Chronic severe constipation: current pathophysiological aspects, new diagnostic approaches, and therapeutic options.

Chronic constipation is a considerable problem because it significantly affects the quality of a patient's life. Constipation can be diagnosed at every age and is more frequent in women and among the elderly. In epidemiological studies, its incidence is estimated at 2-27% in the general population.

An unusual synchronous ileosigmoid and ileoileal knotting: a case report.

Introduction: Ileosigmoid and ileoileal knotting are two rare entities. They usually present as acute abdomen and the diagnosis is established intraoperatively. The treatment is surgical and should be performed as soon as possible to decrease the incidence of perioperative mortality and morbidity.

Anorectal incontinence: a challenge in diagnostic and therapeutic approach.

Anorectal incontinence is a symptom of a complex multifactorial disorder involving the pelvic floor and anorectum, which is a severe disability and a major social problem. Various causes may affect the anatomical and functional integrity of the pelvic floor and anorectum, leading to the anorectal continence disorder and incontinence. The most common cause of anorectal incontinence is injury of the sphincter muscles following delivery or anorectal surgeries.

Heterotopic pancreas of the gallbladder associated with chronic cholecystitis and high levels of amylasuria.

Context: Heterotopic pancreas of the gallbladder is an extremely rare entity, especially when pancreatic tissue appears histologically with an exclusively exocrine structure.

Case Report: We report the case of a 35-year-old man who presented with symptoms of acalculous gallbladder disease with high levels of amylasuria. Immunohistochemical analysis of the surgical specimen of the cholecystectomy revealed pancreatic tissue at the gallbladder wall.

Chronic perineal pain: current pathophysiological aspects, diagnostic approaches and treatment.

Chronic perineal pain is the anorectal and perineal pain without underlying organic disease, anorectal or endopelvic, which has been excluded by careful physical examination, radiological and endoscopic investigations. A variety of neuromuscular disorders of the pelvic floor lead to the different pathological conditions such as anorectal incontinence, urinary incontinence and constipation of obstructed defecation, sexual dysfunction and pain syndromes. The most common functional disorders of the pelvic floor muscles, accompanied by perineal pain are levator ani syndrome, proctalgia fugax, myofascial syndrome and coccygodynia.

Torsion of an intrahydrocelic sac in a child: A case report.

We report the case of a 3-yr-old boy who presented an acute right hydrocele. A rapid scrotal swelling under tension developed the first hours and the child complained for discomfort especially during palpation of the scrotum. Three days later, surgical exploration revealed an incomplete torsion of a communicated and pedunculated peritoneal sac arising from the tunica vaginalis testis.

An extended retroperitoneal abscess caused by duodenal diverticulum perforation: report of a case and short review of the literature.

The authors report a case of an extended retroperitoneal abscess that developed secondarily after a duodenal diverticulum perforation. The diagnosis was established preoperatively endoscopically and by abdominal CT scan. The patient was treated surgically.

Anorectal incontinence. pathogenesis and choice of treatment.

Fecal incontinence represent a complex and multifactorial disorder. Although the condition is widely accepted as belonging to the elderly, it is now becoming apparent that younger adults are also frequently affected. Its incidence is estimated at 2% of the general population, while in the elderly it may increase up to 60%.

Constipation of anorectal outlet obstruction: pathophysiology, evaluation and management.

Constipation is a subjective symptom of various pathological conditions. Incidence of constipation fluctuates from 2 to 30% in the general population. Approximately 50% of constipated patients referred to tertiary care centers have obstructed defecation constipation.

How necessary is vagotomy after pancreaticoduodenectomy and total pancreatectomy.

Background/aims: Gastrectomy with gastrojejunostomy is a fundamental step used for the restoration of the alimentary tract after pancreaticoduodenectomy or total pancreatectomy. Anastomotic ulcers occurring after pancreaticoduodenectomy, is a well known problem. The aim of our study is to investigate the incidence of anastomotic ulcer after pancreaticoduodenectomy or total pancreatectomy and to elucidate whether vagotomy is necessary.