Closure of a perineal sinus connected with the small bowel developing after radical surgery for rectal carcinoma: A report of the operative procedures used in two cases

A technique for closure of a perineal sinus connected with the small bowel is described herein. One patient who underwent Miles' operation and another who underwent total pelvic exenteration for rectal carcinoma developed a perineal sinus through which a large amount of intestinal fluid was discharged. The pelvic orifice of the sinus was successfully closed in both patients using a right rectus abdominis muscle flap. In one patient, the muscle flap was reflected with the peritoneal surface inside and fixed to the pelvic floor covering the pelvic orifice of the sinus. In the other patient, the flap was isolated without the attached peritoneum and the peritoneal side of the flap covered with omentum.     

Treatment for hydrofluoric acid burns

Various approaches to HF burn have been studied. This presentation offers a somewhat different approach which centres around the use of benzethonium chloride solution and betamethasone. A review of 10 case records confirms the effectiveness of this treatment when compared to that in prior use, especially in the treatment of an emergency.     

Bleeding manifestations in 24 patients with familial amyloidotic polyneuropathy

Focal or generalized hemorrhage is a commonly encountered complication in patients with many kinds of amyloidosis. We studied 24 patients (18 males, 6 females) with familial amyloidotic polyneuropathy and found that five had experienced one or more bleeding episodes. In four of these five patients, bleeding occurred in the terminal stage. The incidence of hemorrhage in familial amyloidotic polyneuropathy is lower than that of other types of amyloidosis or that which has been reported in this disease. In our experience clotting abnormalities were rare; clotting factor deficiency appeared not to exist in familial amyloidotic polyneuropathy.