Perianal application of 0.2 percent nitroglycerin ointment after hemorrhoidectomy significantly reduced narcotic requirements on the second postoperative day. Headaches and a subsequent need for nonnarcotic medications may limit benefits of nitroglycerin.
In women with presumed candidiasis hypersensitivity syndrome, nystatin does not reduce systemic or psychological symptoms significantly more than placebo. Consequently, the empirical recommendation of long-term nystatin therapy for such women appears to be unwarranted.
Post operative pain is often the cause of many ED visits. When patients are discharged and return with postoperative abdominal pain, common etiologies include incisional pain, neuropathic pain, musculoskeletal pain from immobility, ileus, and more sinister causes including adhesive bowel obstruction, abscess formation, and anastomotic leak. We present a 62 year-old female without any hereditary thrombophilia or other prothrombotic factors who presented to the ED after a sigmoid colectomy and diverting ileostomy for perforated diverticulitis and subsequent ileostomy reversal with abdominal pain. CT discovered a left ovarian vein thrombus extending into the left renal vein. With a myriad of diagnoses, it is important to have a low threshold for imaging to rule out serious pathology and also diagnose any unusual causes that can be treated promptly to prevent organ damage and subsequent complications.
The purpose of this case is to highlight a rare case of sigmoid colon-to-rectum fistula. A 66-year-old man with a history of pelvic radiation and diverticulosis presented to the emergency department with a 3-week history of abdominal pain and watery diarrhea. Computed tomography (CT) imaging was significant for a sigmoid-to-rectum fistula with sigmoid stricture. The patient underwent a laparoscopic colectomy with end colostomy. Pathology revealed perforated diverticulitis. To date, there have been no cases reported in literature describing sigmoid-to-rectum fistula. In conclusion, it is important to consider the development of complex diverticular disease in patients with history of pelvic radiation.
74-year-old male presented to the emergency department with complaint of fever, weakness, and fatigue and was admitted to the hospital for further workup. The patient was found to have gram negative bacteremia and Clostridioides difficile infection. Computed tomography imaging of the abdomen and pelvis was obtained and demonstrated air in the retroperitoneal/ presacral space tracking to the left hemipelvis and femoral joint. Concern for possible septic joint lead to an Orthopedic surgery evaluation and magnetic resonance imaging of the left hip and pelvis which revealed a complicated perirectal infection tracking to the left hemipelvis. The patient was taken to the operating room with colorectal surgery for further management and treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.