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Management of idiopathic ulcer of the anal canal by excision in HIV-positive patients.
Nadal SR; Manzione CR; Horta SH; Galvao V; Department of Proctology, The
March 30, 2000
Dis Colon Rectum. 1999 Dec;42(12):1598-601. Unique Identifier : AIDSLINE

PURPOSE: The aim of this article is to show our results from the surgical treatment of idiopathic anal ulcers. METHODS: We present 33 patients with acquired immunodeficiency syndrome and idiopathic perianal ulcers. They presented with anal pain that failed to improve with medical treatment. Evaluation under anesthesia typically showed an irregular ulcer in the anal canal and an intersphincteric abscess. Surgical treatment consisted of an incision around the ulcer, its excision including margins but not its base, and abscess drainage. RESULTS: All patients experienced significant immediate postoperative pain relief. Biopsies of the ulcer showed chronic inflammation, and no specific agents appeared in cultures. CONCLUSIONS: These lesions seem to have the same cryptogenic origin as perianal abscesses, and we recommend surgical treatment to provide symptom relief.

JOURNAL ARTICLE Abscess/COMPLICATIONS/SURGERY Acquired Immunodeficiency Syndrome/COMPLICATIONS Adult Anus Diseases/COMPLICATIONS/SURGERY Anus Neoplasms/DIAGNOSIS Biopsy Bowen's Disease/DIAGNOSIS Carcinoma in Situ/DIAGNOSIS Carcinoma, Squamous Cell/DIAGNOSIS Chronic Disease Cytomegalovirus Infections/DIAGNOSIS Drainage Female Fissure in Ano/COMPLICATIONS/*SURGERY/VIROLOGY Follow-Up Studies Human HIV Infections/COMPLICATIONS HIV Seropositivity/*COMPLICATIONS Male Proctitis/PATHOLOGY Wound Healing