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At least 1,279 records · Page 71Linked to original sources
PubMed1985

Surgery of anorectal anomalies.

This article discusses the disparate views regarding sphincteric anatomy, both normal and abnormal, and describes preoperative procedures for and operative approaches to resolving anorectal anomalies.

Anal Canal↗
PubMed2001

Antenatally diagnosed cloacal exstrophy variant with intravesical phallus in a twin pregnancy.

We report a rare case of covered cloacal exstrophy variant with a hemiphallus trapped within partially closed bladder halves. The persistence of the cloacal membrane until at least 18 weeks' gestation, confirmed by antenatal ultrasound scanning, is discordant with existing theories of embryogenesis of cloacal exstrophy. The clinical presentation highlights the need for careful assessment, before and during surgery, to obtain a complete understanding of the anatomic defect before gender assignment and appropriate reconstructive efforts. A multispecialty approach and antenatal counseling are important, especially when only one fetus of twins has major birth defects.

Abnormalities, Multiple↗
PubMed2003

Role of laparoscopy in patients with previous negative exploration for impalpable testis.

OBJECTIVES: To evaluate the impact of laparoscopy in the treatment of patients with previous negative inguinal exploration for impalpable undescended testes. METHODS: A retrospective review was performed of patients who underwent laparoscopy after prior incomplete or "questionable" negative inguinal explorations for nonpalpable undescended testes. RESULTS: Twenty-seven males aged 1 to 22 years old, with 30 impalpable testes, underwent laparoscopy after prior negative open exploration. The operative notes were available for all patients. In 9 patients (33%), blind-ending spermatic vessels, vas deferens, and a closed ring were found. However, in the remaining 18 patients (67%), viable intra-abdominal or inguinal gonads (9 patients) and intra-abdominal remnants (9 patients) were identified. In 1 patient, seminoma of an intra-abdominal testis was present. CONCLUSIONS: When a patient is referred with an inconclusive previous open exploration for an impalpable gonad, laparoscopy has an important role in establishing or refuting the diagnosis of an absent testis. Moreover, therapeutic laparoscopy provides definitive options to standard open techniques when a viable testis or remnant is encountered. In this study, laparoscopy proved more accurate than open exploration with operative notes available defining the nature of the exploration.

Adolescent↗
PubMed2000

Complete duplication of the bladder, urethra, vagina, and uterus in girls.

UNLABELLED: OBJECTIVES. To present our experience with 3 girls with complete duplication of the bladder, urethra, vagina, and uterus, a very rare anomaly, and review published reports. Associated anomalies in these cases represent a wide spectrum. METHODS: We report 3 girls with complete duplication of the bladder, urethra, vagina, and uterus. The associated anomalies were different in each child. The first patient had a symphysis diastasis creating an abdominal hernia with two bladders dislocated into this space. The second patient had anal atresia with colon duplication. The third had cloacal exstrophy with one opened bladder and a second closed, with persistent urogenital sinus. Each patient was carefully evaluated, but the anatomy in 2 patients was not completely defined until surgical exploration. RESULTS: Each girl underwent surgical repair. In the first patient, iliac osteotomy, approximation of the symphysis pubis, and excision of the hernia was done. In the second, excision of the common wall between the two descending colons and posterior sagittal anorectoplasty were performed. In the third patient, staged reconstruction of the cloacal exstrophy with anastomosis of the bladders and vaginas was done. CONCLUSIONS: Complete duplication of the urogenital system in girls is associated with different anomalies. Which surgical procedures will be required depends on the multiple anatomic variables.

Abnormalities, Multiple↗
PubMed1985

Urogenital problems in the neonatal foal.

The common conditions affecting the urogenital tract of the neonatal foal and their medical and surgical management are described. Early recognition and treatment of serious abnormalities are necessary for a successful outcome in the equine neonate.

Animals↗
PubMed2002

[Johanson-Blizzard syndrome: a case report].

UNLABELLED: The Johanson-Blizzard syndrome is a rare autosomal recessive syndrome. This syndrome includes congenital aplasia of the cutis, aplasia of the alae nasi, bilateral hearing loss, dental malformations and pancreatic insufficiency. CASE REPORT: We report a sporadic case male infant from nonconsanguineous parents. He presented aplasia of the cutis and high anorectal malformation, associated with exocrine pancreatic insufficiency. A colostomy was performed at birth and anorectal atresia was corrected surgically at two months. Exocrine pancreatic insufficiency required immediate enzyme supplementation.

Abnormalities, Multiple↗
PubMed2003

Reoperative surgery for anorectal anomalies.

Complications occur during the repair of anorectal malformations relatively frequently. Unfortunately, these complications are often preventable. Furthermore, the consequences of these complications are significant. Not only do patients experience unnecessary pain and suffering, but a secondary operation always renders less optimal functional results. A 20-year experience in the care of children with anorectal malformations was retrospectively analyzed. Patients who previously underwent surgical repair at other institutions, and subsequently required secondary surgery by the primary author were evaluated; 334 patients were identified. Reasons for reoperation included fecal incontinence in 77 patients; dehiscence and retraction in 96; recto-genito-urinary fistulae in 55; persistent urogenital sinus in 31 cloaca patients; acquired vaginal atresia in 21; acquired urethral atresia in 9; posterior urethral diverticulum in 20; and overflow pseudo incontinence in 25 patients. Except for fecal incontinence, all other complications are considered preventable. The source of the complications in almost all other settings are technical errors at the time of the primary repair. Recommendations are presented to help prevent these complications, and suggestions are made on how to treat them when they occur.

Anal Canal↗
PubMed2003

Sphincter muscle stimulator to be used before treating anal atresia.

Closed rectum is a very frequently encountered anomaly of the newborns in our university hospital. Before making a rectal opening, the anorectal sphincter muscle needs to be stimulated to prevent any damage to the muscle itself In this study, we have designed a stimulator that provides reasonably constant output current depending on the physiological impedance of the rectal area. The current amplitude can be set between 20 and 250 mA. Stimulation pulses are adjusted for duration of 230 micros and can be obtained at a repetition period between 1.75 and 20 ms. Fifteen patients in the Pediatric Surgery Department of Erciyes University Hospital were subjected to our stimulation tests. On average, about 140 mA was enough to stimulate the muscle when probes were applied over the skin. On the other hand, with the placement of probes beneath the skin, stimulation was obtained for pulse amplitude of 40 mA.

Anal Canal↗