Malignancies of the anal canal.

BACKGROUND: The carcinomas of the anal canal consist of truly rare clinical entities compared to the most common colorectal malignancies. Consequently, little have been reported on their natural history and course. PURPOSE: The present study is aiming to describe the experience of our clinic with anal cancer and to clarify the incidence of the disease in the Hellenic population. MATERIAL AND METHODS: A 5-year retrospective study was conducted. We searched all cases of patients, diagnosed with anal carcinoma in our medical center. Medical records and histological examination results were all thoroughly registered and evaluated. RESULTS: On the whole, 60 patients were diagnosed with a malignant tumor of anal canal. Among them, 25 cases involved anal adenocarcinoma, 26 cases referred to a squamous cell carcinoma and in 5 cases, Bowen disease was identified. Two melanomas, one GIST stromal tumor and one case of Paget disease, were recognized as well. CONCLUSIONS: It seems that in our center the frequency and prevalence of anal adenocarcinoma is increased compared to the results from international data. More studies involving larger series of patients are required in order to shed further light in the true incidence of anal cancer and it subtypes in Hellenic population.

Burns and ulcerative colitis.

The co-existence of an extensive burn with a systemic disease negatively affects the outcome of the burn as well as the progress of the disease. A case report is presented regarding a 70-yr-old female patient with 45% total body surface area burns and ulcerative colitis under treatment. The outcome of the burns is described and it is pointed out that the healing process of the burns and the remission of the ulcerative colitis were related.

Experimental autotransplantation of the parathyroid gland.

The lateral parathyroid gland of the rabbit was resected and autotransplanted under an ear skin flap. A skin flap at the opposite side was used as control. The success of autotransplantation was established by microangiography of the transplant and by measuring plasma concentrations of parathyroid hormone (PTH), calcium and phosphorus. After 4 months the animals were killed and the transplant was studied histologically and by electron microscopy. Fourteen animals were included in the study. There was an increase in PTH derived from the transplanted gland after 4-6 postoperative days. All animals developed hypocalcaemia during the 3 days after transplantation. There were no significant changes in serum phosphorus. Transplantation did not alter the morphology of the distribution of the cells in the transplanted gland, which functioned normally after the fourth postoperative day.

Toxic megacolon secondary to acute ischemic colitis.

A 72-year-old woman without significant medical history was admitted with abdominal pain, high fever, leukocytosis, bloody diarrhea and marked dilation of the transverse, descending and sigmoid colon. Toxic megacolon was diagnosed and responded well to medical treatment. Seven weeks after her admission, however, the patient developed a stenotic lesion in the sigmoid colon. The lesion was managed surgically. Histological examination of the resected colon revealed resolving ischemic colitis affecting only part of the thickness of the intestinal wall. The patient has been healthy since the surgery, i.e., for two years.

Duodenostomy.

The methods of managing a difficult duodenal stump after gastric resection are reviewed. One of two methods of catheter drainage of the duodenum can be used: end-stump catheterization or lateral tube drainage. A series of cases managed by end-stump duodenostomy is reviewed. The rationale for this technique and its advantages are presented.