Paediatric rectal prolapse in Rwanda.

During the 1994 crisis in Rwanda, a high incidence of full-thickness rectal prolapse was noted among the refugee children in the south-west of the country. The prolapses arose as a result of acute diarrhoeal illness superimposed on malnutrition and worm infestation. We used a modification of the Thiersch wire technique in 40 of these cases during two months working in a refugee camp. A catgut pursestring was tied around the anal margin under local, regional or general anaesthesia. This was effective in achieving short-term control of full-thickness prolapse until the underlying illness was corrected. Under the circumstances, no formal follow-up could be arranged; however, no complications were reported and only one patient presented with recurrence.     

经腹直肠前壁折叠及直肠侧壁悬吊固定治疗直肠脱垂

目的:探讨经腹直肠前壁折叠及直肠侧壁悬吊固定治疗直肠脱垂的应用价值。方法:回顾分析25例Ⅱ度～Ⅲ度直肠脱垂病人的临床资料,采用经腹直肠前壁折叠及直肠侧壁悬吊固定治疗。结果:病人术后均获随访,平均随访40.8个月,痊愈23例,好转2例,无术后并发症及复发者。结论:经腹直肠前壁折叠及直肠侧壁悬吊固定治疗直肠脱垂是一种较好的手术方式,手术同时应治疗其他的合并病。     

Delorme术加肛管缩窄术治疗直肠黏膜脱垂

目的探讨采用直肠黏膜神状切除肠壁折叠术加（Delorme）肛管缩窄术治疗直肠黏膜脱垂的疗效。方法回顾性分析2002年4月至2008年8月收治的35例直肠黏膜脱垂患者,均进行Delorme术加肛管缩窄术。结果32例一次治愈,3例经再次STARR手术治疗后痊愈,治愈率100％。随访2～3年,无复发,无后遗症。结论针对直肠黏膜脱垂Delorme术加肛管缩窄术是一种安全、可靠、简单、疗效显著及无明显并发症的治疗方法。     

Surgical options for apical prolapse repair

Pelvic organ prolapse is a common medical condition that affects the quality of life of many women. Approximately 50% of parous women have pelvic organ prolapse and the lifetime risk for surgical intervention is 6.7% at the age of 80 years. In the USA, the number of women at risk for symptomatic prolapse is increasing, which is consistent with the recent increase in the overall number of prolapse and incontinence procedures being performed. Although prolapse is usually multicompartmental and isolated defects are rare, the apical compartment deserves special attention because apical support is integral to a durable prolapse repair. Since many women may initially present to their primary care physicians, all members of the medical community should have a basic understanding of the diagnosis and treatment for apical prolapse.     

Bulimia nervosa presenting as rectal purging and rectal prolapse: case report and literature review

Rectal prolapse, but not rectal purging (excessive finger evacuation to induce defecation), has been formally associated with eating disorders in the medical literature. We describe a young woman with bulimia nervosa and irritable bowel syndrome who used rectal purging as a method of counteracting the effects of her binge eating and who underwent two corrective surgeries for rectal prolapse in a 15-month interval. Further research into the relationship between eating disorders, rectal purging, and gastrointestinal dysfunction is called for.     

Use of collagen implant for posterior rectopexy in complete rectal prolapse: preliminary communication

A variety of materials has been used for perirectal implantation in the treatment of complete rectal prolapse. A new material (Zenoderm) prepared from porcine corium has been used successfully in 4 patients. The material proved to be inert, biologically non-irritant, pliable, workable and strong.     

Surgical treatment of arrhythmias

Author gives a review based on the literature and experiences gained during his own overseas studies about the history of arrhythmia surgery. Surgical procedures are described currently in use for arrhythmias considered to be surgically treated. Results of these procedures are also discussed. Author stands for the introduction and necessity of arrhythmia surgery in this country.