Supralevator abscess is a rare form of anorectal disease responsible for very rare but morbid manifestations, one of which is superior spread through fascial planes. We present a rare case of a ...spreading anorectal abscess in a patient who presented with only diffuse abdominal pain, and we review similar cases in the literature according to anatomical considerations, presentation, diagnostic procedures, and treatment options. We identified 7 previously reported cases of spreading anorectal abscesses. Most abscesses had a horseshoe morphology, and all patients presented or developed abdominal pain. All patients had perianal swelling and pain. Five out of 7 patients were previously mistreated. Only 2 abscesses spread through both the pre- and retroperitoneal planes. Abdominal pain is a dominant feature of extraperitoneal inflammation originating from anorectal abscesses. The absence of perianal signs is rare, and proper inspection of the patient along with the medical history can lead to quicker diagnosis and decisive treatment.
Aim Several biomarkers are currently used as diagnostic and prognostic tools in patients with cancer. Soluble urokinase plasminogen activator receptor (suPAR) is elevated in acute and chronic ...inflammatory procedures and several observational studies during the last 20 years have investigated its role in oncology. The purpose of this article was to review the current literature regarding suPAR’s role in clinical practice. Methods A systematic literature search of PubMed, Scopus, OpenGrey and Cochrane Library databases through September 2021 was conducted using the following search terms: “supar”or “soluble urokinase plasminogen receptor” and “cancer” or “malignancy”. Original articles reporting on suPAR’s role in the diagnosis, prognosis and prediction of therapeutic outcomes in patients with confirmed or suspected cancer were included. Results Among 45 found articles, the most were observational cohort studies. The included studies were further categorized by cancer site. SuPAR level was higher in patients with cancer compared to healthy controls, but its diagnostic and prognostic accuracy differs depending on the site of cancer. Conclusion SuPAR has promising aspects in the field of oncology and public health and future research should further investigate its use in clinical practice. As it is elevated in different types of cancer, it could potentially serve as an adjunctive tool for the mass screening of patients with non-specific signs of cancer, but larger cohort studies that support these findings must be conducted.
Aim To present the experience from collective data regarding patients with retroperitoneal sarcomas that have been operated in and followed up by the University General Hospital of Patras in Rion, ...Greece, between 2009 and 2020. Methods A retrospective analysis of adult patients treated at our hospital with a diagnosis of primary retroperitoneal sarcoma who underwent tumour resection. Results Data from 29 patients were analysed. The mean age at diagnosis was 56.1 years; 55.2% of patients were male (n=16). Liposarcomas (on histology) were identified in 19 (65.5%) patients, leiomyosarcoma six (20.7%), and other histologic subtypes in four (13.8%) patients. Tumours >5cm were presented in 27 (93.1%) patients. Negative margins were attained in 13 (44.8%) of all patients who underwent surgical resection. Five (17.2%) patients received neoadjuvant radiation, four (13.8%) postoperative radiation, and three (10.3%) patients received both chemotherapy and radiation prior to surgery with the rest of the patients being treated with surgical excision alone. A 3-year follow-up was successful in 21 (72.4%) patients; five (23.8%) patients died. In total, 16 (55.2%) patients were found to have a local recurrence, with no significant difference in patients' age, gender, tumour size, histology, negative surgical margin (Ro) resection, neoadjuvant chemotherapy, or radiation therapy. There was a significant difference in the 3-year survival rate between patients having positive or negative surgical margins (p=0.027). Conclusion The higher 3-year survival rate in patients with retroperitoneal sarcomas when achieving Ro resection warrant further investigation with a larger sample size across different institutions.
This report describes the case of an 84‐year‐old male who was brought to the emergency room because a dental bur was swallowed accidentally during a dental procedure. The foreign body was ...successfully removed by gastroenterologists endoscopically 8 days after the ingestion and was identified as a 2‐cm‐long dental bur.
Although the majority of ingested foreign bodies pass through the gastrointestinal tract, endoscopic intervention is necessary in 10%–20% of these cases.
A 48-year-old patient presented acutely in our emergency department, reporting a fainting episode that took place several minutes prior, as well as continuous rectal blood loss. The patient’s prior ...medical history included known grade IV haemorrhoidal disease for the past 33 years, as well as one more instance of hospitalization for haemorrhoid-associated blood loss. Examination of the patient’s vital signs revealed a blood pressure of 98/67 mm Hg and a pulse rate of 68 bpm, while the respiratory rate and temperature were within the normal limits. Anorectal inspection revealed massive, grade IV internal haemorrhoidal disease, with numerous prolapsed and ulcerated haemorrhoids as well as active bleeding sites. Digital palpation of the rectum returned stool of normal consistency, as well as ample fresh blood. Complete blood count report returned hemoglobin (Hb) values of 7.0 g/dl and hematocrit (Hct) of 24.3% in addition to marked neutrophilia (73.9%), indicating severe acute blood loss.
Supralevator abscess is a rare form of anorectal disease responsible for very rare but morbid manifestations, one of which is spreading superiorly through fascial planes.
We present a rare case of a ...spreading anorectal abscess presented only as diffuse abdominal pain and review similar cases of the literature according to the anatomical considerations, presentation, diagnostic procedures and treatment options.
We identified seven cases of spreading anorectal abscesses. Most abscesses had a horse-shoe morphology and all patients presented or developed abdominal pain. All patients had perianal swelling and pain. Five out of seven were previously mistreated. Only two abscesses spread through both pre and retroperitoneal planes.
Abdominal pain is a dominant feature of extraperitoneal inflammation originating from anorectal abscesses. The absence of perianal signs is rare and proper inspection of the patient along with the medical history can lead to quicker diagnosis and decisive treatment.
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