A non-healing peri-anal abscess can be difficult to manage and is often attributed to chronic disease. This case documents a male in his seventh decade who presented with multiple peri-anal collections. The abscess cavity had caused necrosis of the internal sphincter muscles resulting in faecal incontinence. Biopsies were conclusive for diffuse large B-cell lymphoma. A de-functioning colostomy was performed and the patient was initiated on CHOP-R chemotherapy. Anal lymphoma masquerading as a peri-anal abscess is rare. A high degree of suspicion must be maintained for an anal abscess which does not resolve with conservative management.
<p><b>Background:</b> This study evaluated the impact of decreasing renal function on short-term outcomes in patients undergoing primary coronary artery bypass grafting (CABG).</p><p><b>Methods:</b> The study period was from February 1999 to February 2009. Data on 4050 patients undergoing primary CABG were prospectively collected and analyzed retrospectively. The study population was divided into 3 groups: the CABG:N group, patients with preoperative serum creatinine levels <2 mg/dL (n = 3947); the CABG:RF group, patients with preoperative creatinine levels >2 mg/dL (n = 87); and the CABG:D group, patients on dialysis (n = 16).</p><p><b>Results:</b> The significant differences between the groups (CABG:D > CABG:RF > CABG:N) in short-term outcomes were with respect to blood product use (<i>P</i> < .001), postoperative acute myocardial infarction (<i>P</i> < .001), pulmonary complications (<i>P</i> .001), infection (<i>P</i> < .001), and death (P < .001). The risk of short-term death (30 days) in the CABG:D group (4/16, 25%) was 25 times greater than that in the CABG:N group (38/3947, 0.96%).</p><p><b>Conclusion:</b> CABG in the presence of renal failure is associated with significant morbidity and mortality.</p>
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