scholarly journals A novel template for anorectal fistula reporting in anal endosonography and MRI – a practical concept

2019 ◽  
Vol 21 (4) ◽  
pp. 483
Author(s):  
Iwona Sudoł-Szopińska ◽  
Małgorzata Kołodziejczak ◽  
Giulio Santoro Aniello
Keyword(s):  
Preoperative Evaluation ◽  
Preoperative Assessment ◽  
Fistula Tract ◽  
Anal Endosonography ◽  
Anorectal Fistula ◽  
Resonance Imaging ◽  
Anal Sphincters ◽  
Fistula Surgery ◽  
Magnetic Resonance Imaging Mri

Anorectal fistula surgery is associated with risks of recurrence and/or faecal incontinence due to anal sphincter injuries. In order to minimise these complications, preoperative evaluation of the anatomy of the fistula tract and morphology of the anal sphincters is mandatory. Anal endosonography (AES) and Magnetic Resonance Imaging (MRI), due to high resolution of images and ability to identify a number of fistula elements which are important for surgeons in treatment planning, are the methods of choice in the diagnosis of anorectal fistulas.In this paper, a new template for endosonographic and MRI report, systematically describing all anorectal fistula’s characteristics, is presented. This template provides practical information for the surgeon, useful in preoperative assessment and postoperative follow-up.

Transanal Opening of Intersphincteric Space for Fistula-in-Ano

2021 ◽  
pp. 000313482198904
Author(s):  
Yu-bo Li ◽  
Ju-hua Chen ◽  
Meng-di Wang ◽  
Jun Fu ◽  
Bing-chuan Zhou ◽  
...  
Keyword(s):  
Fistula Tract ◽  
Resonance Imaging ◽  
Clinical Database ◽  
Fistula In Ano ◽  
Fistula Surgery ◽  
P 16 ◽  
Preoperative Magnetic Resonance ◽  
Intersphincteric Fistula

Background The role of the intersphincteric space in the pathogenesis of fistula-in-ano is being increasingly recognized. Submucosal and intersphincteric rectal abscesses have been surgically managed by laying open and draining the intersphincteric space as well as by the modified ligation of intersphincteric fistula tract (LIFT) procedure. In 2017, the transanal opening of intersphincteric space (TROPIS) technique was reported for the treatment of high, complex anal fistulae. Aim We aim to investigate the advantages of performing the TROPIS procedure in patients with fistula-in-ano. Methods This was a prospective cohort study investigating the outcomes in patients who had undergone a procedure using the TROPIS technique for the treatment of fistula-in-ano. Preoperative magnetic resonance imaging scans and electronic colonoscopies were performed on all patients. A clinical database evaluating the following variables was constructed: age, gender, body mass index (BMI), previous fistula surgery, type of fistula, postoperative complications, duration of follow-up, success rate, and incontinence scores pre- and postoperatively. Results The TROPIS procedure was performed on 41 patients with fistula-in-ano with a follow-up time of 6-23 months. The characteristics of the patients were as follows: 36 males, 6 females, mean age 38.6±13.2 years, and mean BMI 23.5±3.9 kg·m−2. All patients (41) had transsphincteric fistulae, and 90.2% (37) had high fistula. Of the 41 patients, 22% (9) had recurrent fistulae, 29.27% (12) had horseshoe fistulae, 7.3% (3) had supralevator fistulae, and 14.6% (6) had an associated abscess. The fistula healed completely in 85.3% (35) of patients and failed to heal in 14.7% (6) of patients, and the healing of high fistula was 86.5% (32). Of those patients who had not healed completely, 2 were found to have contracted iatrogenic infections due to foreign residues and underwent surgery with the passing of a loose seton. The additional 4 patients who had not healed underwent a fistulotomy and healed completely thereafter. There were no significant changes in incontinence scores. The incontinence scores were .15 ± .36 preoperatively and .22 ± .47 3 months postoperatively (t = −1.438, P = .16). Conclusions The TROPIS technique is a novel sphincter-preserving procedure, which can be effectively used in treating fistula-in-ano.

Magnetic Resonance Imaging (MRI) Diagnosis of Fetal Corpus Callosum Abnormalities and Follow-up Analysis

2021 ◽  
pp. 088307382110162
Author(s):  
Xu Li ◽  
Qing Wang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Corpus Callosum ◽  
Resonance Imaging ◽  
Neurodevelopmental Delay ◽  
Mri Diagnosis ◽  
Magnetic Resonance Imaging Mri ◽  
Lost To Follow Up ◽  
Singleton Pregnancies

Objectives: We analyzed the magnetic resonance imaging (MRI) manifestations of fetal corpus callosum abnormalities and discussed their prognosis based on the results of postnatal follow up. Methods: One hundred fifty-five fetuses were diagnosed with corpus callosum abnormalities by MRI at our hospital from 2004 to 2019. Gesell Development Scales were used to evaluate the prognosis of corpus callosum abnormalities after birth. Results: Corpus callosum abnormalities were diagnosed in 149 fetuses from singleton pregnancies, and 6 pairs of twins, 1 in each pair is a corpus callosum abnormality. Twenty-seven cases (27/155) were lost to follow up, whereas 128 cases (128/155) were followed up. Of these, 101 cases were induced for labor, whereas 27 cases were born naturally. Among the 27 cases of corpus callosum abnormality after birth, 22 cases were from singleton pregnancies (22/27). Moreover, 1 twin from each of 5 pairs of twins (5/27) demonstrated corpus callosum abnormalities. The average Gesell Development Scale score was 87.1 in 19 cases of agenesis of the corpus callosum and 74.9 in 3 cases of hypoplasia of the corpus callosum. Among the 5 affected twins, 2 had severe neurodevelopmental delay, 2 had mild neurodevelopmental delay, and 1 was premature and died. Conclusion: The overall prognosis of agenesis of the corpus callosum is good in singleton pregnancies. Hypoplasia of the corpus callosum is often observed with other abnormalities, and the development quotient of hypoplasia of the corpus callosum is lower compared with agenesis of the corpus callosum. Corpus callosum abnormalities may occur in one twin, in whom the risk may be increased.

scholarly journals Bone marrow abnormalities detected by magnetic resonance imaging as initial sign of hematologic malignancies

2018 ◽  
Author(s):  
Ida Sofie Grønningsæter ◽  
Aymen Bushra Ahmed ◽  
Nils Vetti ◽  
Silje Johansen ◽  
Øystein Bruserud ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Cell Types ◽  
Hematologic Malignancies ◽  
Resonance Imaging ◽  
Initial Sign ◽  
Magnetic Resonance Imaging Mri

The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.

Gluteal protuberance as a first symptom of branched pilonidal sinus with anal fistula – case report

Nowa Medycyna ◽  
2019 ◽  
Vol 26 (4) ◽  
Author(s):  
Katarzyna Krasińska ◽  
Szymon Głowacki ◽  
Tomasz Pokładowski ◽  
Feliks Orchowski
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Anal Fistula ◽  
Pilonidal Sinus ◽  
Fistula Tract ◽  
Anal Sphincters ◽  
Postoperative Course ◽  
Complete Cure ◽  
Left Buttock

The authors present the case of a patient who underwent a surgery due to a branched pilonidal sinus with branching to anal sphincters and a purulent cistern in the left buttock. The lesion was diagnosed accidentally. The patient’s main ailments were non-specific buttock pains experienced for several months, which were followed by periodic febrile states. Advanced diagnostics of this region was planned and carried out. The patient was qualified for Bascom II procedure with simultaneous excision of the anal fistula tract and opening of the left buttock fluid cistern. No complications were observed in the postoperative course. The follow-up after 2 months showed no recurrence. The authors emphasize the fact that the lesions of the gluteal cleft are difficult to diagnose, diagnosed late and often asymptomatic. Proper diagnostics and proper surgical technique allow for complete cure.

scholarly journals Multifocal Balo's Concentric Sclerosis in Children: Report of a Case and Review of Literature

2017 ◽  
Vol 08 (S 01) ◽  
pp. S136-S138
Author(s):  
Sanjeev Kumar Bhoi ◽  
Suprava Naik ◽  
Jayantee Kalita ◽  
U. K. Misra
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Acute Disseminated Encephalomyelitis ◽  
Review Of Literature ◽  
Resonance Imaging ◽  
Concentric Pattern ◽  
Baló’S Concentric Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Post Infectious

ABSTRACTBalo's concentric sclerosis (BCS) is a rare demyelinating lesion considered to be a variant of multiple sclerosis (MS). On magnetic resonance imaging (MRI) Balo's concentric sclerosis shows the typical concentric pattern. We report a case of 10 year old child with BCS who presented as post infectious acute disseminated encephalomyelitis (ADEM). He is asymptomatic and had no relapse after 6 years of follow-up.

scholarly journals Short-lasting unilateral neuralgiform headache with autonomic symptoms associated with idiopathic hypertrophic pachymeningitis

2018 ◽  
Vol 1 ◽  
pp. 251581631879054
Author(s):  
J Matthijs Biesbroek ◽  
Dirk R Rutgers ◽  
Sander van Gulik ◽  
Catherina JM Frijns
Keyword(s):  
Brain Mri ◽  
Resonance Imaging ◽  
Hypertrophic Pachymeningitis ◽  
Trigeminal Autonomic Cephalalgia ◽  
Autonomic Symptoms ◽  
Meningeal Inflammation ◽  
Magnetic Resonance Imaging Mri ◽  
Multiple Episodes ◽  
Rule Out

Short-lasting unilateral neuralgiform headache with autonomic symptoms (SUNA) is a rare form of trigeminal autonomic cephalalgia. SUNA is frequently associated with a trigeminal neurovascular conflict and rarely occurs secondary to other intracranial pathology. We report a patient with SUNA that was associated with ipsilateral meningeal inflammation caused by idiopathic hypertrophic pachymeningitis (HP). During the 9-year follow-up, she experienced multiple episodes of SUNA, most of which occurred during exacerbations of the pachymeningitis. This is the third case of SUNA associated with HP reported in the literature. Based on this observation, we suggest that in patients presenting with SUNA, besides dedicated magnetic resonance imaging (MRI) of the trigeminal nerve, gadolinium-enhanced brain MRI should be performed to rule out HP.

scholarly journals Pineocytoma with diffuse dissemination to the leptomeninges

Rare Tumors ◽  
2011 ◽  
Vol 3 (4) ◽  
pp. 163-165 ◽  
Author(s):  
Caitlin Gomez ◽  
Jeffrey Wu ◽  
Whitney Pope ◽  
Harry Vinters ◽  
Antonio DeSalles ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Radiotherapy ◽  
Leptomeningeal Dissemination ◽  
Resonance Imaging ◽  
Pineal Parenchymal Tumors ◽  
Craniospinal Radiation ◽  
Long Term Follow Up ◽  
Magnetic Resonance Imaging Mri

Pineal parenchymal tumors are rare. Of the three types of pineal parenchymal tumors, pineocytomas are the least aggressive and are not known to diffusely disseminate. In this paper, we report the successful treatment of a case of pineocytoma with diffuse leptomeningeal relapse following initial stereotactic radiotherapy. A 39-year-old female presented with headaches, balance impairment, urinary incontinence, and blunted affect. A pineal mass was discovered on magnetic resonance imaging (MRI). A diagnosis of pineocytoma was established with an endoscopic pineal gland biopsy, and the patient received stereotactic radiotherapy. Ten years later, she developed diffuse leptomeningeal dissemination. The patient was then successfully treated with craniospinal radiation therapy. Leptomeningeal spread may develop as late as 10 years after initial presentation of pineocytoma. Our case demonstrates the importance of long-term follow-up of patients with pineal parenchymal tumors following radiation therapy, and the efficacy of craniospinal radiation in the treatment of leptomeningeal dissemination.

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