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PubMedDate not supplied

[Angiodysplasia of the colon].

The authors present a case review of a congenital abnormality of the inferior mesenteric blood vessels which resulted in ischemia of the descending colon and rectosigmoid area. The resulting colitis is only very rarely secondary to a vascular congenital abnormality. In this case, rectosigmoidoscopy, barioum study of the large bowel and a biopsy of the rectal mucosa pointed towards the ischemic nature of the lesion. This led to the selective angiographic study of the inferior mesenteric vessels with findings of a dilated inferior mesenteric artery and angiodysplasia. Surgical treatment included tying off of the inferior mesenteric artery and resection of the descending and rectosigmoid colon followed by transverse colon-rectum anastomosis. The angiographic and histopathologic studies were of great importance in establishing the true nature of the patient's clinical syndrome. One must keep in mind that the rectosigmoidoscopic findings may be seen in other disease states which do not have a vascular origin. These include Crohn's disease, severe amoebiasis and penumatosis of the intestine.

Colitis↗
PubMedDate not supplied

Local resection of rectal cancer.

Stringent patient selection and careful preoperative evaluation are important factors for the successful treatment of all rectal cancers. The lack of histopathologic evaluation is the parameter that even in the best scenario, allows for a 5% risk of nodal involvement that cannot be assessed and therefore treated. However, in appropriately selected situations, local treatment of rectal cancer allows for effective and safe curative therapy.

Chemotherapy, Adjuvant↗
PubMed2000

[Treatment of patients with foreign bodies in rectum].

The analysis of treatment results in 112 patients with foreign bodies in the rectum, aged from 16 to 80 years, was carried out. 99.1% of the patients were men. All the patients were examined and treated in proctology department of the Moscow municipal clinical hospital N 67 from 1969 to 1998. The examination was made by standard scheme, including rectal touch, rectoromanoscopy, X-ray and ultrasonic examinations. In 107 patients the foreign body was removed without surgery, 5 patients required laparotomy. When possible it was removed by fingers and also with use of forceps. When small foreign bodies could not be reached by finger, they were removed through rectoscope. Foreign bodies of big sizes, proximal end of which was in the sigmoid colon, were removed under anasthesia with the help of the assistant who fixed the foreign body through the abdominal wall in the left ileac region. In impossibility of the subject removal by these methods and presence of complications (perforation, peritonitis), laparotomy with subsequent transanal subject removal without colon section was performed, in case of perforation--with wound suturing or colostomy.

Adolescent↗
PubMed2000

Anal fissures.

BACKGROUND: Anal fissures are common conditions, presenting with bleeding, itching, and pain of varying severity. Pain and bleeding is frequently attributed to haemorrhoids, which may delay commencement of appropriate therapy. Other causes for bleeding must also be excluded, with investigations taking into account the clinical findings and the age of the patient. OBJECTIVE: To discuss the pathogenesis and management of anal fissures. DISCUSSION: Recent studies have changed our understanding of the pathophysiology of anal fissures. It is now known that the majority of fissures are caused by internal sphincter spasm and resulting in ischaemia of the anal mucosa. Pharmacological agents that relax the sphincter have provided a novel approach to treatment, allowing surgery to be avoided in some patients.

Chronic Disease↗
PubMed2000

Transanal endoscopic surgery for rectal tumors.

OBJECTIVE: To report our results with local excision by transanal endoscopic microsurgery (TEM) to treat 42 cases of rectal lesions (29 adenomas and 13 carcinomas). METHODS: Prospective, descriptive study. Sex distribution: 55% men, 45% women, mean age 65 years (range: 17-84 years). SYMPTOMS: rectal bleeding 67%, diarrhea 23%. SURGICAL TECHNIQUE: mucosectomy 6 cases, full-thickness excision 36 cases. Average follow-up: 11 months (range: 1-36 months). RESULTS: We analyzed operating time (average 85 min; range: 25-180 min), bleeding (average 100 ml, range 10-350 ml), distance of the tumor from the anal verge (lower tumor margin: mean, 8.8 cm; range, 1-20 cm; distal tumor margin: mean, 12.9 cm; range, 5-22 cm), tumor size (mean, 3.9 cm; range, 2-10 cm), postoperative hospital stay (average, 4 days; range, 2-15 days), morbidity (hemorrhage 1 case; perforation, 1 case), mortality (0) and follow-up (temporary incontinence to flatus in 6 cases, 1 recurrence of carcinoma treated with abdominoperineal resection, 2 recurrences of adenoma and 2 new adenomas). CONCLUSIONS: TEM is a safe technique for the treatment of rectal lesions. Low morbidity and recurrence rates and short hospital stays make TEM a procedure of choice when local rectal surgery is indicated.

Adolescent↗