Mark H Kimmins

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PURPOSE Rectal prolapse typically occurs in elderly patients, who are often poor surgical candidates because of the presence of multiple comorbidities. Abdominal approaches to procidentia have low recurrence rates but are associated with higher rates of morbidity and mortality. Perineal rectosigmoidectomy (Altemeier repair) is a safe and effective approach(More)
PURPOSE Known late complications of ileal pouch-anal anastomoses include chronic pouchitis, poor pouch function, or stricture. These may jeopardize the pouch and may require pouch salvage procedures. Prolapse of the ileoanal pouch is a little-known complication infrequently noted in the literature. The objective of this study was to determine the prevalence(More)
Tremendous variation in patient care exists, both among medical centers and among individual surgeons, in the field of colon and rectal surgery. Clinical or critical pathways based on "best demonstrated practices" from the medical literature have led to improved outcomes for many disease entities. The objective of this study was to develop a pathway for(More)
Approach to the Patient One of the things that distinguishes surgeons who are comfortable and competent in the management of anorectal disease from others is their approach to the patient. Such an approach ideally should put the patient at ease and reduce the fear and embarrassment that are often associated, in the patient's mind, with seeking care for(More)
Duodenal Crohn's disease is a rare condition not frequently encountered by the general or colo-rectal surgeon. Manifestations of Crohn's disease may appear in the duodenum as result of primary involvement, or secondary to complications of more distal gastrointestinal disease. Symptoms of duodenal Crohn's are often non-specific, and diagnosis can be(More)
This report documents the first known pediatric survivor of seat-belt-associated gastric transection. An 11-year-old boy presented with abdominal ecchymoses after a motor vehicle accident. Physical and radiological examination determined the need for abdominal exploration. During the operation, a near-complete transection of the stomach was found, which was(More)
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