Thursday, 23 April 2009

panproctocolectomy for severe perianal crohns with rectus abdominis flap reconstruction

A man in his 30s presented with a history of 18 years of crohns disease confined to his colon and rectum with a watering can anus. He was unresponsive to medical treatment and continued to smoke

The colon was fully mobilized and extensive excision of peranal skin affected by multiple fistulae performed. The colon, rectum and anus were removed from the perineum.

This left a big defect!

A vertical rectus abdominis flap was raised based on inferior epigastic vessels (forceps pointing to these)

The flap was rotated around and placed in perineum to fill the defect.
The patient went home 9 days after the operation with all healed

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  1. the picture with the description;

    ''This left a big defect!''

    what area of the is that?

  2. Do not play with your anus with pingers.
    Or your anus will become like this ass hole.

  3. The exact reason why colon cancer develops in some persons and not in others is not clear. The incidence of colon cancer is quite varied among different countries and within different ethnic groups inside the same country. Industrialized countries like United States, Canada, UK, Western Europe, Australia and Japan have a much higher incidence of colorectal cancer compared to the less industrialized parts of the world like Asia, Africa, and South America. 

    Progon B