ABSTRACT
OBJECTIVE: The treatment of ano- or rectovaginal fistula is still difficult. The use of the Martius flap is well described as an adjunctive technique in their repair. We report our experience of a modified Martius flap in the management of ano- or rectovaginal fistula. METHOD: This is a retrospective study of 14 women presenting with an anovaginal (n = 9) or rectovaginal fistula (n = 5). All were treated by a modified Martius graft. The aetiology included Crohn's disease (n = 7), ulcerative colitis (n = 4), radio-induced (n = 1), obstetric (n = 1) and villous tumour (n = 1). RESULTS: All 14 fistulas healed within the 3 months after surgery. Subsequently, two patients with Crohn's disease required an abdominoperineal resection owing to progressive anal lesions. Two other patients experienced faecal incontinence which improved with functional rehabilitation treatment. CONCLUSION: A modified Martius flap is a valuable option in the treatment of ano- or rectovaginal fistula. In the case of Crohn's disease, however, the prognosis depends primarily on subsequent clinical evolution of the condition.
Subject(s)
General Surgery/methods , Rectovaginal Fistula/therapy , Transplants , Vaginal Fistula/therapy , Adolescent , Adult , Crohn Disease/surgery , Crohn Disease/therapy , Fecal Incontinence/therapy , Female , Humans , Middle Aged , Models, Anatomic , Rectovaginal Fistula/surgery , Retrospective Studies , Time Factors , Vaginal Fistula/surgeryABSTRACT
We report the case of a 6-year-old boy who showed a large epidermal nevus mixed with a plexiform neurofibroma, which was associated with "café au lait" macules and a nephroblastoma. This association could not be classified in one of the five well defined epidermal nevus syndrome. To our knowledge this is the first time that this type of epidermal nevus syndrome has been described, which raises the question of the relationship between neurofibromatosis 1, nephroblastoma and epidermal nevus.
Subject(s)
Kidney Neoplasms/complications , Neurofibromatosis 1/complications , Nevus/complications , Skin Neoplasms/complications , Wilms Tumor/complications , Child , Humans , Kidney Neoplasms/pathology , Male , Neurofibromatosis 1/pathology , Nevus/pathology , Skin Neoplasms/pathology , Wilms Tumor/pathologyABSTRACT
Chronic osteomyelitis is a severe long-term bone infection which retains its mechanical qualities. The authors report 10 cases of osteomyelitis of the tibia treated by muscular and fascio-cutaneous flaps and reviewed at one year follow-up. Four cases concerned the third upper part of the tibia, 3 the middle and 3 the lower third. Two total failures at the third lower part and three complications which finally healed with delay were observed. The results of this small series compared with the reports in the literature suggest the value of large excision with coverage by a well vascularized flap and the need for antibiotics. The choice of flap is related to type and site of the bone defect. Another question should be raised concerning the surgical strategy in one--or two--stage management and the duration of antibiotic therapy.
Subject(s)
Leg Ulcer/surgery , Osteitis/surgery , Surgical Flaps , Tibia , Adolescent , Adult , Aged , Chronic Disease , Female , Humans , Male , Middle AgedABSTRACT
INTRODUCTION: The pathogenesis of necrotizing cellulitis remains uncertain. Factors that enhance clot formation may contribute to tissue necrosis. CASE REPORT: A case of necrotizing cellulitis of the penis in a patient with a transient protein S deficiency, is reported. CONCLUSION: The responsibility of this transient hypercoagulable state in the occurrence of tissue necrosis in this patient is discussed.
Subject(s)
Blood Coagulation Disorders/complications , Cellulitis/etiology , Penile Diseases/etiology , Protein S Deficiency , Adult , Cellulitis/blood , Debridement , Humans , Male , Necrosis , Penile Diseases/blood , Penile Diseases/surgery , Skin TransplantationABSTRACT
A case is reported of an isolated aneurysm of the common hepatic artery revealed by pain in liver region. The etiology is mainly dominated by atheroma and media dysplasia. Detection is currently during investigation of a pain syndrome or jaundice and no longer after rupture of aneurysm. Ultrasound imaging value is emphasized and angiography provides valuable data. Surgical treatment and particularly the indication for hepatic revascularization are discussed as a function of anamnestic and angiographic arguments and intraoperative findings.
