OBJECTIVES: The study aimed to describe the use of an improvised vacuum-assisted closure (VAC) system in the management of enterocutaneous fistulas in patients admitted at the Philippine General Hospital (PGH) from January to December 2009. Demographic data as well as outcomes of patients were described.

METHODS: The study is a case series involving patients with enterocutaneous fistulas admitted at the PGH from January to December 2009 on whom an improvised VAC system was employed. Pertinent data were gathered, and frequencies and percentages were also computed.

RESULTS: The modified VAC system was employed in 19 patients. The most common etiology reported was iatrogenic (74%). Nine patients (47%) had spontaneous resolution during admission. The mean time to spontaneous closure with VAC usage was 17 days (range: 5 to 56). Three patients were discharged after a mean of 21 days (range: 8 to 44) on VAC, with efficient effluent collection using a stoma appliance. Of the three, 2 to patients had spontaneous fistula closure on follow up. Five patients declined further treatment. There was one mortality reported.

CONCLUSION: The use of an improvised VAC system may contribute to and hasten successful non-surgical treatment of patients with enterocutaneous fistulas.

Human ; Negative-pressure Wound Therapy ; Hospitals, General ; Iatrogenic Disease ; Philippines ; Intestinal Fistula ; Patient Discharge

Stercoral perforation commonly occurs in the colon, and is mainly due to a hard fecaloma obstructing the sigmoid and eventually perforating the wall due to increased intraluminal pressure causing ischemic necrosis and erosion. In the Philippines, we see cases of colon perforation from ingestion of fruit seeds, usually the santol, Sadoricum koetjape, which is abundant in the country. We report a rare case of a 46-year-old female who presented with an indirect inguinal hernia on the left, which on exploration was found to ahve incarceration of the terminal ileum and perforation from santol seeds. She subsequently underwent limited right hemicolectomy and primary hernia repair. From the literature avaliable, there has never been report of terminal ileal perforation from fruit seeds in Asian or Western countries.

Human ; Female ; Middle Aged ; Colon, Sigmoid ; Hernia, Inguinal ; Herniorrhaphy ; Fruit ; Philippines ; Intestinal Perforation ; Colonic Diseases ; Ileum ; Colectomy

For so many years, abdominoperineal excision has been the mainstay of surgical treatment for rectal cancer 7 cm and below the anal verge. With continued research and introduction of new technology, the management of rectal malignancies has involved making it possible to save the sphincter complex mechanism despite the distance from the verge. Concurrent with these developments is the introduction of a multidisciplinary team approach which the UP-Philippine General Hospital Colorectal Division has adopted in managing colorectal cancer cases. With the adoption of these advancements in the management of patients with rectal cancer, it is surmised that the institution's APR rates have decreased.

OBJECTIVES: The study aimed to document and compare the abdominoperineal resection (APR) rates at the Philippine General Hospital (PGH), before and after the introduction of a multidisciplinary team for colorectal cancer, over the course of 5 years (2005-2009).

METHODS: The study included all adult patients undergoing resection for low to mid rectal cancer, described as a tumor with distal extent of 11 cm or below from the anal verge (FAV), from January 1, 2005 to December 31, 2009. Data pertinent to the management were gathered. Frequencies and rates before and after the introduction of a multidisciplinary team approach were computed and compared.

RESULTS: There were a total of 230 rectal resection for cancer over a five-year period. The patients' mean age was 53 years (range: 26 to 83). There were 122 males and 108 females. Almost half of the patients (48.7%) presented with a clinical stage of Stage IIIB. Forty-three percent of patients underwent either pre-operative radiotherapy or combined chemoradiotherapy. Cumulatively, the APR rate was 30.90 percent (sphincter-saving rate 69.10%) The APR rate for 2009 was 12.82 percent (sphincter-saving rate 87.18) corresponding to a 39.18 percent decrease in APR rate from the highest APR rate recorded in 2006 (52%).

CONCLUSION: A multidisciplinary team (MDT) approach resulted in lower APR rates among patients with rectal cancer at the UP-PGH.

Human ; Aged 80 And Over ; Aged ; Middle Aged ; Colorectal Neoplasms ; Hospitals, General ; Philippines ; Rectal Neoplasms ; Rectum ; Chemoradiotherapy ; Digestive System Surgical Procedures ; Patient Care Team

A rare case of a young pregnant patient on her 32nd week of pregnancy, diagnosed with colorectal cancer, presenting with rectal bleeding, is reported. The various issues concerning the management of this malignancy in a pregnant patient is described and the value of a multidisciplinary approach to achieve favorable results for both the mother and child is emphasized. Key words: colorectal cancer, complications in pregnancy, rectal bleeding

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