Anorectal disease:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Philadelphia, PA
Saunders
2010
|
| Series: | Surgical clinics of North America
90,1 |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XVI, 217 S. zahlr. Ill., graph. Darst. |
| ISBN: | 9781437718751 |
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Record in the Search Index
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| adam_text | Titel: Anorectal disease
Autor: Steele, Scott R.
Jahr: 2010
Anorectal Disease
Contents
Foreword
Ronald F. Martin
Preface
Scott R. Steele
Anorectal Anatomy and Physiology
Andrew Barleben and Steven Mills
The rectum and anal canal form the last portion of the gastrointestinal tract.
The rectum serves as a reservoir for fecal contents, and the anal canal reg-
ulates continence and defecation via synchronization of events regulated
by complex interactions between sympathetic and parasympathetic
nerves, striated and smooth muscle, and environmental factors. Normal
function can be compromised by various pathologies. Investigation into
these pathologies includes a detailed history and thorough physical exam
and can be augmented by a number of different studies, including manom-
etry, electromyelography, defecography, nerve stimulation, and compli-
ance. Some of these techniques have incorporated the use of ultrasound
and magnetic resonance imaging.
Diagnosis and Management of Symptomatic Hemorrhoids 17
Erica B. Sneider and Justin A. Maykel
Hemorrhoidal disease is a common problem that is managed by various
physicians, ranging from primary care providers to surgeons. This article
reviews the pathophysiology, clinical presentation, and updated treatment
of hemorrhoids, including nonoperative options, office-based procedures,
and surgical interventions from standard excision to stapled hemorrhoido-
pexy and Doppler-guided ligation. The article also covers complications
and provides guidance for special circumstances, such as pregnancy,
hemorrhoidal crisis, and inflammatory bowel disease.
Anal Fissure 33
Daniel O. Herzig and Kim C Lu
Anal fissure is a common disorder that is effectively treated and prevented
with conservative measures in its acute form, whereas chronic fissures
may require medical or surgical therapy. This article discusses the nonop-
erative and operative management strategies, reviews the current litera-
ture on expected outcomes, and provides guidance on dealing with
fissures in special situations, such as patients with inflammatory bowel
disease or hypotonic sphincters.
Contents
Anorectal Abscess and Fistula-in-Ano: Evidence-Based Management 45
Julie A. Rizzo, Anna L. Naig, and Eric K. Johnson
The management of anorectal abscess and anal fistula has changed mark-
edly with time. Invasive methods with high resulting rates of incontinence
have given way to sphincter-sparing methods that have a much lower as-
sociated morbidity. There has been an increase in reports in the medical
literature describing the success rates of the varying methods of dealing
with this condition. This article reviews the various methods of treatment
and evidence supporting their use and explores advances that may lead
to new therapies.
Rectovaginal Fistula 69
Bradley J. Champagne and Michael F. McGee
Despite the prevalence and severe implications of rectovaginal fistula, there
is no universally accepted evidence-based approach to surgical manage-
ment. This article offers a disease-based review of traditional management
strategies and highlights the variety of technical approaches that are cur-
rently effective for the eradication of this socially disabling condition.
Anorectal Crohn s Disease 83
Robert T. Lewis and David J. Maron
Crohn s disease manifests with perianal or rectal symptoms in approxi-
mately one-third of patients, and is associated with a more aggressive nat-
ural history. Due to the chronic relapsing nature of the disease, surgery has
been traditionally avoided. However, combined medical and surgical inter-
vention when treating perianal fistulae has been shown to offer the best
chance for success. Endoanal ultrasound examination or pelvic magnetic
resonance imaging should be done in conjunction with an examination un-
der anesthesia to characterize the disease. Any abscess should be drained
and setons placed if there is active rectal inflammation or complex fistulae.
Antibiotics and immunosuppressive therapy (especially with infliximab)
should also be initiated. Simple fistulae can be treated surgically by fistu-
lotomy or anal fistula plug. Complex fistulae can be closed with either an
anal fistula plug or covered with flaps. Up to 20% of patients anorectal
Crohn s disease require proctectomy for persistent and disabling disease.
Condyloma and Other Infections Including Human Immunodeficiency Virus 99
Peter K. Lee and Kirsten Bass Wilkins
Sexually transmitted diseases (STDs) are a common public health problem
and as such may be more common in a surgical practice than is believed.
The recognition that a virus can be responsible for a cancer has profound
significant public health implications. This article reviews the presentation
and management of the more common perianal STDs including human
immunodeficiency virus, as well as the pathogenesis and management
of anal intraepithelial neoplasia.
Contents
Evaluation and Management of Pilonidal Disease 113
Ashley E. Humphries and James E. Duncan
Pilonidal disease is a common condition, ranging from the routine cyst with
abscess to extensive chronic infection and sinus formation. It can be asso-
ciated with significant morbidity and prolonged wound healing after defin-
itive surgery. This article reviews the history and pathogenesis of this often
challenging surgical problem and the numerous nonoperative and opera-
tive treatment options currently available for it.
Pruritus Ani: Etiology and Management 125
Katharine W. Markell and Richard P. Billingham
Pruritus ani is a dermatologic condition characterized by an unpleasant
itching or burning sensation in the perianal region. This article briefly dis-
cusses the incidence and classification of pruritus ani followed by
a more lengthy discussion of primary and secondary pruritus ani. The im-
portant points are summarized and a simple algorithm is provided for the
clinical management of pruritus ani.
Anal Stenosis 137
Mukta V. Katdare and Rocco Ricciardi
Anal stenosis occurs most commonly following a surgical procedure, such
as hemorrhoidectomy, excision and fulguration of anorectal warts, endo-
rectal flaps, or following proctectomy, particularly in the setting of muco-
sectomy. Patients who experience anal stenosis describe constipation,
bleeding, pain, and incomplete evacuation. Although often described as
a debilitating and difficult problem, several good treatment options are
available. In addition to simple dietary and medication changes, surgical
procedures, such as lateral internal sphincterotomy or transfers of healthy
tissue are other potentially good options. Flap procedures are excellent
choices, depending on the location of the stenosis and the amount of via-
ble tissue needed. This article presents the definition, pathophysiology,
diagnosis, and treatment of anal stenosis, and methods to prevent it.
Anal Neoplasms 147
Kelly Garrett and Matthew F. Kalady
A variety of lesions comprise tumors of the anal canal, with carcinoma in
situ and epidermoid cancers being the most common. Less common
anal neoplasms include adenocarcinoma, melanoma, gastrointestinal
stromal cell tumors, neuroendocrine tumors, and Buschke-Lowenstein tu-
mors. Treatment strategies are based on anatomic location and histo-
pathology. In this article different tumors and management of each,
including a brief review of local excision for rectal cancer, are discussed
in turn.
Contents
Retrorectal Tumors 163
Kelli Bullard Dunn
Retrorectal or presacral tumors are rare and can be challenging to diag-
nose and treat. Because the retrorectal space contains multiple embryo-
logic remnants derived from various tissues, the tumors that develop in
this space are heterogeneous. Most lesions are benign, but malignant neo-
plasms are not uncommon. Lesions are classified as congenital, neuro-
genic, osseous, inflammatory, or miscellaneous. Although treatment
depends on diagnosis and anatomic location, most retrorectal lesions
will require surgical resection.
Rectal Foreign Bodies 173
Joel E. Goldberg and Scott R. Steele
Rectal foreign bodies present a difficult diagnostic and management di-
lemma because of delayed presentation, a variety of objects, and a wide
spectrum of injuries. An orderly approach to the diagnosis, management,
and post-extraction evaluation of the patient with a rectal foreign body is
essential. This article outlines and describes the stepwise evaluation and
management of the patient with a rectal foreign body. The authors also de-
scribe the varied techniques needed to successfully remove the different
foreign bodies that may be encountered.
Fecal Incontinence 185
Anders Mellgren
Fecal incontinence is a debilitating and socially embarrassing condition.
Significant advances in the evaluation and treatment of this condition
have been made in recent years, and several new treatment modalities
are in the pipeline to be made available to affected patients. This article
reviews the workup and operative and nonoperative management of fecal
incontinence, and it discusses the emerging role of methods, such as
bioinjectable agents and sacral nerve stimulation.
Overview of Pelvic Floor Disorders 195
M. Shane McNevin
Disorders of the pelvic floor are common sources of morbidity, decreased
quality of life, and are unfortunately increasing in incidence. Owing to their
complex and often coexistent nature, a comprehensive, multidisciplinary
strategy of testing and care is required. Many nonoperative and operative
approaches for management of the symptoms of pelvic floor disorders are
available. This article reviews the evaluation and management for these
difficult disorders.
Index 207
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| isbn | 9781437718751 |
| language | English |
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| physical | XVI, 217 S. zahlr. Ill., graph. Darst. |
| publishDate | 2010 |
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| spelling | Anorectal disease guest ed. Scott R. Steele Philadelphia, PA Saunders 2010 XVI, 217 S. zahlr. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Surgical clinics of North America 90,1 Anus / Surgery Rectum / Surgery Anus / Diseases / Treatment Rectum / Diseases / Treatment Anus Diseases Treatment Anus Surgery Rectum Diseases Treatment Rectum Surgery Steele, Scott R. Sonstige (DE-588)140543716 oth Surgical clinics of North America 90,1 (DE-604)BV000003239 90,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=018930517&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Anorectal disease Surgical clinics of North America Anus / Surgery Rectum / Surgery Anus / Diseases / Treatment Rectum / Diseases / Treatment Anus Diseases Treatment Anus Surgery Rectum Diseases Treatment Rectum Surgery |
| title | Anorectal disease |
| title_auth | Anorectal disease |
| title_exact_search | Anorectal disease |
| title_full | Anorectal disease guest ed. Scott R. Steele |
| title_fullStr | Anorectal disease guest ed. Scott R. Steele |
| title_full_unstemmed | Anorectal disease guest ed. Scott R. Steele |
| title_short | Anorectal disease |
| title_sort | anorectal disease |
| topic | Anus / Surgery Rectum / Surgery Anus / Diseases / Treatment Rectum / Diseases / Treatment Anus Diseases Treatment Anus Surgery Rectum Diseases Treatment Rectum Surgery |
| topic_facet | Anus / Surgery Rectum / Surgery Anus / Diseases / Treatment Rectum / Diseases / Treatment Anus Diseases Treatment Anus Surgery Rectum Diseases Treatment Rectum Surgery |
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