Radiation-induced total regression of a highly recurrent giant perianal condyloma: report of case.

We report a case of a highly recurrent giant perianal condyloma, or Buschke-Lowenstein tumor, which was successfully treated by telecobalt therapy. We conclude that radiation therapy is an optional treatment modality for the management of giant perianal condylomata in selected cases.

[Chagasic megacolon. Treatment by abdominal recto-sigmoidectomy with mechanical colo-rectal termino-lateral anastomosis. Preliminary results]. / Megacólon chagásico. Tratamento pela retossigmoidectomia abdominal com anastomose mecânica colorretal término-lateral. Resultados preliminares.

Abdominal rectosigmoidectomy with end to side colorectal mechanical anastomosis is proposed as a new technique for surgical treatment of Chagasic megacolon. The rectum is sectioned and closed at the level of the peritoneal reflexion. The end of the descending colon is anastomosed to the posterior surface of the rectum, as distal as possible, using the intraluminal stapler (Ethicon CDH33). The final result of the operation is similar to Duhamel-Haddad technique with the advantage of being a one stage operation. Forty-three patients with chagasic megacolon were operated on during the period 1989-1994. Twenty-seven were female and 16 were male with ages ranging from 23 to 76 and a mean of 46.1 years. Results obtained were satisfactory; there were no deaths; only three postoperative complications occurred (6.9%). Only one of these (dehiscence of the rectal cupula) was specific for the proposed technique. The two others were intestinal obstruction, due to volvulus of the small intestine in one case and to adhesions in the other. All complications were managed by surgery. All patients are being followed regularly and up to the present time they report daily bowel movements, passing well-formed stools. There are no complaints of fecal incontinence sexual function or disturbed formation of fecaloma in the rectal stump. The colorectal anastomosis was ample in all patients. Since this is a one stage operation with a low rate of complications, the short hospital stay largely compensates the cost of the mechanical suturing device. Regarding recurrences, a long follow-up period of at least 10 years is necessary to evaluate the real effectiveness of this technique.

[Anaphylaxis after dextran 40 infusion: report of a case and review of the literature]. / Anafilaxia após infusão de dextran 40: relato de caso e revisão bibliográfica.

Anaphylactic reactions to colloid volume substitutes, such as dextran, are rare, however, with their increasing utilization in clinical practice an increasing awareness of their potential antigenicity is required. This article reports a severe allergic reaction induced by infusion of dextran 40 during the beginning of a general anesthesia in a 59 year old patient who was going to be submitted to an operation for treatment of chagasic megacolon. The patient died from this complication after 28 days. A review of literature of this complication and a discussion about its physiopathological mechanism and prevention is presented.