Annals of Colorectal Research Annals of Colorectal Research Ann Colorectal Res http://www.colorectalresearch.com 2322-5262 2322-5289 10.5812/acr. en jalali 2017 6 25 gregorian 2017 6 25 2 1
en 10.17795/acr-17769 New Techniques in Anal Fistula Management New Techniques in Anal Fistula Management review-article review-article Context

The management of complicated anal fistula is a serious issue in coloproctology. Various methods have been described but the choice must be made based on the course of the fistula tract in relation to the sphincter. As anal fistulas are caused by anal gland infection, the anal gland and ducts should be removed for the process of healing to begin and for the anal sphincter preservation. The aim of this study is to briefly explain and assess three new sphincter preserving surgical treatments, including fibrin glue and anal plug techniques and the procedure of ligation of intersphincteric fistula tract (LIFT) and also to evaluate the failure and success rates of these techniques.

Evidence Acquisition

We conducted a search in the literature of the last decade, in the PubMed database, using the keywords: anal Fistula, LIFT procedure, fibrin glue and anal plug.

Results

Using anal fistula plug provides another option for the treatment of complex anal fistulas and does appear to be an effective technique in some cases. The technique of intersphincteric fistula tract ligation as a fistula treatment surgery, aims for total anal sphincter preservation and appears to be both safe and easy to perform, with encouraging early outcomes. The authors suggest further controlled studies comparing the LIFT procedure with standard therapies.

Conclusions

Fibrin sealant injection should be in the armamentarium of the specialists' surgical treatments for fistula-in-ano. The surgeons and their patient should be aware of the limited success expectations, when using fibrin glue technique as the treatment.

Context

The management of complicated anal fistula is a serious issue in coloproctology. Various methods have been described but the choice must be made based on the course of the fistula tract in relation to the sphincter. As anal fistulas are caused by anal gland infection, the anal gland and ducts should be removed for the process of healing to begin and for the anal sphincter preservation. The aim of this study is to briefly explain and assess three new sphincter preserving surgical treatments, including fibrin glue and anal plug techniques and the procedure of ligation of intersphincteric fistula tract (LIFT) and also to evaluate the failure and success rates of these techniques.

Evidence Acquisition

We conducted a search in the literature of the last decade, in the PubMed database, using the keywords: anal Fistula, LIFT procedure, fibrin glue and anal plug.

Results

Using anal fistula plug provides another option for the treatment of complex anal fistulas and does appear to be an effective technique in some cases. The technique of intersphincteric fistula tract ligation as a fistula treatment surgery, aims for total anal sphincter preservation and appears to be both safe and easy to perform, with encouraging early outcomes. The authors suggest further controlled studies comparing the LIFT procedure with standard therapies.

Conclusions

Fibrin sealant injection should be in the armamentarium of the specialists' surgical treatments for fistula-in-ano. The surgeons and their patient should be aware of the limited success expectations, when using fibrin glue technique as the treatment.

Anal Fistula;Rectal Fistula;Fecal Incontinence;Anal Sphincter Anal Fistula;Rectal Fistula;Fecal Incontinence;Anal Sphincter http://www.colorectalresearch.com/index.php?page=article&article_id=17769 Rasoul Azizi Rasoul Azizi Department of Colorectal Surgery, Rasoul Akram Medical Center, Iran University of Medical Sciences (IUMS), Tehran, IR Iran; Department of Colorectal Surgery, Rasoul Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9121242149, Fax: +98-2166509056 Department of Colorectal Surgery, Rasoul Akram Medical Center, Iran University of Medical Sciences (IUMS), Tehran, IR Iran; Department of Colorectal Surgery, Rasoul Akram Medical Center, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9121242149, Fax: +98-2166509056 Saman Mohammadipour Saman Mohammadipour Department of Colorectal Surgery, Rasoul Akram Medical Center, Iran University of Medical Sciences (IUMS), Tehran, IR Iran Department of Colorectal Surgery, Rasoul Akram Medical Center, Iran University of Medical Sciences (IUMS), Tehran, IR Iran
en 10.17795/acr-18991 Middle East Experience With Transanal Endoscopic Microsurgery (TEM) Middle East Experience With Transanal Endoscopic Microsurgery (TEM) research-article research-article Background

Transanal Endoscopyic Microsurgery (TEM) has been a new method of micro invasive surgery for management of special conditions. Big deal of this procedure is avoiding of open abdominal surgeries or better exposure in transanal approches.

Objectives

The purpose of this study was to present a single institutional experience in Shiraz, Iran regarding the application of Transanal Endoscopic Microsurgery (TEM). To our knowledge this is the first report from the Middle East.

Patients and Methods

Between 2009 and 2012, thirty patients underwent TEM in our center. We assessed complications and recurrence rate. Patients with fewer than six months of follow-up were excluded.

Results

Patients included 17 men and 13 women with the mean age of 44.4 years (ranged 17-80). The mean tumor distance from the anal verge was 9.8 cm. One patient with adenomatous polyp experienced recurrence 14 months postoperatively. Regarding procedure-related complications, one case developed hemorrhage and another one fever and infection in the site of operation. Two patients experienced incontinence for about 3 weeks after TEM surgery.

Conclusions

Considering the cultural and religious context of the Middle East, we recommend TEM procedure in specialized centers in this part of the world.

Background

Transanal Endoscopyic Microsurgery (TEM) has been a new method of micro invasive surgery for management of special conditions. Big deal of this procedure is avoiding of open abdominal surgeries or better exposure in transanal approches.

Objectives

The purpose of this study was to present a single institutional experience in Shiraz, Iran regarding the application of Transanal Endoscopic Microsurgery (TEM). To our knowledge this is the first report from the Middle East.

Patients and Methods

Between 2009 and 2012, thirty patients underwent TEM in our center. We assessed complications and recurrence rate. Patients with fewer than six months of follow-up were excluded.

Results

Patients included 17 men and 13 women with the mean age of 44.4 years (ranged 17-80). The mean tumor distance from the anal verge was 9.8 cm. One patient with adenomatous polyp experienced recurrence 14 months postoperatively. Regarding procedure-related complications, one case developed hemorrhage and another one fever and infection in the site of operation. Two patients experienced incontinence for about 3 weeks after TEM surgery.

Conclusions

Considering the cultural and religious context of the Middle East, we recommend TEM procedure in specialized centers in this part of the world.

Rectal Neoplasms;Colorectal Surgery;Microsurgery;Endoscopy;Therapeutics Rectal Neoplasms;Colorectal Surgery;Microsurgery;Endoscopy;Therapeutics http://www.colorectalresearch.com/index.php?page=article&article_id=18991 Seyed Vahid Hosseini Seyed Vahid Hosseini Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Reza Roshanravan Reza Roshanravan Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Abbas Rezaeianzadeh Abbas Rezaeianzadeh Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Salar Rahimikazerooni Salar Rahimikazerooni Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7112306972, Fax: +98-7112330724 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-7112306972, Fax: +98-7112330724 Mastoureh Mohammadipour Mastoureh Mohammadipour Department of Colorectal Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Colorectal Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Ali Saberi Ali Saberi Department of Colorectal Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Colorectal Surgery, Shiraz University of Medical Sciences, Shiraz, IR Iran Hossein Shabahang Hossein Shabahang Department of Colorectal Surgery, Mashhad University of Medical Sciences, Mashhad, IR Iran Department of Colorectal Surgery, Mashhad University of Medical Sciences, Mashhad, IR Iran Ali Reza Safarpour Ali Reza Safarpour Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Leila Ghahramani Leila Ghahramani Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.17795/acr-17264 An Overview of Clinical and Pathological Characteristics and Survival Rate of Colorectal Cancer in Iran An Overview of Clinical and Pathological Characteristics and Survival Rate of Colorectal Cancer in Iran review-article review-article Conclusions

In Iran, colorectal cancer tends to manifest at locally advanced stage with poor prognosis. Therefore, public health strategies, such as screening programs, should be planned for early detection of this aggressive neoplasm.

Evidence Acquisition

The articles published in PubMed without language and time restrictions were included in this review. Only original clinical articles were included in the review and non-clinical studies, including cellular, molecular, genetics, and animal reports, were excluded. The case reports, letters, reviews, and clinical reports with less than 100 patients were excluded, as well. All the clinical data regarding the patients’ demographics, tumor characteristics, and survival rate were collected.

Results

A total of 178 studies were identified at the initial step of literature search. After applying the inclusion and exclusion criteria, 27 studies, including 38073 patients were eligible. The mean age of the patients was 57.2 years, and the male-female ratio was 1.38. Colon, rectum, and rectosigmoid junction accounted for 58%, 28%, and 14% of all colorectal primary sites, respectively. Moreover, the average proportion of the patients with stages 0-I, II, III, and IV was 9%, 39%, 36%, and 16%, respectively. Besides, tumor grades 1, 2, and 3 were reported in 52%, 37%, and 11% of the patients, respectively. Adenocarcinoma (96.8%) was the most frequent histological type. The mean and median survival rate was 80.1 and 55.2 months, respectively. Additionally, the average 5-year overall survival rate was 52.5%.

Context

Colorectal cancer is one of the most common cancers and the leading cause of cancer death in Iran. This study aimed to identify the clinical and pathological characteristics, as well as survival rate of colorectal cancer in Iran.

Conclusions

In Iran, colorectal cancer tends to manifest at locally advanced stage with poor prognosis. Therefore, public health strategies, such as screening programs, should be planned for early detection of this aggressive neoplasm.

Evidence Acquisition

The articles published in PubMed without language and time restrictions were included in this review. Only original clinical articles were included in the review and non-clinical studies, including cellular, molecular, genetics, and animal reports, were excluded. The case reports, letters, reviews, and clinical reports with less than 100 patients were excluded, as well. All the clinical data regarding the patients’ demographics, tumor characteristics, and survival rate were collected.

Results

A total of 178 studies were identified at the initial step of literature search. After applying the inclusion and exclusion criteria, 27 studies, including 38073 patients were eligible. The mean age of the patients was 57.2 years, and the male-female ratio was 1.38. Colon, rectum, and rectosigmoid junction accounted for 58%, 28%, and 14% of all colorectal primary sites, respectively. Moreover, the average proportion of the patients with stages 0-I, II, III, and IV was 9%, 39%, 36%, and 16%, respectively. Besides, tumor grades 1, 2, and 3 were reported in 52%, 37%, and 11% of the patients, respectively. Adenocarcinoma (96.8%) was the most frequent histological type. The mean and median survival rate was 80.1 and 55.2 months, respectively. Additionally, the average 5-year overall survival rate was 52.5%.

Context

Colorectal cancer is one of the most common cancers and the leading cause of cancer death in Iran. This study aimed to identify the clinical and pathological characteristics, as well as survival rate of colorectal cancer in Iran.

Colorectal Neoplasms;Clinical Characteristics;Pathology;Survival Colorectal Neoplasms;Clinical Characteristics;Pathology;Survival http://www.colorectalresearch.com/index.php?page=article&article_id=17264 Sareh Hoseini Sareh Hoseini Cancer Research Center, Omid Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Cancer Research Center, Omid Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran Leila Moaddabshoar Leila Moaddabshoar Student Research Committee, Resident of Radiation Oncology, Shiraz University of Medical Sciences, Shiraz, IR Iran Student Research Committee, Resident of Radiation Oncology, Shiraz University of Medical Sciences, Shiraz, IR Iran Simin Hemati Simin Hemati Department of Radiation Oncology, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Radiation Oncology, Isfahan University of Medical Sciences, Isfahan, IR Iran Mohammad Mohammadianpanah Mohammad Mohammadianpanah Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, P. O. Box: 71936, Shiraz, IR Iran. Tel: +98-7116125168, Fax: +98-7116474320 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, P. O. Box: 71936, Shiraz, IR Iran. Tel: +98-7116125168, Fax: +98-7116474320
en 10.17795/acr-16599 Laparoscopic Appendectomy in Complicated Appendicitis of Children Laparoscopic Appendectomy in Complicated Appendicitis of Children research-article research-article Conclusions

We recommend laparoscopic approach for all children presenting complicated appendicitis as the initial procedure of choice.

Objectives

In this study, we investigated the security, efficacy and complications of laparoscopy in children with complicated appendicitis in Mofid Children's Hospital.

Patients and Methods

From April 2010 to January 2013, we performed laparoscopic appendectomy (LA) in all cases of non-complicated and complicated appendicitis (including perforated appendicitis and localized or generalized peritonitis based on the operation findings and pathological reports).Primary outcomes were incidence of complications, intra-abdominal abscess and wound infection. Secondary outcomes were length of operation, length of hospital stay, resumption of diet, incidence of bowel obstruction, duration of antibiotic use and readmission. Laparoscopy appendectomy was performed with two working ports.

Results

LA was performed in 123 children aged 2 to 14 years (mean of eight years) over a 3-year period, of whom only 34 cases had complicated appendicitis (either localized or generalized peritonitis). There was one conversion to open appendectomy (OA) in a patient with appendicular abscess with a mass, which excluded from our analysis. There were 6 patients with generalized peritonitis and 26 patients with localized abscess, and two patients with appendicular mass. The Average duration of symptoms was four days (ranged 3-6 days). The mean length of operation was 52 minutes (ranged 40-80 minutes). The average length of hospital stay was 4.4 days (ranged 4-7 days). They were able to restart oral intake from 16 to 48 hours postoperatively. Two patients (5%) had postoperative complications; one patient with intra-abdominal abscess who underwent reoperation and the second patient with umbilical wound infection was resolved with antibiotherapy. The average follow-up was 14 months (ranged from 4-36 months).

Background

Laparoscopy is not an accepted procedure for complicated appendicitis in children for most pediatric surgeons. This procedure is associated with a higher incidence of postoperative abdominal abscess reported in some studies.

Conclusions

We recommend laparoscopic approach for all children presenting complicated appendicitis as the initial procedure of choice.

Objectives

In this study, we investigated the security, efficacy and complications of laparoscopy in children with complicated appendicitis in Mofid Children's Hospital.

Patients and Methods

From April 2010 to January 2013, we performed laparoscopic appendectomy (LA) in all cases of non-complicated and complicated appendicitis (including perforated appendicitis and localized or generalized peritonitis based on the operation findings and pathological reports).Primary outcomes were incidence of complications, intra-abdominal abscess and wound infection. Secondary outcomes were length of operation, length of hospital stay, resumption of diet, incidence of bowel obstruction, duration of antibiotic use and readmission. Laparoscopy appendectomy was performed with two working ports.

Results

LA was performed in 123 children aged 2 to 14 years (mean of eight years) over a 3-year period, of whom only 34 cases had complicated appendicitis (either localized or generalized peritonitis). There was one conversion to open appendectomy (OA) in a patient with appendicular abscess with a mass, which excluded from our analysis. There were 6 patients with generalized peritonitis and 26 patients with localized abscess, and two patients with appendicular mass. The Average duration of symptoms was four days (ranged 3-6 days). The mean length of operation was 52 minutes (ranged 40-80 minutes). The average length of hospital stay was 4.4 days (ranged 4-7 days). They were able to restart oral intake from 16 to 48 hours postoperatively. Two patients (5%) had postoperative complications; one patient with intra-abdominal abscess who underwent reoperation and the second patient with umbilical wound infection was resolved with antibiotherapy. The average follow-up was 14 months (ranged from 4-36 months).

Background

Laparoscopy is not an accepted procedure for complicated appendicitis in children for most pediatric surgeons. This procedure is associated with a higher incidence of postoperative abdominal abscess reported in some studies.

Abdominal Abscess;Follow-Up Studies;Hospitals, Community;Laparoscopy;Laparotomy Abdominal Abscess;Follow-Up Studies;Hospitals, Community;Laparoscopy;Laparotomy http://www.colorectalresearch.com/index.php?page=article&article_id=16599 Leily Mohajerzadeh Leily Mohajerzadeh Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2122924488 Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran; Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran. Tel/Fax: +98-2122924488 Mohsen Rouzrokh Mohsen Rouzrokh Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Ahmad Khaleghnejad Tabari Ahmad Khaleghnejad Tabari Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Alireza Mirshemirani Alireza Mirshemirani Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran khashayar Atqiaee khashayar Atqiaee Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Naghi Dara Naghi Dara Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran Pediatric Surgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
en 10.17795/acr-17014 Anterior Perineal Plane Technique in Low Rectal Cancer Anterior Perineal Plane Technique in Low Rectal Cancer research-article research-article Background

Rectal cancer is a common gastrointestinal cancer. It is tried to use sphincter preservation methods due to the location of the tumor and its proximity to the anal sphincter.

Objectives

In this study, a new method of rectal resection through perineum is introduced.

Patients and Methods

In this study, 15 patients with lower rectal cancer were enrolled from 2009 to 2011. After chemoradiation, releasing of the rectum and sigmoid through the abdomen were performed by open surgery or laparoscopy, then, the tumor was removed through perineal incision and anastomosis was performed.

Results

There were eight women and seven men. The mean age of patients was 55 years. All patients had some degrees of stool incontinence. Eight patients had a score of 15-18, and seven below 15 according to the Cleveland criteria. The score of patients’ satisfaction was 8 from 10. Complications including infection, abscess or leak were not observed.

Conclusions

Sphincter preservation method in lower rectal cancer through perineum is possible which is associated with low complications.

Background

Rectal cancer is a common gastrointestinal cancer. It is tried to use sphincter preservation methods due to the location of the tumor and its proximity to the anal sphincter.

Objectives

In this study, a new method of rectal resection through perineum is introduced.

Patients and Methods

In this study, 15 patients with lower rectal cancer were enrolled from 2009 to 2011. After chemoradiation, releasing of the rectum and sigmoid through the abdomen were performed by open surgery or laparoscopy, then, the tumor was removed through perineal incision and anastomosis was performed.

Results

There were eight women and seven men. The mean age of patients was 55 years. All patients had some degrees of stool incontinence. Eight patients had a score of 15-18, and seven below 15 according to the Cleveland criteria. The score of patients’ satisfaction was 8 from 10. Complications including infection, abscess or leak were not observed.

Conclusions

Sphincter preservation method in lower rectal cancer through perineum is possible which is associated with low complications.

Rectal Neoplasms;Sphincter Preservation;Perineum Rectal Neoplasms;Sphincter Preservation;Perineum http://www.colorectalresearch.com/index.php?page=article&article_id=17014 Rasoul Azizi Rasoul Azizi Department of Colorectal Surgery, Rasoul Akram Medical Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Department of Colorectal Surgery, Rasoul Akram Medical Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Roubik Behboo Roubik Behboo Department of Colorectal Surgery, Rasoul Akram Medical Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Department of Colorectal Surgery, Rasoul Akram Medical Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, IR Iran Abbas Abdollahi Abbas Abdollahi Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118022677; +98-9153141917, Fax: +98-5118525255 Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran; Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran. Tel: +98-5118022677; +98-9153141917, Fax: +98-5118525255
en 10.17795/acr-16520 Synchronic Volvulus of Sigmoid and Transverse Colon: A Rare Case of Large Bowel Obstruction Synchronic Volvulus of Sigmoid and Transverse Colon: A Rare Case of Large Bowel Obstruction case-report case-report Introduction

Volvulus of two segments of colon has been reported rarely, as either synchronous or metachronous events. Colonic volvulus involving both transverse and sigmoid colon is a rare medical problem frequently dismissed as a cause of large bowel obstruction

Case Presentation

A 73-year-old female presented with colicky abdominal pain, abdominal distension and anorexia for several days. Abdominal radiography showed distended intestinal loops. Patient went under laparotomy and transverse and sigmoid volvulus was discovered.

Conclusions

In spite of transverse colon and sigmoid volvulus rarity, it is advised to include these in the differential diagnosis of patients with chronic abdominal pain associated with recurrent bowel obstruction.

Introduction

Volvulus of two segments of colon has been reported rarely, as either synchronous or metachronous events. Colonic volvulus involving both transverse and sigmoid colon is a rare medical problem frequently dismissed as a cause of large bowel obstruction

Case Presentation

A 73-year-old female presented with colicky abdominal pain, abdominal distension and anorexia for several days. Abdominal radiography showed distended intestinal loops. Patient went under laparotomy and transverse and sigmoid volvulus was discovered.

Conclusions

In spite of transverse colon and sigmoid volvulus rarity, it is advised to include these in the differential diagnosis of patients with chronic abdominal pain associated with recurrent bowel obstruction.

Intestinal Volvulus;Colon, Transverse;Colon, Sigmoid;Intestinal Obstruction Intestinal Volvulus;Colon, Transverse;Colon, Sigmoid;Intestinal Obstruction http://www.colorectalresearch.com/index.php?page=article&article_id=16520 Alireza Hoseini Alireza Hoseini Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Reza Eshragi Samani Reza Eshragi Samani Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Hamed Parsamoin Hamed Parsamoin Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-3112343261, Fax: +98-3112335030 Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran. Tel: +98-3112343261, Fax: +98-3112335030 Hamidreza Jafari Hamidreza Jafari Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran
en 10.17795/acr-17748 Amyand’s Hernia: An Extremely Rare Condition of Inguinal Hernia Accompanied With Acute Appendicitis Amyand’s Hernia: An Extremely Rare Condition of Inguinal Hernia Accompanied With Acute Appendicitis case-report case-report Introduction

A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand’s hernia. Here we present a case with Amyand’s hernia.

Case Presentations

A 63-year-old Caucasian man with a perforated vermiform appendix in the hernia sac (acute suppurative appendicitis), presented an incarcerated right groin hernia and underwent simultaneous appendectomy and hernia repair.

Conclusions

A surgeon repairing hernia may encounter unexpected intraoperative findings, like Amyand’s hernia. It is important to be always prepared for such conditions and apply the appropriate treatment.

Introduction

A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand’s hernia. Here we present a case with Amyand’s hernia.

Case Presentations

A 63-year-old Caucasian man with a perforated vermiform appendix in the hernia sac (acute suppurative appendicitis), presented an incarcerated right groin hernia and underwent simultaneous appendectomy and hernia repair.

Conclusions

A surgeon repairing hernia may encounter unexpected intraoperative findings, like Amyand’s hernia. It is important to be always prepared for such conditions and apply the appropriate treatment.

Amyands Hernia;Acute Appendicitis Amyands Hernia;Acute Appendicitis http://www.colorectalresearch.com/index.php?page=article&article_id=17748 Reza Eshraghi Samani Reza Eshraghi Samani Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Seyed AliReza Hosseini Seyed AliReza Hosseini Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Surgery, Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Shahab Shahabi Shahmiri Shahab Shahabi Shahmiri Department of Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Surgery, Alzahra Hospital, Soffeh Blv, Isfahan, IR Iran, Tel: +98-9111137105 Department of Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran; Department of Surgery, Alzahra Hospital, Soffeh Blv, Isfahan, IR Iran, Tel: +98-9111137105 Lotfallah Abedini Lotfallah Abedini Department of Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran Department of Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, IR Iran
en 10.17795/acr-14461 In the Pregnancy, Psyllium Powder Consumption Could Significantly Prevent Constipation In the Pregnancy, Psyllium Powder Consumption Could Significantly Prevent Constipation letter letter Pregnancy; Constipation Pregnancy; Constipation http://www.colorectalresearch.com/index.php?page=article&article_id=14461 Murat Kekilli Murat Kekilli Department of Gastroenterology, Hitit University Corum Training and Research Hospital, Corum, Turkey; Department of Gastroenterology, Hitit University Corum Training and Research Hospital, Corum, Turkey. Tel: +90-3642230300 Department of Gastroenterology, Hitit University Corum Training and Research Hospital, Corum, Turkey; Department of Gastroenterology, Hitit University Corum Training and Research Hospital, Corum, Turkey. Tel: +90-3642230300 Yusuf Serdar Sakin Yusuf Serdar Sakin Department of Gastroenterology, Gulhane School of Medicine, Ankara, Turkey Department of Gastroenterology, Gulhane School of Medicine, Ankara, Turkey
en 10.17795/acr-15204 Psyllium Powder Laxatives Are Effective Treatment of Constipation in Pregnancy, but What Is About Safety? Psyllium Powder Laxatives Are Effective Treatment of Constipation in Pregnancy, but What Is About Safety? letter letter Pregnancy ; Constipation ; Psyllium Laxative Pregnancy ; Constipation ; Psyllium Laxative http://www.colorectalresearch.com/index.php?page=article&article_id=15204 Renata Bor Renata Bor First Department of Medicine, University of Szeged, Szeged, Hungary First Department of Medicine, University of Szeged, Szeged, Hungary Klaudia Farkas Klaudia Farkas First Department of Medicine, University of Szeged, Szeged, Hungary First Department of Medicine, University of Szeged, Szeged, Hungary Anita Balint Anita Balint First Department of Medicine, University of Szeged, Szeged, Hungary First Department of Medicine, University of Szeged, Szeged, Hungary Tamas Molnar Tamas Molnar First Department of Medicine, University of Szeged, Szeged, Hungary; First Department of Medicine, University of Szeged, Szeged, Hungary. Tel: +36-62545198, Fax: +36-62545185 First Department of Medicine, University of Szeged, Szeged, Hungary; First Department of Medicine, University of Szeged, Szeged, Hungary. Tel: +36-62545198, Fax: +36-62545185