The performance of prompt, individualized surgical treatment in conjunction with the use of advanced measures of critical care to combat the disastrous consequences of multiple organ failure would contribute greatly to improve survival rate in victims of this dreadful entity.

House advancement flap anoplasty is a relatively simple procedure, combining the beneficial features of rectangular flaps and V-Y plasties. It can be used in nearly all types of anoderm deficiencies with a high rate of success and patient satisfaction.

No abstract

Anal passage of a full-thickness infarcted colonic segment (so-called "cast") not accompanied by any features of acute peritonitis is a very rare occurrence and may be the main advertising manifestation of acute colonic ischemia. Most of the reported cases of acute colonic ischemia are secondary to abdominal aortic aneurysms and ensuing inferior mesenteric artery thrombosis or to the repair of these aneurysms. The preceding events causing ischemia in other cases are Hartmann reversal, rectal resection and colonic J-pouch construction, and acute pancreatitis. In this article we present our experience on four cases of colonic cast passage, all of which developed subsequent to colorectal resection. Three of these casts are supposed to be mucosal and one is transmural. Generally, surgery is the rule and consists of the resection of the concerned ischemic segment. Every clinician should be aware of this form of presentation of bowel ischemia, not only following aneurysm surgery but also in the postoperative course of colorectal surgery.

Primary adenocarcinoma arising at the umbilicus is a very rare condition. The umbilicus has been found to show a wide variety of tumors and is predisposed to metastases from visceral tumors because of its relationships and generous vascular and embryologic connections. Herein, we describe a case of a primary umbilical adenocarcinoma with short time survival related to local recurrence and multiple hepatic metastases 6 months after her surgical treatment.

A case of gastric remnant carcinoma coexisting with a chronic afferent loop syndrome harboring multiple enteroliths in a grossly dilated and elongated afferent loop is presented herein. The patient had undergone a Polya type antecolic Billroth II reconstruction for a stenosing duodenal ulcer 40 years previously. A concise review of the relevant literature is also presented.

The results of this series suggest that coring-out of a fistula using a fistulectome may be a valid treatment for complicated anal fistula.

Giant invasive condyloma acuminatum, also known as Buschke-Löwenstein tumor, is a human papilloma virus (HPV) type 6 or 10-associated lesion which is rarely seen in the anorectum. These lesions despite their histologic benignity are clinically malignant with a propensity for recurrence and invasion. The aggressive character of this lesion and its likelihood of malignant transformation together with the associated significant mortality require early surgical excision with clear margins. Authors report on a patient with giant perianal condyloma acuminatum who was treated in a single session by total excision and fasciocutaneous VY advancement flap.