Current outcomes of emergency large bowel surgery.

Introduction: Emergency large bowel surgery (ELBS) is known to carry an increased risk of morbidity and mortality. Previous studies have reported morbidity and mortality rates up to 14.3%.

An unusual cause of acute internal haemorrhage: cystic artery pseudoaneurysm secondary to acute cholecystitis.

Spontaneous cystic artery haemorrhage is a rare complication of acute cholecystitis. Here we describe a case report of this unusual cause of internal haemorrhage, and discuss the pathogenesis and management strategies.

APRIL is a novel clinical chemo-resistance biomarker in colorectal adenocarcinoma identified by gene expression profiling.

Background: 5-Fluorouracil(5FU) and oral analogues, such as capecitabine, remain one of the most useful agents for the treatment of colorectal adenocarcinoma. Low toxicity and convenience of administration facilitate use, however clinical resistance is a major limitation. Investigation has failed to fully explain the molecular mechanisms of resistance and no clinically useful predictive biomarkers for 5FU resistance have been identified.

Effect of several sugars on consumer perception of cured sheepmeat.

This article reports the perception of cooked, nitrite-cured sheepmeat sausage that included 1.5% glucose, sucrose, xylose, or no sugar addition. The 4 sugar treatments were dry-cooked, vacuum packed, and stored chilled, and were hedonically assessed after 0, 1, and 2 mo.

Prospective randomised multi-centre trial comparing the clinical efficacy, safety and patient acceptability of circular stapled anopexy with closed diathermy haemorrhoidectomy.

Objective: Unlike excisional haemorrhoidectomy, stapled anopexy (SA), which does not involve radical excision, has theoretical advantages, thus offering potential patient benefits. We compared the clinical efficacy, safety and patient acceptability of SA, with closed haemorrhoidectomy (CH).

Patients And Methods: 182 patients with symptomatic haemorrhoids (grades II, III, IV) were randomly assigned to receive SA or CH and were followed for up to 1 year (6, 12, 24, 48 weeks) after operation.

Pathological audit of stapled haemorhoidopexy.

Introduction: Stapled haemorrhoidopexy is increasingly used for the surgical management of prolapsing haemorrhoids. Accurate placement of the staple line is essential to avoid involvement of the internal anal sphincter (IAS) and the pain sensitive squamous epithelium. The aim of this study was to correlate histology with symptomatic outcome after stapled haemorrhoidopexy.

Eniluracil treatment completely inactivates dihydropyrimidine dehydrogenase in colorectal tumors.

Purpose: To determine the effect of eniluracil on colorectal tumor dihydropyrimidine dehydrogenase (DPD) activity.

Patients And Methods: Patients who were to undergo primary colorectal tumor resection received oral eniluracil 10 mg/m(2) twice daily for 3 days before surgery. Mononuclear cells were obtained before the start of eniluracil and on the morning of surgery, to measure DPD activity, protein, and mRNA.

Minimal access surgery for cholelithiasis induces an attenuated acute phase response.

Background: Some benefits of laparoscopic (LC) and minilaparotomy (MC) cholecystectomy may reflect attenuation of the acute phase response. The authors examined components of this response.

Methods: Patients were randomized to LC (n = 11) or MC (n = 11).

Minimal modulation of lymphocyte and natural killer cell subsets following minimal access surgery.

Background: Trauma, whether accidental or surgically induced, is known to cause significant modulation of the cell-mediated immune response. Minimal access surgery (MAS) has been shown to improve postoperative recovery and enhance rehabilitation. The degree of immunosuppression resulting from two MAS techniques was studied and compared by measuring the circulating T lymphocyte and natural killer (NK) cell subsets.

Streptococcal myositis and the acute abdomen: a case report.

Spontaneous streptococcal myositis, previously rare, is now reported more frequently. The condition is caused by overwhelming group A beta-haemolytic streptococcal infection and is not necessarily fatal.

A regional audit of the investigation and treatment of colorectal and pelvic floor disorders (1984-1991).

The activities of a regional physiology unit established for the investigation of colorectal and pelvic floor physiology in health and disease in a clinically relevant setting has been audited and its evolution described over a period of eight years. Trends in surgical treatment of some of these disorders over the same period have also been documented in the Lothian Region. Although there has been little change in the number of patients investigated annually patterns of investigation appear to change.

Solitary rectal ulcer: the place of biofeedback and surgery in the treatment of the syndrome.

Thirty-one patients with the solitary rectal ulcer syndrome were studied, the majority of whom presented with fresh blood per rectum and a rectal ulcer, mucorrhoea, or a varying degree of rectal prolapse. Fourteen patients were treated conservatively or with surgery and had a high rate of recurrence of the solitary rectal ulcer syndrome. Seventeen patients were treated with biofeedback for the associated obstructed defecation (anismus) either before or immediately after surgery with a lower recurrence rate.

Outlet obstruction constipation (anismus) managed by biofeedback.

Fifteen subjects presenting with intractable constipation due to obstructive defecation, mean (SEM) duration 8.8 (1.8) years, had the inappropriate contraction and electromyographic changes in the pelvic floor muscles and external and sphincter typical of this condition.

Constipation associated with chronic spinal cord injury: the effect of pelvic parasympathetic stimulation by the Brindley stimulator.

Ten subjects with severe constipation due to complete spinal cord injury (SCI) had prolonged oro-anal transit time (p less than 0.01), diminished faecal water content (p less than 0.05) and a reduced frequency of defaecation (p less than 0.

The importance of the orientation of the electrode plates in recording the external anal sphincter EMG by non-invasive anal plug electrodes.

Two non-invasive anal plug electrodes of similar size have been compared, one with the electrode plates orientated circularly in the anal canal and the other with the plates in the long axis of the anal canal. There was a significant increase in the amplitude in the EMG signals recorded at rest and during squeeze from the external anal sphincter with a longitudinally placed electrode in 117 patients. Inappropriate contraction of the external anal sphincter when straining at stool was more readily detected using the longitudinal electrode in 52 patients investigated for intractable constipation.

Disordered colorectal motility in intractable constipation following hysterectomy.

Colorectal and anal sphincter motility and electrophysiology were investigated in 14 women with profound constipation following hysterectomy and compared with an asymptomatic group of control subjects. Twelve patients complained of significant urinary symptoms. No differences in the motor function of the anal sphincters were detectable.

Use of the pudendo-anal reflex in the treatment of neurogenic faecal incontinence.

An electrical stimulator has been devised to treat neurogenic faecal incontinence caused by pudendal nerve neuropathy and works on the basis of repeated stimulation of the pudendo-anal reflex arc. Although conduction in the pudendo-anal reflex arc may be prolonged, and is so in neurogenic faecal incontinence, it must be shown to be present before the method can be used. This stimulation results in an immediate rise in the pressure in the anal canal and a significant increase in the electromyographic activity of the external anal sphincter.