Biomedical subjects

J L Rocha Ramírez

Publications and source records attributed to J L Rocha Ramírez.

5 recordsLinked to original sources

PubMed2003

Endoanal sonography in assessment of fecal incontinence following obstetric trauma.

OBJECTIVES: Fecal incontinence is a common, incapacitating and largely unrecognized medical problem and can be caused by various factors. Obstetric trauma is the most common cause of fecal incontinence secondary to trauma. We aimed to analyze the role of endoanal ultrasound in assessment of this type of fecal incontinence, and report the functional results of surgical treatment. METHODS: We reviewed the records of all 22 patients with fecal incontinence secondary to obstetric trauma who were evaluated by endoanal ultrasound and underwent surgical management in our department from April to 1997 to April 2002. Pre- and postoperative evaluation of the degree of incontinence was done using the incontinence score of Jorge and Wexner. RESULTS: The patients had a median age of 43 (range, 29-68) years. All had vaginal deliveries, five of which (22.7%) were instrumental. Most of the patients had total fecal incontinence (solids) with preoperative incontinence score values of 15-20 (median, 18). Endoanal ultrasound confirmed structural defects in the anterior external anal sphincter alone in 16 (72.7%) patients, and both anterior external and internal sphincter defects in six (27.3%) patients. A thinned perineal body was present in all patients. All patients received surgical treatment with overlapping sphincteroplasty and there was improvement of continence in 19 (86.4%) patients with postoperative incontinence score values between 4 and 0 (median, 2). CONCLUSIONS: Endoanal sonography is an accurate method for assessing sphincter anatomy, delineating both internal and external anal sphincters. Surgical treatment of sphincter defects is associated with good outcome.

Adult↗

PubMedDate not supplied

[Crohn disease].

Explore the source record for details and available documents.

Biopsy↗

PubMedDate not supplied

[Malignant stromal tumor of the transverse colon. Case report].

OBJECTIVE: Case report of a malignant stromal tumor of the transverse colon. BACKGROUND: Colon sarcomas are rare; the most frequent presentation is the leiomyosarcoma. Forty five cases of malignant stromal tumor have been reported in the international literature. The histogenesis of these mesenchymatous neoplasms is determined by ultrastructural analysis and immunohistochemical stains, nevertheless when special techniques are negative and there is uncertainty related to the cellular differentiation line (smooth muscle, neural or undifferentiated) it is preferable to call them stromal tumors of gastrointestinal tract. METHOD: A 46 year old patient with the diagnosis of malignant stromal tumor of transverse colon and the prescribed treatment was reported. RESULTS: A case of a patient with the diagnosis of malignant stromal tumor in transverse colon is presented, who had as the main clinical features abdominal pain, transanal hemorrhage and finally intestinal occlusion. He was submitted to exploratory laparotomy finding a transverse colon intussusception, which was treated with an extended right hemicolectomy and a post surgical satisfactory recovery. Follow-up to three years hasn't found tumoral activity. CONCLUSIONS: Stromal tumors are rare in colon, treatment is a wide surgical resection with curative or palliative purposes.

Colonic Neoplasms↗

PubMedDate not supplied

[Colonic adenoma: risk factors for their malignant transformation].

BACKGROUND: Almost all colorectal cancers develop from adenomatous polyp, its detection and resection prevent the malignization. Several adenoma characteristics like: number, size, morphology, histologic type and grade of dysplasia have become considered as malignization risk factors. AIMS: This study was designed to determine the frequency of colorectal adenoma and the principal risk factors for malignization. METHODS: Between June of 1989 and July of 1994, 846 colonoscopies were performed and retrospectively analyzed in the same number of patients. The patients with colorectal polyps were chosen for the analysis of this study as well all the polyps characteristics, to determine the risk factors for malignization. RESULTS: There were 183 patients (21.6%) with 322 colorectal polyps. Of all of them, only 214 (66.4%) underwent colonoscopy snare resection and were studied; 120 (57%) were neoplastic polyps and 94 (43%) non neoplastic; among those neoplastic polyps, 100 (83.4%) were tubular adenomas, 11 (9.1%) were tubulovillous adenomas, and 9 (7.5%) were villous adenomas. We found 16 (7.4%) polyps with adenocarcinoma, 14 (87.5%) were found in patients older than 50 years of age and in polyps larger than 1 cm in diameter (p 0.040). Eleven (68.7%) were sessiles (p 0.001). CONCLUSIONS: After the evaluation of polyps, the tubular adenomas were the neoplastic polyps more frequently found. In this particular study, the patient age, polyp size and morphology were the more statistically significant risk factors for malignization in our patient group.

Adenoma↗

PubMedDate not supplied

[Colitis cystica profunda. A case report].

OBJECTIVE: To present a pathology not previously informed in national literature. BACKGROUND: Colitis cystica profunda (CCP) is a rare benign entity and with an unknown etiology. There are 148 cases documented in world literature at the present time. Histologically it is defined as the obliteration of lamina propria by fibroblasts and the presence of submucous cysts. It comes in localized, segmental or diffuse forms and associated to other entities as solitary rectal ulcer, rectal prolapse, alterations in the pelvic floor, etc. Treatment can be medical or surgical according to severity of its manifestations. METHOD: A case of CCP is revised as well as the treatment effectuated. RESULTS: A case of patient with the diagnosis of CCP of localized type is presented, which principal symptom was transanal mucous secretion; on physical exploration a sessile mucous polypoid formation at 8 cm from anal verge was found and was treated with surgical resection with a satisfactory outcome. CONCLUSIONS: In a patient with alterations in pelvic floor or puborectal bundle contraction and sigmoidorectal intussusception CCP must be suspected. Treatment can be medical with a high percentage of failure being optimal treatment the surgical one.

Adult↗