Objectives: To describe and investigate the value of an education program for parents of children born with an imperforate anus in order to help them cope with the new situation of having a stoma. A comparison is made...Objectives: To describe and investigate the value of an education program for parents of children born with an imperforate anus in order to help them cope with the new situation of having a stoma. A comparison is made with a group of parents following routine hospital. A secondary aim was to illuminate the parents’ feelings and concerns in the first month after the birth of the child. Subjects and methods: The program was tested in 20 Vietnamese mothers of babies born with an imperforate anus;10 followed an intervention comprising an education program and 10 the ordinary routine hospital. The study design is both qualitative and quantitative. The mothers were interviewed, using open-ended questions, within a week of their child’s birth and then repeatedly for up to one month. Finally, the conditions of children were accessed on their return to the hospital for the second operation after one month of care at home. The qualitative data were subjected to content analysis. Results: All mothers felt sad and worried in the beginning, but this quickly changed to confidence, particularly among mothers in the intervention group who received education. While at home, mothers in both groups had financial concerns, as they were unable to work as much as expected and also had to buy equipment for colostomy care. The mothers in the control group complained about a lack of knowledge and how it affected the care of their child. The mothers in the intervention group, however, felt confident in their caring even at home. When the families returned for the second operation, the children in the intervention group were significantly healthier, had increased more in weight, and had fewer complications and emergency return visits to hospital compared to the control group. In the control group skin problems around the stoma, diarrhea, bleeding or constipation while at home were reported (p < 0.01). Conclusion: The education improved the care at home resulting in healthier children and more confident parents.展开更多
We are reporting the case of a 32-year-old female who had suffered from fecal incontinence(FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of ag...We are reporting the case of a 32-year-old female who had suffered from fecal incontinence(FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of age, she was still fecally incontinent despite extensive pelvic floor reeducation. A magnetic resonance imaging and an anal electromyography were performed. Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus, a redo was performed of the recto-neo-anal intra-sphincteric anastomosis. A neurostimulator device was subsequently implanted for persistent incontinence. Solid and liquid FI resolved, and her quality of life improved markedly. Combining surgery to correct the position of the neo-anus within the anal sphincter complex and neurostimulation could thus become a new approach in cases of refractory FI for patients with imperforate anus as a newborn. Follow-up into adulthood after pediatric imperforate anus surgery should be recommended for adult patients with persistent FI.展开更多
BACKGROUND Imperforate hymen is a rare obstructive anomaly of the female reproductive tract.It is associated with complications,such as cyclical abdominal pain,urinary retention,and pelvic mass.CASE SUMMARY A 13-year-...BACKGROUND Imperforate hymen is a rare obstructive anomaly of the female reproductive tract.It is associated with complications,such as cyclical abdominal pain,urinary retention,and pelvic mass.CASE SUMMARY A 13-year-old girl presented several times to the emergency room with lower abdominal pain for a year.She received conservative treatment,such as pain control,at each visit.She visited our gynecological clinic for worsening pain,and a 14-cm hematocolpos was found on ultrasonography.She was finally diagnosed with an imperforate hymen with hematocolpometra.Hymenectomy was performed,which resulted in event-free regular cyclical menstruation.CONCLUSION Imperforate hymen should be considered in a premenarcheal adolescent girl with periodic abdominal pain.展开更多
Background: Imperforate hymen (IH) is formed if no canal is created between the vaginal plate and the urogenital sinus. Treatment of IH is surgical. Different types of incisions and postoperative treatment are propose...Background: Imperforate hymen (IH) is formed if no canal is created between the vaginal plate and the urogenital sinus. Treatment of IH is surgical. Different types of incisions and postoperative treatment are proposed. Case: A 12-year-old girl presented with a 3-day history of pain in the lower abdomen. Examination of the external genitalia disclosed a bulging hymen. Ultrasound examination of her lower abdomen revealed hematocolpos. A diagnosis of hematocolpos caused by IH was established and surgical treatment was decided. Conclusion: Treatment of choice for IH is undeniably surgical. Although different types of procedures have been proposed, the surgeon should choose the one that best suits the patient’s needs without harming anatomical structures closely related to the hymen.展开更多
Imperforate hymen?is a congenital obstructive abnormality of the female genital tract and its incidence is estimated at 1/2000 female births. The diagnosis may go unnoticed during the examination of the new born in th...Imperforate hymen?is a congenital obstructive abnormality of the female genital tract and its incidence is estimated at 1/2000 female births. The diagnosis may go unnoticed during the examination of the new born in the birth room. Most often, this malformation is discovered at puberty.?Treatment of?Imperforate hymen?is hymenotomy or hymenectomy. Different types of incisions are mentioned in the literature. We have reported the case of a 14-year-old?girl with hematocolpos and hematometra on hymenal impforforate. In cultures and religions where the loss of the hymen is a social problem among unmarried girls, a medical certificate must be given to the patient.展开更多
Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and man...Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis(Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up.展开更多
Anorectal malformations (ARM) are common anomalies in neonates. Diagnostic and therapeutic delays in the management of ARM may lead to colonic perforation, and even death. Physical examination of the perineum is often...Anorectal malformations (ARM) are common anomalies in neonates. Diagnostic and therapeutic delays in the management of ARM may lead to colonic perforation, and even death. Physical examination of the perineum is often sufficient to diagnose ARM in neonates. Notwithstanding, delayed diagnosis of ARM has become increasingly familiar to surgeons, as evidenced by the number of recent publications on this topic in the literature. In this commentary, we discuss spontaneous colonic perforation due to delayed diagnosis of ARM in neonates, and highlight the importance of early diagnosis in assuring good outcomes with surgical management. At this point, a thorough examination of the perineum during the initial newborn assessment is mandatory, particularly in those patients presenting with abdominal signs or symptoms.展开更多
文摘Objectives: To describe and investigate the value of an education program for parents of children born with an imperforate anus in order to help them cope with the new situation of having a stoma. A comparison is made with a group of parents following routine hospital. A secondary aim was to illuminate the parents’ feelings and concerns in the first month after the birth of the child. Subjects and methods: The program was tested in 20 Vietnamese mothers of babies born with an imperforate anus;10 followed an intervention comprising an education program and 10 the ordinary routine hospital. The study design is both qualitative and quantitative. The mothers were interviewed, using open-ended questions, within a week of their child’s birth and then repeatedly for up to one month. Finally, the conditions of children were accessed on their return to the hospital for the second operation after one month of care at home. The qualitative data were subjected to content analysis. Results: All mothers felt sad and worried in the beginning, but this quickly changed to confidence, particularly among mothers in the intervention group who received education. While at home, mothers in both groups had financial concerns, as they were unable to work as much as expected and also had to buy equipment for colostomy care. The mothers in the control group complained about a lack of knowledge and how it affected the care of their child. The mothers in the intervention group, however, felt confident in their caring even at home. When the families returned for the second operation, the children in the intervention group were significantly healthier, had increased more in weight, and had fewer complications and emergency return visits to hospital compared to the control group. In the control group skin problems around the stoma, diarrhea, bleeding or constipation while at home were reported (p < 0.01). Conclusion: The education improved the care at home resulting in healthier children and more confident parents.
文摘We are reporting the case of a 32-year-old female who had suffered from fecal incontinence(FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of age, she was still fecally incontinent despite extensive pelvic floor reeducation. A magnetic resonance imaging and an anal electromyography were performed. Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus, a redo was performed of the recto-neo-anal intra-sphincteric anastomosis. A neurostimulator device was subsequently implanted for persistent incontinence. Solid and liquid FI resolved, and her quality of life improved markedly. Combining surgery to correct the position of the neo-anus within the anal sphincter complex and neurostimulation could thus become a new approach in cases of refractory FI for patients with imperforate anus as a newborn. Follow-up into adulthood after pediatric imperforate anus surgery should be recommended for adult patients with persistent FI.
文摘BACKGROUND Imperforate hymen is a rare obstructive anomaly of the female reproductive tract.It is associated with complications,such as cyclical abdominal pain,urinary retention,and pelvic mass.CASE SUMMARY A 13-year-old girl presented several times to the emergency room with lower abdominal pain for a year.She received conservative treatment,such as pain control,at each visit.She visited our gynecological clinic for worsening pain,and a 14-cm hematocolpos was found on ultrasonography.She was finally diagnosed with an imperforate hymen with hematocolpometra.Hymenectomy was performed,which resulted in event-free regular cyclical menstruation.CONCLUSION Imperforate hymen should be considered in a premenarcheal adolescent girl with periodic abdominal pain.
文摘Background: Imperforate hymen (IH) is formed if no canal is created between the vaginal plate and the urogenital sinus. Treatment of IH is surgical. Different types of incisions and postoperative treatment are proposed. Case: A 12-year-old girl presented with a 3-day history of pain in the lower abdomen. Examination of the external genitalia disclosed a bulging hymen. Ultrasound examination of her lower abdomen revealed hematocolpos. A diagnosis of hematocolpos caused by IH was established and surgical treatment was decided. Conclusion: Treatment of choice for IH is undeniably surgical. Although different types of procedures have been proposed, the surgeon should choose the one that best suits the patient’s needs without harming anatomical structures closely related to the hymen.
文摘Imperforate hymen?is a congenital obstructive abnormality of the female genital tract and its incidence is estimated at 1/2000 female births. The diagnosis may go unnoticed during the examination of the new born in the birth room. Most often, this malformation is discovered at puberty.?Treatment of?Imperforate hymen?is hymenotomy or hymenectomy. Different types of incisions are mentioned in the literature. We have reported the case of a 14-year-old?girl with hematocolpos and hematometra on hymenal impforforate. In cultures and religions where the loss of the hymen is a social problem among unmarried girls, a medical certificate must be given to the patient.
文摘Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis(Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up.
基金Supported by The National Natural Science Foundation of China,No.81270461/H0307Ministry of Education of China,No.201200356Third Military Medical University,No.2011XHG08
文摘Anorectal malformations (ARM) are common anomalies in neonates. Diagnostic and therapeutic delays in the management of ARM may lead to colonic perforation, and even death. Physical examination of the perineum is often sufficient to diagnose ARM in neonates. Notwithstanding, delayed diagnosis of ARM has become increasingly familiar to surgeons, as evidenced by the number of recent publications on this topic in the literature. In this commentary, we discuss spontaneous colonic perforation due to delayed diagnosis of ARM in neonates, and highlight the importance of early diagnosis in assuring good outcomes with surgical management. At this point, a thorough examination of the perineum during the initial newborn assessment is mandatory, particularly in those patients presenting with abdominal signs or symptoms.
