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Forensic Science, Medicine, and... Mar 2022A case of a sadistically motivated homicide with extraordinary injuries is reported. A 32-year-old woman was naked with signs of severe blunt trauma and oral, vaginal...
A case of a sadistically motivated homicide with extraordinary injuries is reported. A 32-year-old woman was naked with signs of severe blunt trauma and oral, vaginal and anal penetration. At the crime scene, the intestine lay next to the woman without connection to the body. During the trial before the criminal court, the perpetrator admitted fisting and inserting several objects into the vagina, anus and oral cavity. Moreover, after anal and vaginal insertion of the hands, large parts of the intestine were torn and pulled out through the anus and the vagina. The results of the forensic pathological examination and additional investigation are discussed and compared with the pertinent literature. This extraordinary case of a sadistically motivated homicide ended with a final judgment that is extremely rare in German jurisdiction.
Topics: Adult; Anal Canal; Criminals; Female; Homicide; Humans; Lacerations; Rape
PubMed: 34677793
DOI: 10.1007/s12024-021-00433-6 -
World Journal of Gastroenterology Oct 2014Anal fistulas are a common manifestation of Crohn's disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a... (Review)
Review
Anal fistulas are a common manifestation of Crohn's disease (CD). The first manifestation of the disease is often in the peri-anal region, which can occur years before a diagnosis, particularly in CD affecting the colon and rectum. The treatment of peri-anal fistulas is difficult and always multidisciplinary. The European guidelines recommend combined surgical and medical treatment with biologic drugs to achieve best results. Several different surgical techniques are currently employed. However, at the moment, none of these techniques appear superior to the others in terms of healing rate. Surgery is always indicated to treat symptomatic, simple, low intersphincteric fistulas refractory to medical therapy and those causing disabling symptoms. Utmost attention should be paid to correcting the balance between eradication of the fistula and the preservation of fecal continence.
Topics: Anal Canal; Crohn Disease; Digestive System Surgical Procedures; Fecal Incontinence; Gastrointestinal Agents; Humans; Patient Care Team; Predictive Value of Tests; Rectal Fistula; Risk Factors; Treatment Outcome; Wound Healing
PubMed: 25309057
DOI: 10.3748/wjg.v20.i37.13205 -
BMJ (Clinical Research Ed.) Sep 1993
Topics: Anal Canal; Fecal Incontinence; Female; Humans; Obstetric Labor Complications; Pregnancy
PubMed: 8401042
DOI: 10.1136/bmj.307.6905.636 -
Surgical Oncology Clinics of North... Jan 2017Anal canal cancer is an uncommon malignancy but one that is often curable with optimal therapy. Owing to its unique location, histology, risk factors, and usual... (Review)
Review
Anal canal cancer is an uncommon malignancy but one that is often curable with optimal therapy. Owing to its unique location, histology, risk factors, and usual presentation, a careful diagnostic approach is warranted. This approach includes an excellent history and physical examination, including digital rectal examination, laboratory data, and comprehensive imaging. Anal cancer staging and formulation of a treatment plan depends on accurate imaging data. Modern radiographic techniques have improved staging quality and accuracy, and a thorough knowledge of anal anatomy is paramount to the optimal multidisciplinary treatment of this disease.
Topics: Anal Canal; Anus Neoplasms; Carcinoma, Squamous Cell; Diagnostic Imaging; Endosonography; Humans; Neoplasm Staging; Reproducibility of Results; Sensitivity and Specificity
PubMed: 27889036
DOI: 10.1016/j.soc.2016.07.002 -
California Medicine Mar 1963Carcinoma of the anus is a rare tumor when skin tumors which may have arisen from the perianal skin are excluded. A significant proportion of anal carcinomas, exclusive...
Carcinoma of the anus is a rare tumor when skin tumors which may have arisen from the perianal skin are excluded. A significant proportion of anal carcinomas, exclusive of those from perianal skin, may very well have their origin from the intermediate zone of transitional epithelium and its and ducts, which would account for the different histological patterns presented by these cancers. These tumors are frequently described as of low grade malignancy and indeed some of them may be; but, the majority behave as very aggressive carcinomas, capable not only of rapid and extensive local invasion but also capable of lymph node metastasis. The treatment should be surgical and aggressive if operation is feasible.
Topics: Anal Canal; Anus Neoplasms; Carcinoma; Humans; Lymphatic Metastasis; Male
PubMed: 13952532
DOI: No ID Found -
Asian Journal of Surgery Oct 2023
Topics: Humans; Anus Neoplasms; Rectal Fistula; Anal Canal; Treatment Outcome
PubMed: 37344312
DOI: 10.1016/j.asjsur.2023.05.085 -
Archives of Pathology & Laboratory... Nov 2010The anal canal possesses complex anatomy and histology and gives rise to a variety of tumor types. Challenging issues remain with regard to both the pathologic diagnosis... (Review)
Review
CONTEXT
The anal canal possesses complex anatomy and histology and gives rise to a variety of tumor types. Challenging issues remain with regard to both the pathologic diagnosis and the clinical management of these tumors.
OBJECTIVES
To provide an updated overview of the histogenesis, clinical and pathologic characteristics, diagnostic terminology, and relevant clinical management of the various types of anal canal tumors.
DATA SOURCES
Recent literature on clinical and pathologic characteristics of anal canal tumors.
CONCLUSIONS
Although most anal canal tumors are of squamous lineage, a complex variety of other tumors also occurs. Recognition of such diverse tumor entities will allow accurate pathologic diagnosis and most optimal clinical management.
Topics: Adenocarcinoma; Anal Canal; Anus Neoplasms; Carcinoma, Squamous Cell; Humans; Melanoma
PubMed: 21043813
DOI: 10.5858/2009-0668-RAR.1 -
Medicina (Kaunas, Lithuania) 2004The prevalence of minor anorectal diseases is 4-5% of adult Western population. Operations are performed on ambulatory or 24-hour stay basis. Requirements for ambulatory... (Review)
Review
The prevalence of minor anorectal diseases is 4-5% of adult Western population. Operations are performed on ambulatory or 24-hour stay basis. Requirements for ambulatory anesthesia are: rapid onset and recovery, ability to provide quick adjustments during maintenance, lack of intraoperative and postoperative side effects, and cost-effectiveness. Anorectal surgery requires deep levels of anesthesia. The aim is achieved with 1) regional blocks alone or in combination with monitored anesthesia care or 2) deep general anesthesia, usually with muscle relaxants and tracheal intubation. Modern general anesthetics provide smooth, quickly adjustable anesthesia and are a good choice for ambulatory surgery. Popular regional methods are: spinal anesthesia, caudal blockade, posterior perineal blockade and local anesthesia. The trend in regional anesthesia is lowering the dose of local anesthetic, providing selective segmental block. Adjuvants potentiating analgesia are recommended. Postoperative period may be complicated by: 1) severe pain, 2) urinary retention due to common nerve supply, and 3) surgical bleeding. Complications may lead to hospital admission. In conclusion, novel general anesthetics are recommended for ambulatory anorectal surgery. Further studies to determine an optimal dose and method are needed in the group of regional anesthesia.
Topics: Adjuvants, Anesthesia; Adult; Ambulatory Surgical Procedures; Anal Canal; Anesthesia; Anesthesia, Conduction; Anesthesia, General; Anesthesia, Local; Anesthesia, Spinal; Anus Diseases; Cost-Benefit Analysis; Digestive System Surgical Procedures; Humans; Intubation, Intratracheal; Nerve Block; Pain, Postoperative; Postoperative Complications; Rectal Diseases; Rectum
PubMed: 15007268
DOI: No ID Found -
Korean Journal of Radiology 2017Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic... (Review)
Review
Although a rare disease, anal cancer is increasingly being diagnosed in patients with risk factors, mainly anal infection with the human papilloma virus. Magnetic resonance imaging (MRI) with external phased-array coils is recommended as the imaging modality of choice to grade anal cancers and to evaluate the response assessment after chemoradiotherapy, with a high contrast and good anatomic resolution of the anal canal. MRI provides a performant evaluation of size, extent and signal characteristics of the anal tumor before and after treatment, as well as lymph node involvement and extension to the adjacent organs. MRI is also particularly helpful in the assessment of complications after treatment, and in the diagnosis for relapse of the diseases.
Topics: Aged; Anal Canal; Antimetabolites, Antineoplastic; Anus Neoplasms; Female; Fluorouracil; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Positron Emission Tomography Computed Tomography; Radiation, Ionizing; Tomography, X-Ray Computed
PubMed: 29089827
DOI: 10.3348/kjr.2017.18.6.946 -
Digestion 2004Neural control of pelvic organs is affected by a unique coordination of somatic and autonomic motor nervous systems. Sensory information and feedback is supplied by both... (Review)
Review
Neural control of pelvic organs is affected by a unique coordination of somatic and autonomic motor nervous systems. Sensory information and feedback is supplied by both visceral and somatic sensory fibers. The anatomical features of the pelvic floor and perineal muscles, and their innervation are described. Altogether more detailed information is known in humans on the peripheral innervation as compared to the central nervous system centers and connections of pelvic organ neurocontrol. Controversies in regional neuroanatomy are explained. Reports on individual variability and asymmetry - the former particularly with methods revealing structures, and the latter with functional methods - are interesting but need further validation.
Topics: Afferent Pathways; Anal Canal; Autonomic Nervous System; Humans; Motor Neurons; Pelvic Floor; Urethra
PubMed: 15087575
DOI: 10.1159/000077874