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.
Introduction Proctologic examination is a deeply intimate procedure which deals with a body area in which prejudices, taboos and constraints prevail, and may also relate to previous trauma; yet this procedure is of paramount importance for the investigation of patients with symptoms that foretell pathologies associated with distal colon, rectum and anus. Objectives This study aimed to analyze all cases scheduled of rigid proctosigmoidoscopy performed by the Coloproctology Service, Hospital Santa Marcelina, in 8 of its 10 years of residency in the specialty. Materials and methods We analyzed mean age, gender distribution, device's height of reach in relation to the anal verge, the percentage of abnormal tests stratified to perform, or not perform, anoscopy and proctosigmoidoscopy, and major diseases detected. Results 844 rigid proctosigmoidoscopy procedures scheduled and performed by the Coloproctology Service, Hospital Santa Marcelina, between September 2006 and August 2014, were analyzed. The distribution was similar between genders and the mean age was 51.2 years. With respect to the device's height of reach from the anal verge, these values were stratified as follows: distance reached >15 cm, 10–15 cm, and <10 cm from the anal verge. Distances >15 cm from the anal verge were attained in 692 (82% of RR) tests, between 10 and 15 cm in 94 (11.1%) tests, and <10 cm in 58 (6.9%) tests. Conclusion In this study, it was found that proctology examination and rigid proctosigmoidoscopy are mandatory procedures in cases of symptoms depending on these practices.
Parastomal hernia (PH) is a type of incisional hernia which forms together with the opening of the abdominal wall used for the externalization of a stoma and the risk of parastomal hernia is increases in cases of technical error, advanced age, increased intraabdominal pressure, ascites, skin infection, intestinal constipation, malnutrition, chronic cough, obesity, diabetes mellitus, a sedentary lifestyle, immunosupression and corticosteroid use. Objective: The aim of this article is to report a case of paraileostomy hernia involving the biliary vesicle. Case report: female patient, 80 years of age, with a previous history of radical cystectomy with Bricker ileostomy, complaining of colic abdominal pain in the lower right quadrant for 5 days and gradual progression associated with vomiting and fecal constipation, but with the expulsion of flatulence. At admission the patient presented a distended abdomen, with evidence of a voluminous incisional hernia in the median operating wound, as well as paraileostomy hernia where pain and hyperemia were present in the anterior axillary line Conclusion: Incarceration and strangulation of the biliary vesicle in a paraileostomal hernia of a Bricker is an extremely rare gastrointestinal condition of urgency with a diagnosis made generally intraoperatively
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