Squamous-cell carcinoma developing after an ileoanal pouch procedure: report of a case.

Purpose: This study was designed to report a new variant of a rare but serious complication of restorative proctocolectomy.

Methods: We present a 47-year-old female who underwent restorative proctocolectomy after 16 years of disease. Twenty-five years after her pouch procedure, she underwent pouchoscopy for fever and poor pouch function.

Vacuum-assisted closure of complex perineal wounds.

The Vacuum-assisted Closure device decreases the time to wound healing, thus increasing the deposition of granulation tissue, and decreasing the use of wound care specialists. Perineal wounds present a special challenge. We present four cases of complex perineal wounds in which the Vacuum-assisted Closure device was used.

Endorectal ultrasound in the preoperative evaluation of rectal cancer.

For rectal cancer, the decisions about neoadjuvant therapy, radical resection, or local excision depend on accurate preoperative staging. Multiple modalities are available to stage rectal cancer, including digital rectal examination, computed tomography, magnetic resonance imaging (MRI), and endorectal ultrasound (ERUS). Digital rectal examination accuracy varies from 58% to 88% for depth of penetration.

Nonoperative management of complicated diverticular disease.

The complications of diverticular disease of the colon can be divided into those related to inflammatory conditions (diverticular abscess, fistula, and perforation) and those related to noninflammatory conditions (lower gastrointestinal hemorrhage and noninflammatory stricture or obstruction). Nonoperative management of uncomplicated diverticulitis includes bowel rest and antibiotics. For abscesses, percutaneous drainage by radiologic guidance often turns complicated diverticulitis to an uncomplicated condition.

Surgeon-performed ultrasound: endorectal ultrasound.

Endorectal (ERUS) and endoanal (EAUS) ultrasound imaging is increasingly being performed by surgeons in the office and outpatient setting for the assessment of both benign and malignant disease. Multiple studies have demonstrated the accuracy of these modalities in identifying pertinent anatomy and anatomic abnormalities. The ultrasound is easily tolerated by most patients, and is easily performed with minimal preparation on the patient's part.

Perianal mucinous adenocarcinoma: unusual case presentations and review of the literature.

Perianal mucinous adenocarcinoma is a rare cancer constituting 3 to 11 per cent of all anal carcinomas. It may arise de novo or from a fistula or abscess cavity. We present two cases of this disease process.

Acute management of exposure to liquid ammonia.

Ammonia injury is an uncommon injury, but it is associated with high morbidity and mortality. This case report demonstrates the pathophysiology and treatment of both cutaneous burn wounds and inhalation injury caused by ammonia. Frequent bronchoscopy was used to attempt to avoid intubation and its associated morbidity.