Background: Bacterial translocation occurs in preseptic conditions such as intestinal obstruction through unclear mechanism. The C-reactive protein is an acute phase reactant and a marker of ischemia. Methods: 45 albino male rats were divided into 3 groups each 15 rats. GI control, GII simple intestinal-obstruction and GIII strangulated obstruction. Outcome measures were: (1) Bacteriologic count and typing for intestinal contents, intestinal wall, liver, mesenteric lymph nodes and blood (cardiac and portal) (2) Histopathologic: mucosal injury score, inflammatory cell infiltrate in the wall, MLN, liver, (3) Biochemical: serum CRP, IL-10, mucosal stress pattern (glutathione peroxidase-malonyldialdhyde tissue levels). Results: (1) Intestinal obstruction associates with BT precursors (Bact-overgrowth, mucosal-acidosis, immuno-incomptence), (2) Bacterial translocation (frequency and density) was found higher in strangulated I.O, that was mainly enteric (aerobic and anaerobic) and mostly E.coli, (3) The pathogen commonality supports the gut origin hypothesis but the systemic inflammatory response goes with the cytokine generating one. (4) The CRP median values for GI, II, III were 0.5, 6.9, 8.5 mg/L, for BT +ve 8 mg/L and 0.75 mg/L for BT -ve rats. Conclusion: Bacterial translocation occurs bi-directional (systemic-portal) in intestinal obstruction and the resultant inflammatory response pathogenesis is mostly 3 hit model. The CRP is a non selective marker of suspected I.O cases. However, it is a reliable marker of BT, BT density and vascular compromise during I.O. Key words: Intestinal Obstruction. Ischemia. Bacterial Translocation. Rats. RESUMO Objetivo:Translocação bacteriana ocorre em condições pré-sépticas como na obstrução intestinal por mecanismo não esclarecido. A proteína C-reativa é um marcador de ischemia em fase aguda. A proposição é investigar os possíveis efeitos da obstrução intestinal no equilíbrio ecológico microbiano. Métodos: 45 ratos machos albinos foram distribuídos em três grupos de 15 ratos. GI controle, GII obstrução intestinal simples e GIII obstrução estrangulada. As medidas adotadas foram: (1) Contagem bacteriológica do conteúdo intestinal, parede intestinal, fígado, linfonodos mesentéricos e sangue (coração e portal) (2) Avaliação histopatológica da lesão da mucosa, infiltrado celular inflamatório da parede, linfonodos mesentéricos, fígado, (3) Avaliação bioquímica. Resultados: (1) Obstrução intestinal está associada a precursora translocação bacteriana (crescimento bacteriano, acidose da mucosa, imuno-incompetência), (2) Translocação bacteriana (freqüência e densidade) foi maior na obstrução intestinal estrangulada, principalmente entérica (aeróbios e anaeróbios), sobretudo E.coli, (3) A ocorrência comum é de origem intestinal. Conclusão: A translocação bacteriana na obstrução intestinal é bi-direcional (sistêmica e portal) A proteina C-reativa não é um marcador seletivo na suspeita de obstrução intestinal. Contudo é marcador confiável da translocação bacteriana, na densidade e com...

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LigaSure hemorrhoidectomy provides a valid alternative to closed hemorrhoidectomy. LigaSure patients gain short-term benefits in terms of reduced postoperative pain, wound healing, and better satisfaction. Based on our preliminary results, future studies addressing long-term functional results are needed to prove that LigaSure hemorrhoidectomy may be safer for the patients.

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Aim: This study was done to assess the efficacy and advantage of fibrin glue therapy in anal fistulae in comparison to conventional treatment. Patients and Method:The results of treatment of anal fistula by autologous fibrin tissue adhesive in 30 patients were compared with those obtained by conventional surgery in another 30 patients. All patients in both procedures had preoperative mechanical bowel preparations and preoperative intravenous antibiotic.The two groups were matched for age, sex, fistula type and follow-up duration. Results:The non-invasive fibrin glue application was extremely satisfactory in 24 patients out of 30 patients (80%), two healed after another attempt, three showed no postoperative improvement and one patient developed intersphincteric abscess (morbidity 3.3%). Median hospital stay was 1.5 days, while patients' discomfort was minimal. There was no postoperative impairment of anal sphincter function and there was no recurrence. In the group undergoing laying open operations, recurrence occurred in five patients, median hospital stay was 3.1 days, and strong analgesia was needed. Continence disorder occurred in four patients, one patient remained incontinent only for flatus, in two patients minimal soiling persists for more than three months followup. Conclusion:In conclusion, the above data showed that fibrin glue application in anal fistula is a simple, easy, safe, and effective procedure, although longer follow-up and bigger series are needed.

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Background: Genetic events associated to colorectal carcinoma are well characterized, but there is scanty information about this issue in Egyptian subjects. The aim of this study was to investigate tissue p53 overexpression in paraffin embedded tumor and serum p53 antibodies in colorectal cancer patients with special reference to patient outcome.