Musa M B, Katakkar S B, Khaliq A
Can J Surg. 1975 Nov;18(6):579-83.
Among 17 adults with hematologic malignant neoplasms in whom anorectal complications developed, the overall mortality was 53%; for those in whom the disease was not in remission the mortality was 69%, compared with zero for patients who were in remission. All but one of the deaths were directly attributable to septicemia secondary to the anorectal lesion. Over half of the patients had a history of previous anorectal problems or disordered bowel pattern preceding the anorectal complication. The anorectal lesions affecting these 17 patients included prolapsed hemorrhoids (in 5); discrete ulcers in the anal canal and surrounding cellulitis (8); necrosis of the anus and perianal area (2); and perirectal abscesses (2). Only the abscesses responded to surgical drainage. Treatment of the other lesions was conservative: bowel function was maintained as normal as possible, good perineal hygiene was practised and stool softeners were used, while efforts were directed towards achieving remission of the hematologic neoplastic disease.
在17例发生肛肠并发症的血液系统恶性肿瘤成人患者中，总死亡率为53%；疾病未缓解的患者死亡率为69%，而缓解期患者的死亡率为零。除1例死亡外，所有死亡均直接归因于肛肠病变继发的败血症。超过半数的患者在发生肛肠并发症之前有肛肠问题或肠道功能紊乱史。影响这17例患者的肛肠病变包括内痔脱垂（5例）；肛管离散性溃疡及周围蜂窝织炎（8例）；肛门和肛周区域坏死（2例）；以及直肠周围脓肿（2例）。只有脓肿对手术引流有反应。其他病变的治疗是保守的：尽可能维持正常肠道功能，保持良好的会阴卫生并使用大便软化剂，同时努力使血液系统肿瘤疾病缓解。
