The easy performance, the absence of major complications and the good results obtained confirm that these methods are effective and safe in the treatment of anal stenosis.

Transanal excision (TE), endoscopic transanal resection (ETAR) and transanal endoscopic microsurgery (TEM) can be used to remove adenomatous polyps. However, their use is limited by the size or location of the tumor. TE is limited to the lower rectum, TEM offers better access to lesions in the middle and upper rectum, and ETAR is used less frequently than it deserves for resection of rectal lesions.

This paper presents a chart review of 17 patients who had been treated for rectovaginal fistula (RVF) from 1996 to 2000. In most cases (13; 76.5%), the fistula was the result of post-surgical complications. Following vaginal mucosa advancement flap repair or repair after conversion to a fourth-degree perineal laceration, 16 (94%) of the rectovaginal fistulae (during the first attempted repair or after failed treatment) were successfully treated. In all patients but one, faecal diversion was avoided. In two patients, fistulography was both a diagnostic procedure and the method of treatment.

Super giant basal cell carcinoma (BCC) is a rare oncological entity. A 52-year-old man with a history of a left upper facial lesion for 11 years was transferred to our facility seeking an evaluation. He frequented multiple hospitals where he was treated with antibiotics for this condition. He reported having the Mohs procedure 8 months prior to this hospital visit but he did not follow-up with the other institution. The physical examination revealed an ulcer involving the upper left orbito-fronto-parieto-temporal area with bone exposure. Both CT and MRI of the face and the brain demonstrated dehiscence of the left lateral orbital roof and left frontal bone. The biopsy confirmed advanced BCC. He was discharged against medical advice and lost to follow-up. He returned 1 month later with left eye discharge and vision loss. He was diagnosed with cerebral abscess, treated with antibiotics and discharged to hospice.

AIM:To detect the presence of human cytomegalovirus (HCMV) proteins and genes on the ileal pouch of patients with ulcerative colitis who have undergone proctocolectomy with ileal pouch-anal anastomosis (iPAA). METHODS:immunohistochemistry, polymerase chain reaction (PCR) and PCR sequencing methods were utilized to test the presence of HCMV in pouch specimens taken from 34 patients in 86 endoscopies. RESULTS:HCMV genes and proteins were detected in samples from 12 (35.2%) patients. The rate of detection was significant in the endoscopies from patients diagnosed with pouchitis (5 of 12, 41.6%), according to the Japanese classification of pouchitis, in comparison to patients with normal pouch (7 of 62, 11.2%; P = 0.021). in all patients with pouchitis in which the HCMV was detected, it was the first episode of pouchitis. The virus was not detected in previous biopsies taken in normal endoscopies of these patients. During the followup, HCMV was detected in one patient with recurrent pouchitis and in 3 patients whose pouchitis episodes improved but whose positive endoscopic findings persisted.CONCLUSION: HCMV can take part in the inflammatory process of the pouch in some patients with ulcerative colitis who have undergone proctocolectomy with iPAA.