Acquired vesico-rectal fistula is an uncommon complication of pelvic malignant tumors,surgical injury,inflammatory disorders such as tuberculosis infection,radiotherapy and less commonly diverticulum of the urinary tr...Acquired vesico-rectal fistula is an uncommon complication of pelvic malignant tumors,surgical injury,inflammatory disorders such as tuberculosis infection,radiotherapy and less commonly diverticulum of the urinary tract.The fistula is often identified by urinary tract abnormalities such as dysuria,recurrent urinary tract infection,pneumaturia,and fecaluria.Here,we report an unusual case of a patient with a vesico-rectal fistula of tuberculous origin,presenting with severe acute diarrhea,metabolic acidosis,hyperchloremia and hypokalemia while with only mild urinary tract symptoms.The patient was cured by tuberculostatic therapy.展开更多
BACKGROUND Fistula and intraabdominal abscess are common complications of Crohn’s disease(CD),but complex rectal fistula with abscess formation is rare.Tumor necrosis factor antagonists combined with percutaneous dra...BACKGROUND Fistula and intraabdominal abscess are common complications of Crohn’s disease(CD),but complex rectal fistula with abscess formation is rare.Tumor necrosis factor antagonists combined with percutaneous drainage or surgical intervention is optimal treatment for fistulizing CD with intraabdominal abscess.There is no study showing the efficacy of vedolizumab in such complicated condition.CASE SUMMARY A 47-year-old man has decompensated liver cirrhosis,Child B.He suffered from abdominal pain,bloody diarrhea,fever,and body weight loss.CD with rectoprostatic fistula,rectopresacral fistula,presacral abscess and cytomegalovirus(CMV)infection were noted.He received antibiotics,anti-viral therapy,transverse colostomy and vedolizumab treatment.Six months later,he had deep remission and complete fistula tracts closure.CONCLUSION Early vedolizumab and stool diversion are effective and safe in treating CD with complex rectal fistula with abscess formation.展开更多
Song et al have reported a 100% success rate of acellular extracellular matrix (AEM) anal fistula plug in low fistula-in-ano. The results with this product in high fistula-in-ano are keenly awaited.
目的探讨3.0 T磁共振成像(MRI)联合多层螺旋电子计算机断层扫描(MSCT)对肛瘘临床分型的诊断价值。方法回顾性分析2020年1月至2022年5月在石家庄市中医院经手术证实的126例肛瘘病人临床资料,术前均行3.0 T MRI和MSCT检查。根据Parks分类...目的探讨3.0 T磁共振成像(MRI)联合多层螺旋电子计算机断层扫描(MSCT)对肛瘘临床分型的诊断价值。方法回顾性分析2020年1月至2022年5月在石家庄市中医院经手术证实的126例肛瘘病人临床资料,术前均行3.0 T MRI和MSCT检查。根据Parks分类法对比3.0 T MRI和MSCT对肛瘘病人检查的准确率,分析两项联合对肛瘘临床分型的诊断价值。结果3.0 T MRI联合MSCT诊断肛瘘外口的准确率(99.03%)高于MSCT单独诊断(90.29%),联合诊断主瘘管的准确率(100.00%)高于3.0 T MRI、MSCT各自单独诊断(93.65%、91.27%)(P<0.01),联合诊断肛瘘内口、瘘管分支、脓肿与各自单独诊断比较均差异无统计学意义(P>0.05);3.0 T MRI联合MSCT诊断括约肌间型、经括约肌型、括约肌上型、括约肌外型与手术结果的符合率分别为98.48%、100.00%、100.00%、100.00%。结论3.0 T MRI联合MSCT对肛瘘临床分型有良好的诊断价值。展开更多
基金Supported by National Natural Science Foundation of China,No.81272640Guangdong Science and Technology Program,No.2010B031200008 and No.2012B031800043
文摘Acquired vesico-rectal fistula is an uncommon complication of pelvic malignant tumors,surgical injury,inflammatory disorders such as tuberculosis infection,radiotherapy and less commonly diverticulum of the urinary tract.The fistula is often identified by urinary tract abnormalities such as dysuria,recurrent urinary tract infection,pneumaturia,and fecaluria.Here,we report an unusual case of a patient with a vesico-rectal fistula of tuberculous origin,presenting with severe acute diarrhea,metabolic acidosis,hyperchloremia and hypokalemia while with only mild urinary tract symptoms.The patient was cured by tuberculostatic therapy.
文摘BACKGROUND Fistula and intraabdominal abscess are common complications of Crohn’s disease(CD),but complex rectal fistula with abscess formation is rare.Tumor necrosis factor antagonists combined with percutaneous drainage or surgical intervention is optimal treatment for fistulizing CD with intraabdominal abscess.There is no study showing the efficacy of vedolizumab in such complicated condition.CASE SUMMARY A 47-year-old man has decompensated liver cirrhosis,Child B.He suffered from abdominal pain,bloody diarrhea,fever,and body weight loss.CD with rectoprostatic fistula,rectopresacral fistula,presacral abscess and cytomegalovirus(CMV)infection were noted.He received antibiotics,anti-viral therapy,transverse colostomy and vedolizumab treatment.Six months later,he had deep remission and complete fistula tracts closure.CONCLUSION Early vedolizumab and stool diversion are effective and safe in treating CD with complex rectal fistula with abscess formation.
文摘Song et al have reported a 100% success rate of acellular extracellular matrix (AEM) anal fistula plug in low fistula-in-ano. The results with this product in high fistula-in-ano are keenly awaited.
文摘目的探讨3.0 T磁共振成像(MRI)联合多层螺旋电子计算机断层扫描(MSCT)对肛瘘临床分型的诊断价值。方法回顾性分析2020年1月至2022年5月在石家庄市中医院经手术证实的126例肛瘘病人临床资料,术前均行3.0 T MRI和MSCT检查。根据Parks分类法对比3.0 T MRI和MSCT对肛瘘病人检查的准确率,分析两项联合对肛瘘临床分型的诊断价值。结果3.0 T MRI联合MSCT诊断肛瘘外口的准确率(99.03%)高于MSCT单独诊断(90.29%),联合诊断主瘘管的准确率(100.00%)高于3.0 T MRI、MSCT各自单独诊断(93.65%、91.27%)(P<0.01),联合诊断肛瘘内口、瘘管分支、脓肿与各自单独诊断比较均差异无统计学意义(P>0.05);3.0 T MRI联合MSCT诊断括约肌间型、经括约肌型、括约肌上型、括约肌外型与手术结果的符合率分别为98.48%、100.00%、100.00%、100.00%。结论3.0 T MRI联合MSCT对肛瘘临床分型有良好的诊断价值。
