11/114. constipation of prolonged duration. A case is reported of a 19-year old man who went periods of four and a half and four months without a bowel movement and who experienced no distress throughout these periods except for late appearing abdominal cramps. ( info) |
12/114. Stercoral necrosis of the cecum in an incarcerated right inguinal hernia: report of a case. A rare case of stercoral ulcers of the cecum in an incarcerated inguinal hernia is described. Local resection was followed by an uneventful recovery. ( info) |
13/114. Complete vaginal prolapse: an unusual presentation of anovestibular fistula. An adolescent girl with an anovestibular fistula presenting as a complete vaginal prolapse and large-bowel obstruction is reported. The prolapse was reduced manually after repeated bowel washouts and a divided high sigmoid colostomy. The patient is awaiting posterior sagittal anorectoplasty. Possible etiopathologic factors of the prolapse are discussed. A vaginal prolapse in a patient with an anorectal malformation has not been reported previously in the English literature. ( info) |
14/114. Severe juvenile chronic constipation. constipation in the paediatric population is common and encompasses a spectrum of organic and functional pathology which differ from that of the adult population. Recently an expert group published a comprehensive system of classification of childhood functional gastrointestinal disorders that may have useful clinical application. We present the case of an adolescent schoolgirl with severe constipation with extreme anorectal, urological and neurological sequelae who displayed inappropriate behavioral response to her condition. The patient appeared inappropriately unmotivated and undisturbed by the severity of her constipation. This abnormal psychological habituation and adaptation to an abnormal bowel habit perpetuated the constipation. In addition, we examined the role of recent advances in anorectal investigation techniques and treatment in the context of the recent guidelines issued by the American Gastroenterological association ( info) |
15/114. Signifance of faecoliths in the diagnosis of acute appendicitis. Three cases are presented which demonstrate the significance of faecoliths in the diagnosis of acute appendicitis in infants. A wide spectrum of symptoms is noteworthy. The usefulness of a plain X-ray of the abdomen in infants with acute abdomen is stressed. ( info) |
| An 8-year-old girl presented with frequent, nonfebrile, urinary tract infections and a lifelong history of severe constipation. Ultrasound revealed bilateral duplicated renal systems, severe right upper pole hydronephrosis, and moderate left lower pole hydronephrosis. Computerized tomographic scan revealed a large, fecal-impacted colon. Diuretic renogram showed high-grade obstruction (T1/2 >30 minutes) of the right upper pole and left lower pole moieties. After administering an aggressive bowel preparation, a repeat diuretic renogram was performed, which revealed resolution of the left lower pole obstruction. constipation has long been established as a contributing factor to urinary tract infections in children. However, fecal impaction causing ureteral obstruction in a child has not been reported. We report the case of an 8-year-old girl who had left lower pole ureteral obstruction secondary to fecal impaction. ( info) |
17/114. Spontaneous rectovaginal fistula and repair using bulbocavernosus muscle flap. Spontaneous fistula between anorectum and vagina is extremely uncommon. Successful repair depends on etiology, location and the expertise of the surgeon. We report two cases of spontaneous stercoral perforation resulting in rectovaginal fistula (RVF). Both occurred in bedridden patients with fecal impaction. One patient was successfully repaired with a bulbocavernosus (BC) flap interposition. Flap interposition prevents vaginal stenosis in repair of multiple RVF. ( info) |
18/114. Giant fecaloma with idiopathic sigmoid megacolon: report of a case and review of the literature. PURPOSE: fecal impaction is a common condition, and " fecaloma" is an extreme variety of impaction. This is a report of a giant, solitary, and stubborn fecaloma not responding to nonoperative management. A surgical intervention for uncomplicated fecal impaction is rarely needed and reported in the literature. METHOD: A 39-year-old male patient with constipation presented with a firm, mobile, abdominal mass of six-months duration. Investigations revealed an isolated, giant fecaloma in a redundant sigmoid megacolon. After all the conservative measures were unsuccessful in evacuating the stubborn impaction, he was treated by sigmoid colectomy and primary anastomosis. CONCLUSION: A timely surgical intervention in recalcitrant fecal impactions may prevent possible stercoral ulcer perforation with a high mortality. ( info) |
19/114. Stercoral perforation of the colon in a heroin addict. BACKGROUND AND AIMS: Stercoral perforation of the colon is rare. narcotics are well known to produce chronic constipation resulting in stercoral perforation, however, only one case of a heroin addict developing stercoral perforation has been reported. patients AND methods: We present a case of a 67 year-old man with chronic heroin use and stercoral perforation requiring sigmoidectomy and Hartmann's procedure. Computed tomography was performed prior to exploration. RESULTS: This is the first case of computed tomography findings, prior to laparotomy, that have been published for stercoral perforation. ( info) |
20/114. A case of an absent diseased appendix in an incompletely rotated gut. A case of an absent diseased appendix in an incompletely rotated gut in a 35-year-old farmer along with its management and review of literature is presented here. ( info) |