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10/01/1959 12:00 AM
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The Construction and Care of Ileostomy and Colostomy
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So much depends upon the care of the ileostomy or colostomy insofar as its acceptance by the patient is concerned. At best it is a serious psychologic hurdle. Therefore every attempt must be made to have a properly functioning stoma and one that can be cared for with a minimum of trouble.
(C) 1959 Southern Medical Association
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07/01/2009 12:00 AM
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Early Diagnosis of Parastomal Hernia
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No abstract available
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10/01/2005 12:00 AM
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Paradoxical Inflammatory Reaction to Seprafilm: Case Report and Review of the Literature
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This report describes a paradoxical inflammatory reaction to Seprafilm caused by extensive adhesion formation early in the postoperative period. A female patient had development of small bowel obstruction immediately after an uneventful low anterior resection for rectal carcinoma with placement of Seprafilm. The obstruction did not improve with nonoperative therapy. At laparotomy, extensive adhesions necessitating bowel resection and ileostomy were noted. Pathology results showed a giant cell foreign body reaction to Seprafilm. A literature search yielded only two other instances of adverse reactions to Seprafilm. The information provided by this and other atypical reports suggests that further studies aimed at identifying the incidence and pathophysiological mechanisms for such paradoxical reactions are needed.
(C) 2005 Southern Medical Association
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05/01/2006 12:00 AM
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Massive Fecal Impaction Presenting with Megarectum and Perforation of a Stercoral Ulcer at the Rectosigmoid Junction
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A 25-year-old male with lifelong constipation presented to the emergency department with an acute abdomen. Initial resuscitation was performed, and the patient underwent urgent laparotomy. He was found to have feculent peritonitis with megabowel involving the rectum and sigmoid colon and a stercoral ulcer with full thickness erosion, and perforation was also identified on the anti-mesocolic surface at the rectosigmoid junction. Abdominal irrigation and subtotal colectomy with proximal fecal diversion was performed. This case illustrates that recognition of severe, chronic constipation should lead to interventions including disimpaction and aggressive medical management. When indicated, megabowel can be managed surgically in an elective setting based on anatomic findings and physiologic studies. Peritonitis is an ominous late finding in patients with severe constipation.
(C) 2006 Southern Medical Association
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