Introduction
The Coronavirus belongs to a family of RNA viruses that can cause respiratory infection, with the possibility of gastrointestinal manifestations in approximately 5—50% of the cases.
Objective
To report a surgical case with a diagnosis of COVID-19 that developed acute perforated abdomen and pneumothorax.
Case report
This was an 80-year-old female patient with respiratory symptoms, with dry cough and fever and diffuse abdominal pain with signs of peritonitis. She had leukocytosis, kidney dysfunction and an increase in D-dimer with positive PCR for COVID. Computed tomography of the chest and abdomen showed pneumothorax on the right and extensive pneumoperitoneum.
Conclusion
The presentation of COVID-19 with severe pulmonary and abdominal complications requires specialized and emergency treatments, but it has high mortality rates.
Introduction Perianal fistula is a condition commonly found in surgical practice, with an incidence of approximately 1 in 10,000 individuals, with a predisposition for the male gender, occurring mainly in patients between 30 and 50 years and in 80% of the cases originating from infection in the glandular crypts (cryptoglandular).
Objective To perform a retrospective analysis using electronic medical record data of patients submitted to surgical treatment for perianal fistula in Santa Marcelina Hospital in São Paulo, as well as to verify the incidence of relapse and anal continence disorders, in addition to the complexity and types of fistulas and patient characterization.
Results Two hundred patients were submitted to surgical treatment of perianal fistula were analyzed. Among men, there was a higher incidence of patients with lower educational level (p = 0.02), hypertension (0.03), diabetes (0.05), older age (p = 0.001), whereas among women previous perianal abscess predominated (0.001). There was no statistical difference in anal continence between patients submitted to fistulotomy with or without seton.
Conclusion We observed a predominance of male patients and a low incidence of recurrence and symptoms of anal continence disorders, in addition to a predominance of complex fistulas.
Introduction Perianal suppurations have an incidence of 1–2:10,000 inhabitants per year and represent about 5% of proctology consultations, more frequently in males, being rare in childhood. Although perianal or anorectal abscess is an entity of relatively simple diagnosis and treatment, in a considerable percentage of patients difficulties will be found, especially considering that the initial treatment of these patients is performed by non-specialist physicians.
Objective This is a retrospective survey of cases of perianal and anorectal abscess operated in Santa Marcelina Hospital between October 2011 and December 2014.
Patients and methods A retrospective study of patients operated on an emergency basis for perianal and/or anorectal abscess in Santa Marcelina Hospital between October 2011 and December 2014, being excluded patients with inflammatory bowel disease. Data of gender, age, clinical presentation, the season of the year in which the abscess occurred, time of progression of symptoms, comorbidities, signs of Systemic Inflammatory Response Syndrome (SIRS) on admission, surgeries carried out, reoperations and clinical outcome were analyzed.
Results Electronic medical records of 52 patients (73.1% male) who underwent surgical treatment of anorectal and perianal abscess were analyzed. The mean overall age was 43.03 years, and all patients reported pain as the main symptom, with a mean time of symptoms of 6.5 days. As for the season of the year of onset and diagnosis of perianal abscess, 61.5% of patients had this pathology in the summer and spring months.
Conclusion In our study, it can be observed a higher incidence of perianal abscess in males and in the warmer months; furthermore, just over half of the patients developed perianal fistula in their progression.
- BACKGROUND: Inflammatory bowel diseases present progressive and potentially debilitating characteristics with an impact on health-related quality of life (QoL) throughout the course of the disease, and this parameter may even be used as a method of evaluating response to treatment. AIM: The aim of this study was to analyze epidemiological data, medications in use, previous surgeries, and hospitalizations in patients with inflammatory bowel diseases, and to determine the impairment in QoL of these patients. METHODS: This is a prospective, cross-sectional, observational study in patients with inflammatory bowel disease followed up in a tertiary hospital in São Paulo-SP, Brazil. General and disease-related, evolution, and quality-of-life data were analyzed using a validated quality-of-life questionnaire, namely, Inflammatory Bowel Disease Questionnaire (IBDQ). RESULTS: Fifty-six individuals were evaluated, with an equal number of patients with Crohn’s disease and ulcerative colitis. A higher prevalence of previous surgeries (p=0.001) and hospitalizations (p=0.003) for clinical-surgical complications was observed in patients with Crohn’s disease. In addition, the impairment of QoL also occurred more significantly in these patients (p=0.022), and there was a greater impact on females in both forms of inflammatory bowel disease (p=0.005). CONCLUSIONS: Patients with Crohn’s disease are more commonly submitted to surgeries and hospitalizations. Patients affected by both forms of inflammatory bowel disease present impairments in QoL, which are mainly related to intestinal symptoms, and females are more affected than men.
Tuberculosis remains a public health problem and its rare extrapulmonary forms persist with late diagnosis, which delays the diagnosis and favors the dissemination of the disease. The perianal manifestation occurs in approximately 0.7% of tuberculosis cases and usually manifests as fistulizing disease, but may also present with ulcerated lesions, with necrotic and quite painful clinical picture. Initial treatment should be carried out aimed at controlling perineal and perianal sepsis, with subsequent establishment of specific drug therapy provided by the Health Ministry.
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