Cases reported "Anus Diseases"

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1/21. The prepuce flap in the reconstruction of male anal stenosis.

    Circumferential stenosis of the male anal canal was repaired using a subcutaneous prepuce flap. The stenosis was released to create a rhomboid defect. Then, to cover the defect a rectangular flap was designed on the hairless ventral side of the penis. The flap was raised over the Buck's fascia while preserving the subcutaneous vessels in the dartos fascia, which formed the pedicle of the flap. The flap was transposed to the defect by passing it through a tunnel in the perineum. The postoperative course was uneventful and the result was good. The flap had reliable vascularity, was very thin, and pliable so that it could adapt to the rhomboid defect in the anal canal.
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2/21. Ectopic prostatic tissue of the anal canal presenting with rectal bleeding: report of a case.

    PURPOSE: Ectopic prostatic tissue at various sites within and outside the genitourinary system has been reported previously. A case of ectopic prostatic tissue located in the anal canal causing rectal bleeding is presented. METHOD: The patient was referred to our clinic with rectal bleeding. At rectal examination a bleeding sessile polypoid mass 2.5 cm in size was found in anal canal and removed surgically. RESULTS: Histopathologic and immunohistochemical staining of the specimen confirmed the prostatic nature of the tissue. CONCLUSION: Prostatic heterotopia is significant in several respects. Either it may be an important cause of hematuria or unusually, as in our case, it may cause rectal bleeding. In addition, ectopic tissue may be endoscopically confused with malignancy in either urinary or lower gastrointestinal system. This and other reports may disclose the genesis and significance of this peculiar tissue remnant.
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3/21. An unusual presentation of Y-type urethral duplication with perianal abscess: case report.

    Urethral duplications are rare anomalies that manifest in various anatomic forms. These variations are classified broadly as epispadic, hypospadic, and Y-type duplications. In the Y-type, the accessory ventral channel opens into either the perineum or the anal canal. Typically, the dorsal urethra is hypoplastic, and the external meatus is stenotic, so urine is voided through the dominant ventral channel. In the other unusual form, the dorsal urethra is normal and perineal or rectal opening of accessory ventral urethra is an accidental finding. When treating patients with typical Y-type duplications, the accessory ventral urethra is mobilized and then is carried to the glans with one- or 2-stage urethroplasty. In the unusual form, excision of the anterior urethra is the definitive surgical treatment. This report describes a case of unusual Y-type urethral duplication in which the accessory ventral channel had a stenotic perianal opening. The patient developed recurrent attacks of perianal abscess associated with urinary tract infections. To the authors' knowledge, this is the first reported case of Y-type duplication with an hypoplastic accessory ventral channel that was presented with recurrent perianal abscess attacks.
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4/21. A case of focal acantholytic dyskeratosis occurring on both the lip and the anal canal.

    Focal acantholytic dyskeratosis has a distinctive histological pattern that is associated with various clinical expressions. It rarely occurs on the lip or the perianal area. We report a patient with focal acantholytic dyskeratosis occurring on both the upper lip and the anal canal. Histopathologically, the lesions showed hyperkeratosis, suprabasilar clefting, epidermal acantholysis and dyskeratosis. This case represents the first report of a focal acantholytic dyskeratosis occurring on both the lip and the anal canal.
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5/21. Extramammary Paget's disease.

    Two patients with extramammary Paget's disease are being reported. The first case was a 60-year-old male who presented with gradually progressive pruritic ulcerated lesion over perianal region not responding to various topical medications. Dermatological examination revealed a large erythematous sharply marginated scaly plaque in the perianal region extending into the anal canal, covered with grayish crusts and shallow erosions. skin biopsy from the lesion was suggestive of Paget's disease. The second patient, a 60-year-old male, with a three year long history, presented with similar lesions and findings. skin biopsy in this case was also consistent with Paget's disease. These two cases of extramammary Paget's disease involving the perianal region are being reported because of their rarity and also to stress the fact that a high degree of suspicion is needed for the diagnosis of this uncommon disease entity.
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6/21. Acute anal pain due to ingested bone.

    Six cases of acute and anal pain due to impaction of ingested bone in the anal canal are reported. The clinical presentation mimicks common causes of acute anal pain such as perianal abscesses, fissures or thrombosed haemorrhoids. The diagnosis is readily made on simple digital rectal examination. Early removal of the bone results in immediate pain relief, whilst delayed diagnosis may result in deeper penetration of the bone and abscess formation.
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7/21. Hereditary internal anal sphincter myopathy causing proctalgia fugax and constipation. A newly identified condition.

    A newly identified myopathy of the internal anal sphincter is described. In the affected family, at least one member from each of five generations had severe proctalgia fugax; onset was usually in the third to fifth decades of life. Three members of the family have been studied in detail. Each had severe pain intermittently during the day and hourly during the night. constipation was an associated symptom, in particular difficulty with rectal evacuation. Clinically the internal anal sphincter was thickened and of decreased compliance. The maximum anal canal pressure was usually increased with marked ultraslow wave activity. Anal endosonography confirmed a grossly thickened internal anal sphincter. Two patients were treated by internal anal sphincter strip myectomy; one showed marked improvement and one was relieved of the constipation but had only slight improvement of the pain. The hypertrophied muscle in two of the patients showed unique myopathic changes, consisting of vacuolar changes with periodic acid-Schiff-positive polyglycosan bodies in the smooth muscle fibers and increased endomysial fibrosis. in vitro organ-bath studies showed insensitivity of the muscle to noradrenaline, isoprenaline, carbachol, dimethylpiperazinium, and electrical-field stimulation. Immunohistochemical studies for substance p, calcitonin gene-related peptide, galanin, neuropeptide y, and vasoactive intestinal peptide showed staining in a similar distribution to that in control tissue. A specific autosomal-dominant inherited myopathy of the internal anal sphincter that causes anal pain and constipation has been identified and characterized.
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8/21. Double anal canal: complication of rectal fecalith.

    Fecaliths and stercoraceous ulcerations are well-known complications of chronic constipation. The authors present the case of a double anal canal in an elderly man. This anorectal fistula (complex anal fistula) developed as a complication of an impacted rectal fecalith with resultant stercoraceous ulceration. Eventually, a persistent epithelialized canal developed and was demonstrated at double-contrast barium enema examination. The patient remained continent at all times.
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keywords = canal
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9/21. anal canal stenosis and pseudo-obstruction.

    Mechanical large bowel obstruction and pseudo-obstruction can be difficult to differentiate because clinical symptoms and signs are often misleading. Although plain abdominal radiographs showing diffuse gaseous distension, no shut-off point and gas in the rectum are very suggestive of pseudo-obstruction, incomplete clinical examination with over-reliance on the abdominal radiographs may lead to large bowel mechanical obstruction being misdiagnosed as pseudo-obstruction. We report a rare case of large bowel obstruction occurring secondary to anal canal stenosis.
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10/21. Human immunodeficiency virus-associated large-cell immunoblastic lymphoma presenting as a perianal abscess.

    We report a case of perianal non-Hodgkin's lymphoma that presented as a perianal abscess in an otherwise asymptomatic intravenous drug abuser who tested positively for human immunodeficiency virus infection. Extranodal lymphoma of the anal canal is a very rare event, which has recently been described in homosexual men with the acquired immunodeficiency syndrome. This is the first report, to our knowledge, of perianal lymphoma occurring in a nonhomosexual patient with the acquired immunodeficiency syndrome.
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