scholarly journals Colostomy Takedown: Ischemic Complication following Anorectal Malformation Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Wendy Jo Svetanoff ◽  
Justin Sobrino ◽  
Grace S. Mitchell ◽  
Rebecca M. Rentea
Keyword(s):  
Transverse Colon ◽  
Anorectal Malformation ◽  
Anorectal Malformations ◽  
Contrast Study ◽  
Complex Disorders ◽  
Currarino Syndrome ◽  
Presenting Symptoms ◽  
Ischemic Complications ◽  
Ischemic Complication ◽  
Descending Colon

Introduction. Anorectal malformations (ARM) are complex disorders that often require staged reconstructions. We present a case and imaging findings of a child who developed issues following colostomy closure due to segmental colonic ischemia. Case Presentation. A 3-year-old female with Currarino syndrome presented with abdominal distention, blood-flecked stools, and prolonged cecostomy flush time. For her anorectal malformation, a colostomy was initially placed. A new colostomy was created at posterior sagittal anorectoplasty (PSARP) to allow the distal rectum to reach the anus without tension. Differentials for her presenting symptoms included a mislocation of the anus, stenosis at the anoplasty site, stricture within the colon, or sacral mass from Currarino syndrome, causing obstructive symptoms. Workup at our hospital included an anorectal exam under anesthesia (EUA), which showed a well-located anus with without stenosis at the anoplasty site, and an antegrade contrast study revealed a featureless descending colon with a 3-4 mm stricture in the distal transverse colon at the site of the previous colostomy, without an obstructing presacral mass. To alleviate this obstruction, the child underwent removal of the chronically ischemic descending colon and a redo-PSARP, where the distal transverse colon was brought down to the anus. She is now able to successfully perform antegrade flushes. Conclusion. Patients who have had prior surgeries for ARM repair are at a higher risk of complications, including strictures or ischemic complications at areas of previous surgery or colostomy placement. A thorough preoperative workup, including contrast studies, can alert the surgeon to these potential pitfalls.

scholarly journals Management of Severe Attacks of Ulcerative Colitis with New Technologies

1990 ◽  
Vol 4 (7) ◽  
pp. 347-349
Author(s):  
M Campieri ◽  
P Gionchetti ◽  
A Belluzzi ◽  
M Tampieri ◽  
C Brignola ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Transverse Colon ◽  
Bowel Wall ◽  
New Technologies ◽  
Toxic Megacolon ◽  
Abdominal Ultrasound ◽  
Histological Evaluation ◽  
Excellent Correlation ◽  
Severe Ulcerative Colitis ◽  
Descending Colon

Barium enema and colonoscopy are contraindicated in severe attacks of ulcerative colitis because of the possibility of toxic megacolon and perforation. The authors have assessed abdominal ultrasound in 38 patients with severe ulcerative colitis. Ultrasound revealed bowel wall thicknesses ranging from 3.9 to 9.2 mm (mean 7.7) extending the whole length of the colon, to the transverse colon, and to the descending colon, respectively, in 18, 10 and eight patients. The degree of bowel thickening was related to the severity of inflammation based on clinical, sigmoidoscopic and histological evaluation. In two patients, ultrasound showed a thin bowel wall distended without motility, suggesting the diagnosis of toxic megacolon (confirmed radiologically). An excellent correlation (95%) was found between ultrasound and technetium-99 scanning. Ultrasound might be a reasonable first investigation in the assessment of patients with severe ulcerative colitis.

scholarly journals AUTOPSY FEATURES AT THE ACUTE DESTRUCTIVE PANCREATITIS

2020 ◽  
Vol 28 (2) ◽  
pp. 48-54
Author(s):  
Al'fiya K. Imayeva ◽  
Tagir I. Mustafin
Keyword(s):  
Acute Pancreatitis ◽  
Transverse Colon ◽  
Infectious Agent ◽  
Pathological Process ◽  
Postmortem Examination ◽  
Retroperitoneal Space ◽  
Contrast Study ◽  
Type I ◽  
Type Iii ◽  
The Right

In all variants of the destructive form of pancreatitis, the involvement of adipose tissue of both para-pancreatic and distant localization was noted. In this case, it is necessary to improve the pathological diagnosis of acute destructive pancreatitis. The aim of the study was to develop new techniques for postmortem examination of those who died from complications of acute pancreatitis. Pathological studies were supplemented by the methods proposed by the authors, which made it possible to clarify the spread of the infectious agent through the retroperitoneal tissue. The scheme proposed by the authors for recording changes in the tissue of the pancreas and surrounding tissues after a contrast study made it possible to clarify the main ways of propagation of the purulent-necrotic process along the retroperitoneal tissue. The results of postmortem examination of 67 deaths from complications of acute pancreatitis are presented. Based on the study, 5 types of acute destructive pancreatitis were identified. In type I, the pathological process involves the right half of the retroperitoneal tissue, including the mesentery root of the small intestine, the para-pancreatic region, the right para-kidney and sub-hepatic space. The second type is characterized by the presence of inflammatory and destructive changes in the fiber of the right lateral canal, the actual retroperitoneal space on the right and the mesentery root of the transverse colon. Purulent-necrotic changes in para-pancreatic, left perineal tissue, mesentery of the transverse colon, also in peritoneum were typical for type III acute destructive pancreatitis. For type IV disease, in addition to areas of involvement as in type III, involvement of the pelvic tissue and the left sections of the retroperitoneal space itself were noted. The spread of the infectious agent to both the right and left parts of the retroperitoneal tissue was defined as type V acute destructive pancreatitis.

Regional Differences in Rates of Insorption of Sodium and Water from the Human Large Intestine

1971 ◽  
Vol 49 (12) ◽  
pp. 1023-1029 ◽  
Author(s):  
Ghislain J. Devroede ◽  
Sidney F. Phillips ◽  
Charles F. Code ◽  
James F. Lind
Keyword(s):  
Large Intestine ◽  
Transverse Colon ◽  
Regional Differences ◽  
Deuterium Oxide ◽  
Human Colon ◽  
Close Correlation ◽  
Arterial Blood ◽  
Perfusion Studies ◽  
Descending Colon ◽  
The Times

Regional differences in sodium and water fluxes across the mucosa of the human colon were sought by comparing the arterial appearances of isotopes of sodium and water after instillation of test solutions containing them into four parts of the large intestine. Deuterium oxide and 24Na, in isotonic sodium chloride (154 mM), were placed in the cecum, transverse colon, descending colon, or rectum. The times of appearance and concentration of isotopes in serial samples of arterial blood were integrated with known plasma–disappearance curves to obtain rates of unidirectional flux from colonic lumen to blood (insorption). A gradient of insorption was found. Insorption was most rapid in the cecum and decreased progressively in the transverse colon, descending colon, and rectum. During steady-state perfusion of the entire large intestine the insorption rates of sodium and water, calculated by disappearance of isotopes from the lumen, were intermediate between those observed in the cecum and transverse colon during regional studies. Perfusion studies also revealed a close correlation between insorption and net absorption of sodium and water, implying that a regional gradient of net absorption may exist in the large intestine, analogous to the observed insorption gradient.

scholarly journals Currarino Syndrome (SC): A case at the University Hospital of Mother and Child Lagune Cotonou

2021 ◽  
Vol 4 (2) ◽  
pp. 01-03
Author(s):  
Gbenou A.S
Keyword(s):  
Anorectal Malformations ◽  
University Hospital ◽  
X Ray ◽  
Currarino Syndrome ◽  
Abdominal Approach ◽  
Operative Specimen ◽  
Mother And Child ◽  
Posterior Sagittal Approach ◽  
Surgery Department ◽  
The University

Introduction: The Currarino syndrome (CS) is one of the rare syndromic forms of anorectal malformations (ARM). Observation: This is the clinical case of a 3 days male newborn admitted for high ARM in the pediatric surgery Department of the Lagune Mother and Child University Hospital of Cotonou. An emergency colostomy was performed. At the age of 7 months as a prelude to anorectoplasty, the distal colography revealed a semilunar pelvic opacity in front of the sacrum. The posterior sagittal approach according to Peña could not reveal the distal end of the intestine. The reconstruction of the sphincter-muscular complex was done on a tracheal tube. The abdominal approach allowed the discovery and resection of a presacral mass. The rectal pouch end found was then lowered. Post-operative follows up was uneventful. The standard postoperative X-ray revealed a partial agenesis of the sacrum. The histology of the operative specimen found a cystic lipoma. The diagnosis of CS was done. The search of a HLXB9 mutation was not possible. Conclusion: The clinical observation associated with standard radiological investigations highlighted the triad: anorectal malformation, presacral tumor, and partial agenesis of the sacrum, which upheld the diagnosis of CS; but the search for an indispensable HLXB9 mutation was lacking for the genetic link.

scholarly journals The analysis of continence after posterosagital anorectoplasty in anorectal malformation patients in Wahidin Sudirohusodo hospital of Makassar

2019 ◽  
Vol 7 (6) ◽  
pp. 2022
Author(s):  
Alwi Lawile ◽  
Farid Nur Mantu ◽  
Nita Mariana ◽  
Arifin Seweng
Keyword(s):  
Gender Differences ◽  
Medical Records ◽  
Anorectal Malformation ◽  
Anorectal Malformations ◽  
Posterior Sagittal Anorectoplasty ◽  
Perineal Fistula ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
The One

Background: The management of anorectal malformations universally uses posterior sagittal anorectoplasty (PSARP) as standard surgery. The aim of this research was to determine continence in patients with anorectal malformation after PSARP action.Methods: This study was a descriptive analytical categorical research with cross sectional design. The data were obtained from patients’ medical records and questionnaire given to patients underwent PSARP in Wahidin Sudirohusodo Hospital and network hospitals from June 1 to December 1, 2018. The analysis was done to 60 children ranging from 5 to 8 years old. Most of them were male (56.7%) ranging from 5 to 6 years old (53.3%).Results: The results of the research indicated that based on malformation subtype, most of them suffered from rectourethra fistula (40.0%) with continence problem (61.7%). There was no significant correlation between sex and continence problem (p >0.05). However, it was seen that the percentage of continence subjects was higher in female (65.4%) than in male (58.8%), while the percentage of soiling and constipated subjects was higher in male than in female. Rectourethra fistula was found more frequently in male than in female (70.6%), while vestibuler fistula was found more frequently in female (69.2%). There was no significant correlation between age and defecation problem (p >0.05). However, the percentage of continence and soiling subjects was higher in 5-6 years children then the one for 7-8 year children, while the percentage of constipated subjects was higher in 7-8 year children (21.4%) than 5-8 year children (18.8%).Conclusions: Gender differences in the outcome of children with anorectal malformations must be considered. Men with perineal fistula were likely to experience continence and constipation than women with perineal fistulas. Women with perineal fistulas and vestibular fistulas had almost similar outcome.

scholarly journals Comparison of frequency of complications in loop versus divided colostomy in patients with high variety anorectal malformation

2020 ◽  
Vol 9 ◽  
pp. 4
Author(s):  
Masood Shah ◽  
Nabi Bux Napar ◽  
Faryal Ilyas Jhammat ◽  
Hafiza Shehla Arshad ◽  
Mohammed Saleem
Keyword(s):  
Anorectal Malformation ◽  
Parastomal Hernia ◽  
Anorectal Malformations ◽  
Operational Definition ◽  
P Value ◽  
Group A ◽  
Group B ◽  
Surgery Department ◽  
Stoma Prolapse ◽  
Sigmoid Colostomy

Background: The objective of this study was to compare frequency of stoma related complications of loop versus divided sigmoid colostomy for the management of high variety anorectal malformations. Methodology: This RCT was conducted in the department of Pediatrics Surgery Department of the Children’s Hospital and the Institute of Child Health Lahore, for the period of one year from 1st May 2016 to 1st June 2017. One hundred and twenty patients (Sixty patients in each group) of anorectal malformation meeting inclusion criteria were taken in this study. Patients were divided into two groups randomly using lottery method; loop sigmoid colostomy in Group-A and divided sigmoid colostomy in Group-B. After surgeries patients were followed weekly up till 8 weeks. Stoma related complications (as per operational definition) were noted. Results: The mean age in group –A and group-B were 3.34 ± 1.12 days and 3.36 ± 0.97 days, respectively. In group – A there were 52(86.67%) male and 8(13.33%) females, and in group-B there were 45(75%) male and 15(25%) female patients. In group-A 22(36.66%) patients had complications [3(5.00%) patients had retraction, 8(13.33%) had prolapse, 4(6.67%) had stoma obstruction, parastomal hernia were seen in 4(6.67%), stoma necrosis were seen in 3 (5.00%)] and in group-B, 16(26.66%) patients had different complications [1(1.67%) patients had retraction, 3(5.00%) had prolapse, 5(8.33%) had stoma obstruction, parastomal hernia were seen in 2(3.3%), stoma necrosis were seen 5(8.33%)]. The complications in group-A were higher when compared to group-B, but (p-value = 0.650) were not significant statistically except for stoma prolapse. Conclusion: Though complication rate in both techniques is not statistically different but frequency of stoma prolapse is more in loop colostomy group. Therefore, divide colostomy should be opted as preferred technique.

2q33.1q34 Deletion in a Girl with Brain Anomalies and Anorectal Malformation

2016 ◽  
Vol 150 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Luisa Ronzoni ◽  
Antonio Novelli ◽  
Giulia Brisighelli ◽  
Angela Peron ◽  
Fabio Triulzi ◽  
...  
Keyword(s):  
Anorectal Malformation ◽  
Genomic Dna ◽  
Anorectal Malformations ◽  
Speech Delay ◽  
Feeding Problems ◽  
Microdeletion Syndrome ◽  
Behavioural Phenotype ◽  
Tooth Abnormalities ◽  
Brain Anomalies ◽  
Sparse Hair

2q33 deletions are considered to constitute a distinct clinical entity (Glass syndrome or 2q33 microdeletion syndrome) with a characteristic phenotype. Most patients have moderate to severe developmental delay, speech delay, a particular behavioural phenotype, feeding problems, growth restriction, a typical facial appearance, thin and sparse hair, tooth abnormalities, and skeletal anomalies. Here, we report on a patient with a 2q33.1q34 deletion spanning 8.3 Mb of genomic DNA. Although her clinical features are very reminiscent of the 2q33 microdeletion syndrome, she also presented with brain and anorectal malformations. Based on the present and published patients with 2q33 deletions, we suggest that the critical region for the Glass syndrome may be larger than initially proposed. Moreover, we suggest that brain abnormalities might be an additional feature of the 2q33 microdeletion syndrome, but that anorectal malformation is likely not a key marker.

scholarly journals Anatomical study on origin, course and distribution of cranial and caudal mesenteric arteries in the White New Zealand rabbit (Orycotolagus cuniculus)

2012 ◽  
Vol 2 (2) ◽  
pp. 54-59 ◽  
Author(s):  
M Uddin ◽  
ML Rahman ◽  
MA Alam ◽  
ASML Ahasan
Keyword(s):  
New Zealand ◽  
Abdominal Aorta ◽  
Transverse Colon ◽  
Mesenteric Artery ◽  
Mesenteric Arteries ◽  
Middle Colic Artery ◽  
Colic Artery ◽  
Left Wall ◽  
Zealand Rabbit ◽  
Descending Colon

The present study was carried out on fifteen healthy adult White New Zealand rabbit (Orycotolagus cuniculus) to clarify the obscure mesenteric arteries, which and their branches which are usually involved in intestinal surgery. The mesenteric artery is a high caliber vessel, 2cm in length dependent on the abdominal aorta, right below the emergence of the vessels destined for the liver and stomach. The animals were sacrificed, injecting diazepam (30 mg/kg) in jugular vein. Cannulation of the abdominal aorta, perfusion with warmed water (40ºC) and stained latex injection (Neoprene 450, Capitol Scientific, Austin, U.S.A, Red carmine stain) were performed, followed by fixation. With formalin (10%) the dissection and photographic documents (Casio Cyber-shot, 12.1 mega pixels) made it possible to systemize the arteries and define the vascular patterns of the viscera. The results prone that the cranial mesenteric artery of the White New Zealand rabbit (Orycotolagus cuniculus) arose from the abdominal aorta, at the level of the second lumbar vertebra, entered the cranial mesentery forming its root, then proceeded caudoventrally in the mesojejunum and continued as the last cecal artery. The cranial mesenteric artery gave off: - Caudal pancreaticoduodenal artery to the right lobe of the pancreas and the descending and ascending parts of the duodenum. Middle colic artery, a small vessel (frequently two) arising from the left wall and passing to the transverse colon, Eighteen to twenty jejunal arteries, Ileocecocolic artery to the ileum, cecum, ascending colon, transverse colon and the cranial part of the descending colon. The caudal mesenteric artery arose from the abdominal aorta at the level of the caudal border of the root of the 6th lumbar transverse process, passed caudoventrally in the descending mesocolon, then divided into: left colic artery to the caudal two thirds of the descending colon, and cranial rectal artery to the cranial segment of the rectum. The obtained results were compared with their corresponding in the domestic animals, especially the domestic carnivores and laboratory animals. DOI: http://dx.doi.org/10.3329/ijns.v2i2.11386 International Journal of Natural Sciences (2012), 2(2):54-59

scholarly journals Anorectal Malformations

2018 ◽  
Vol 31 (02) ◽  
pp. 061-070 ◽  
Author(s):  
Richard Wood ◽  
Marc Levitt
Keyword(s):  
Anorectal Malformation ◽  
Functional Results ◽  
Anorectal Malformations ◽  
Long Term Results ◽  
Anatomical Reconstruction ◽  
Associated Anomalies ◽  
Individualized Treatments

AbstractAnorectal malformation are common congenital problems occurring in 1 in 5,000 births and have a spectrum of anatomical presentations, requiring individualized treatments for the newborn, sophisticated approaches to the definitive reconstruction, and management of long-term treatments and outcomes. Associated anomalies related to the cardiac, renal, gynecologic, orthopedic, spinal, and sacral systems impact care and prognosis. Long-term results are good provided there is an accurate anatomical reconstruction and a focus on maximizing of functional results.

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