PubMed Health⌕ Search

Biomedical subjects

N Sohn

Publications and source records attributed to N Sohn.

15 recordsLinked to original sources
PubMed1992

Precise anorectal sphincter dilatation--its role in the therapy of anal fissures.

For the past 20 years, internal anal sphincterotomy has generally been considered to be the standard operation for an anal fissure. We sought an alternative form of treatment because of the wound complications inherent in this operation. Anal dilatation, precisely performed with a Parks' retractor opened to 4.8 cm or with a 40-mm rectosigmoid balloon, has been found to cure successfully the fissure in 93 percent and 94 percent, respectively, of each group and to be associated with fewer complications.

Adult↗
PubMed1987

Primary anorectal lymphoma. A new manifestation of the acquired immune deficiency syndrome (AIDS).

Non-Hodgkin's lymphomas with particular clinicopathologic features occur with a high incidence in homosexual men affected by AIDS. More frequently than in the general population, these lymphomas have an extranodal location including the gastrointestinal tract. We have recently observed four cases of AIDS-associated lymphomas whose primary location is in the lower rectum and anus. The patients were 27 to 44 years of age, had greatly depressed helper-suppressor T-cell ratios, and antibodies to human immunodeficiency virus (HIV). All four presented with anorectal symptoms and originally had surgery for anorectal fistulas or tumor masses. When staged, three patients had no other organ involvement, the fourth only had lymphoma in an axillary lymph node, and all four had large tumor masses confined within the rectum. In terms of histology, the lymphomas were of undifferentiated or of large cell type and of B-cell phenotype. Lymphomas with primary or major location in the rectum are a rare occurrence in the general population, and until recently, are rare even among the lymphomas associated with the immune deficiency syndrome. At the Lenox Hill Hospital in New York City, no rectal lymphoma among the 58 cases of AIDS-related lymphoma diagnosed during the past 4 years was recorded until 10 months ago. The recognition of the new feature in presentation, a neoplasm associated with AIDS, is obviously important for its early diagnosis and treatment. Its unusual occurrence at the suspected portal of entry of the HIV infection is of interest because it may provide new clues to the association between AIDS and neoplasia.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The fate of the rectal segment after diversion of the fecal stream in Crohn's disease: its implications for surgical management.

Diverting the fecal stream has been considered to benefit the course of Crohn's disease. Clinical signs and symptoms have not, however, been distinguished previously from the objective inflammatory changes in the distal segment. We reviewed the course of 16 consecutive patients with Crohn's disease in whom sigmoidoscopy showed normal mucosa at the time of diversion and who underwent an ileostomy or colostomy, the rectal segment being left in place. As early as 3 months after diversion, all 16 patients showed progressive friability, ulceration, and exudation in the retained rectum. Stricture occurred in four and lead to abdominoperineal resection in three. Four of eight patients with only moderate inflammation on sigmoidoscopy underwent reanastomosis which was followed by a return to a normal-appearing rectal mucosa. The rectal segment inflammed after diversion rarely shows the histological characteristics of Crohn's disease when resected. This leads us to suspect that the disorder of nonspecific "diversion colitis" might account for this phenomenon entirely, or at least it may accelerate the Crohn's disease process. Continuity of the intestinal tract should be maintained in the course of Crohn's disease surgery if feasible. If a diversion is clinically warranted, reanastomosis should be considered as early as possible despite progressive inflammation of the rectal mucosa.

Adult↗
PubMed1977

Unhealed perineal wound: lavage with a pulsating water jet.

The use of the pulsating water jet lavage (Water Pik) in the care of the perineal wound is discussed. The relative case with which debridement of a difficult-to-locate perineal wound can be efficiently debrided and cared for by a patient on an ambulatory basis is stressed. This facilitates early patient hospital discharge and offers effective self-care to the patient.

Abscess↗
PubMed1977

Social injuries of the rectum.

Eleven patients with injuries of the rectum and sigmoid colon secondary to the insertion of the clenched fist are presented. Six patients sustained mucosal lacerations of the rectum and four patients had rectosigmoid perforations requiring laparotomy. One patient sustained a severe sphincter laceration producing complete anal incontinence. The management of these conditions is discussed.

Abdomen, Acute↗
PubMed1976

Perforations and foreign bodies of the rectum: report of 28 cases.

A series comprised of 28 patients (five with perforations of the recto-sigmoid colon and 23 with lodged rectal foreign bodies) is presented. The symptomatology, physical, laboratory and x-ray findings are described. Methods of management are discussed, with emphasis on the operative management of perforations and the conservative approach to retained foreign bodies. It is felt that these protocols will be useful to physicians who see this practice less frequently. X-rays of two more unusual cases are depicted. A thorough review of the literature is also presented. This is the largest reported series of patients with retained rectal foreign bodies and/or perforations. The series includes two female patients, a heretofore unreported occurrence.

Abdomen, Acute↗
PubMedDate not supplied

Use of total parenteral nutrition as a "medical colostomy" in management of severe lacerations of the sphincter: report of a case.

A case of anal-sphincter injury with total fecal incontinence is presented. The use of total parenteral nutrition (TPN) as a "medical colostomy" is stressed. After four weeks of support by TPN, the perineal wound had healed and successful sphincteroplasty was performed. TPN was used in the postoperative period to delay bowel movements for one week. The general concept of the use of TPN in sphincter injury is presented giving the surgeon an option in management of these injuries without resorting to a preliminary colostomy.

Adult↗
PubMedDate not supplied

The gay bowel syndrome: clinico-pathologic correlation in 260 cases.

The clinical and pathological findings in a group of 260 homosexual men comprising 10% of a private proctologic practice are reviewed. A clinical pattern of anorectal and colon diseases encountered with unusual frequency in these homosexual patients is termed the gay bowel syndrome. The clinical diagnoses in decreasing order of frequency include condyloma acuminata, hemorrhoids, nonspecific proctitis, anal fistula, perirectal abscess, anal fissure, amebiasis, benign polyps, viral hepatitis, gonorrhea, syphilis, anorectal trauma and foreign bodies, shigellosis, rectal ulcers and lymphogranuloma venereum. 60 anorectal and sigmoid biopsies from 51 patients failed to disclose evidence of specific infection other than condyloma acuminata. Of 21 patients with biopsy diagnosis of nonspecific proctitis, 8 had a specific infection which was detected by other means,--5 cases of shigellosis and one case each of gonorrheal proctitis, amebiasis and lymphogranuloma venereum. In evaluating proctologic problems in the gay male, all of the known sexually transmitted diseases should be considered. Shigellosis, amebiasis and viral hepatitis should be included. Microbiological evaluation is essential. Concurrent infections with 2 or more pathogens should be anticipated. Chlamydia trachomatis, an important cause of nonspecific urethritis in the general population, is high on the list of possible causes of the nonspecific proctitis present in 31 of the 260 patients.

Abscess↗