Systemic vasculitis is generally believed to be an immune complex deposition in blood vessels. Gastrointestinal com­plications of vasculitis have been described as pain, diarrhea, rectal bleeding and abnormal liver enzymes. Taken in isolation, the symptoms are difficult to distinguish from in­flammatory bowel disease, infectious colitis or ischemic coli­tis, although gastrointestinal vasculitis rarely presents without other [...]

Continue reading " Esophageal involvement in Wegener’s granulomatosis: DISCUSSION "

Initial laboratory studies revealed a white blood cell count of 10.7×109/L (4.4 to 11.0×109/L), hemoglobin level of 111 g/L (normocytic, normochromic) and platelet level of 599×109/L. Electrolytes and liver enzyme levels were normal and her creatinine level was 98 pmol/L. The erythrocyte sedimentation rate was 125 mm/h. Urinalysis showed many red blood cells with no [...]

Continue reading " Esophageal involvement in Wegener’s granulomatosis: part 2 "

Esophageal involvement in Wegener’s granulomatosis: A case report and review of the literature Wegener’s granulomatosis is characterized by agranulo- matous arteritis involving the upper and lower respi­ratory tracts, progressive glomerulonephritis and systemic symptoms attributable to small vessel vasculitis. Although multisystemic manifestations are frequent, involvement of the gastrointestinal tract is uncommon. A patient whose initial presentation [...]

Continue reading " Esophageal involvement in Wegener’s granulomatosis "

A recently published method may offer a promising alternative to increase the (neo) rectal compliance follow­ing low resection. A Swiss group described a new pouch cre­ated in an experimental pig model designed by performing a mere longitudinal colotomy of the taenia libera coli followed by a transverse closure. Although the pouch volume of this new [...]

Continue reading " Preservation and restoration of sphincter function in patients with rectal cancer: Part 3 "

By using this technique, resection of the rectum may be extended into the anal canal by removing the internal sphincter completely or partially (‘intersphincteric resec­tion’), thus offering the opportunity for sphincter-preserving resections of tumours below 5 cm from the dentate line. In general, ultralow resection of rectal cancer with coloanal anastomosis is associated with an [...]

Continue reading " Preservation and restoration of sphincter function in patients with rectal cancer: Part 2 "

Surgery is the most important form of treatment for rectal cancer by radical local tumour control. Despite that recurrence-free survival is still the major goal of surgical therapy, it is also widely accepted that the surgeon should re­lieve distressing symptoms associated with the procedure. A major concern of patients with colorectal cancer is the possibility [...]

Continue reading " Preservation and restoration of sphincter function in patients with rectal cancer "

Despite the abundance of literature on management of acha- lasia, there appears to be a relative paucity of prospective, randomized controlled studies that directly compare differ­ent treatment modalities. Until recently, there have only been two really effective methods of treating patients with achalasia: forceful dilation and surgery. Data from uncon­trolled retrospective trials have, in general, [...]

Continue reading " Achalasia: Treatment options revisited. COMPARATIVE STUDIES "