7, 30 and 90 days later. All patients who did not show clear improvement after 30 days received a second dose of 40 U on each side. RESULTS: After 90 days, 51 patients (67%) showed complete recovery, 19 patients (25%) substantial improvement though not complete recovery, and 6 patients (8%) no significant improvement. Transitory gas incontinence was reported by 2 patients (2.6%), and 1 patient presented hemorrhoidal thrombosis. DISCUSSION: Botulinum toxin enables chemical denervation of the internal sphincter, facilitating healing of the anal fissure. Its principal advantages with respect to surgical sphincterotomy are the absence of the general risks of surgery, and reduced incidence of incontinence, which even if it occurs tends to be transitory. The technique does not require hospitalization and is well tolerated. It appears suitable for the initial treatment of uncomplicated anal fissure, reserving surgical treatment for those cases which fail to response adequately.
