Anthony R. Gennaro

Anterior sacral meningocele: Report of five cases and review of the literature

SummaryFive new cases of anterior sacral meningocele are presented, including one secondary to neurofibromatosis, a previously undescribed association. The literature is reviewed, drawing attention to the relationship between anterior sacral meningocele, sacral dysgenesis, and other congenital anomalies. Special consideration is given to the clinical features of this entity, as well as to the techniques and results of surgical management.

A foreign body (chicken bone) in the rectum causing extensive perirectal and scrotal abscess: report of a case.

SummaryA case of foreign-body perforation of the rectum with extensive necrotizing fasciitis is presented and the literature briefly reviewed. The peculiarity of the case was brought out because of the nature of the foreign body (chicken bone) and the extensiveness of the process. The increased risk of swallowing a foreign body if dentures are worn is pointed out.

Intralesional bleomycin injection in treatment of condyloma acuminatum

The antitumoral antibiotic, bleomycin, was given by intralesional injection to ten patients with condyloma acuminatum. Our 70 per cent success rate suggests this is a reasonable alternative treatment in the management of anal warts which prove unresponsive to other modalities.

Obstructive colonic cancer.

SummaryThe clinical courses of 68 patients with obstructive colonic cancers were reviewed. For the majority of patients with an acutely obstructing cancer of the left colon a conventional staged procedure remains the most appropriate treatment. Primary resection is suitable for the more proximal colonic cancer with obstruction. The operative mortality rate was 13.6 per cent, but with the addition of two nonoperative deaths, the figure rises to 16.2 per cent. Only six patients are known to have survived five years.

Colonic diverticula and hemorrhage

SummaryApproximately 17 per cent of 500 patients with diverticular disease had colonic hemorrhage. In most cases the bleeding was mild, but it is potentially a lethal complication. In this series the associated mortality was 3.6 per cent. If the bleeding site is readily identifiable it is reasonable to resect the involved area; if not, total abdominal colectomy with ileorectal anastomosis is the preferred procedure. Selective arteriography is now performed more often, and has been helpful in localizing the site of hemorrhage in several patients.

Re-evaluation of the merit of the liver scan in the management of patients with cancer of the colon and rectum

SummaryRadioisotopic scanning of the liver has limitations but is a useful adjunct in determining the presence or absence of malignant invasion of the liver.

Diverticulitis of the colon

SummaryDiverticulosis affects both sexes about equally, but diverticulitis is more common in females. Twenty-five per cent of patients with diverticulosis will develop diverticulitis; this percentage rises as the follow-up period lengthens. The probability of developing a complication increases with each attack of diverticulitis and when diabetes coexists. The morbidity and mortality (6.5 per cent) associated with these complications remain high. Consequently, elective operation during a quiescent stage of recurrent diverticulitis appears increasingly preferable to the urgent and often multistaged procedures necessary for complicated diverticulitis. Staged procedures—resecting the diseased segment during the first operation, if possible—remain the safest method for treating these complications.

Neurilemoma of the rectum and perirectal area: Report of a case

SummaryA case of retrorectal neurilemoma and a review of world medical literature from 1935 to 1966, for specific nerve-sheath tumors of the rectum and perirectal areas, have been presented. Sixteen cases have been studied. Often, nonspecific pain, a palpable mass and rectal dysfunction are the presenting symptoms. The diagnosis is made by microscopic examination. The neoplasm is encapsulated and has specific morphologic features which differentiate it from the neurofibroma and other tumors.

Tissue CEA in colorectal carcinoma

Immunoperoxidase method can be used to detect cellular or tissue CEA. Forty formalin-fixed paraffin-embedded specimens of colorectal carcinoma, 19 from patients who survived for five years after resection, and 21 from patients who died within five years were studied. Cellular CEA was present in 100 per cent of the specimens. Accurate quantitative evaluation of cellular CEA is currently not feasible. Therefore, the mere presence of cellular CEA has no prognostic value.

Dermatomyositis and associated lesions of the gastrointestinal tract

SummaryDermatomyositis is an uncommon disease which produces, in addition to its well-known skin and musculoskeletal symptoms, variable gastrointestinal complaints. When it first appears in adult life a diligent search should be made for an associated neoplasm, since they occur in more than 50 per cent of such patients over 40 years of age.