A new surgical approach for pilonidal sinus disease: "de-epithelialization technique''.

OBJECTIVE: In the treatment of pilonidal sinus disease different approaches are used such as conservative treatment and fasciocutaneous rotation flap. The aim of this study was to evaluate the efficacy of "de-epithelialization technique" as a new approach in pilonidal sinus disease treatment. MATERIAL AND METHODS: Forty pilonidal sinus disease patients treated with de-epithelialization method were evaluated retrospectively. Patient age, gender, body mass index, wound healing time, visual analog scale scores, operation times, hospital stay duration, drain removal time, cosmetic satisfaction rates, complications, and recurrence rates were evaluated. RESULTS: The numbers of male and female patients in this study were 39 and 1, respectively. The median age of the patients was 25 years and the mean BMI was 26.6. The mean operating time was 43 min, and all patients were discharged 5 h after the operation. Wound healing time varied from 10 to 20 days. Median follow-up period was 9 months (4-17 months). One patient with high body mass index suffered from partial wound separation. No other complications such as infections and fluid collections (hematoma and seromas) were observed. Maximum cosmetic satisfaction rate was 90% (n=36), and no patient had a recurrence during the follow-up period. CONCLUSION: "De-epithelialization" may be considered as a complementary and/or alternative approach to other surgical techniques such as primary closure, rhomboid excision, and Limberg flap in the treatment of pilonidal sinus disease, with acceptable cosmesis and recurrence rates.

A rare condition of anorectal dysfunction in a patient with multiple sclerosis: Coexistence of faecal incontinence and mechanical constipation: Report of case.

INTRODUCTION: Multiple sclerosis is a chronic demyelinating neurological disease and causing a variety of neurological symptoms, including discomfort of anorectal function. Constipation and faecal incontinence present as anorectal dysfunction in MS and anal manometry, colonic transit time, electromyography, and defecography can be used for assessment. PRESENTATION OF CASE: We presented a thirty-three years old woman with rare condition of anorectal dysfunction in multiple sclerosis. Anal manometry, defecography were done, and synchronously anal incontinence and mechanical constipation due to rectocele and anismus were detected in this patient. DISCUSSION: Although anal incontinence and constipation are seen often in patients with multiple sclerosis, in the literature, coexistence of animus, rectocele and anal incontinence are quite rare. CONCLUSION: Defecography and anal manometry are useful diagnostic methods for demonstration of anorectal dysfuntions in patients with MS.

A rare cause of acute appendicitis: an ingested foreign body.

Various kinds of foreign bodies causing appendicitis have been reported. However, a needle contained in the appendix is very rare, especially in adults. We report an unusual case of a twenty year old man who had ingested a needle ten days prior and presented with signs and symptoms of acute abdominal pain. An abdominal computed tomography scan revealed acute appendicitis. The patient was successfully treated with laparoscopic surgical intervention. In cases of a foreign body in the gastrointestinal tract that cannot be removed endoscopically, the emergence of non-specific symptoms may be early symptoms of acute problems in the abdomen.