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At least 1,567 records · Page 87Linked to original sources
PubMed1997

[Defecation problems: incontinence, constipation and impeded defecation; why and what can be done?].

Defaecation disorders may be subsumed in three categories: Inability to control motions = incontinence. Difficulty of evacuation = constipation [inertia coli, outlet obstruction]. Impeded defaecation: Rectocele, enterocele, intussusception. Etiology, examination and therapy are described in detail. Characteristic complaints of patients are listed and matched with probable diagnoses. Beside routine proctologic examination endosonography, estimation of transit time, endoscopy and defecography are discussed. The role of nutrition is stressed and emphasis layed on fibre and fluid intake. The advice, "take more fluid and fibres" does not help a lot, because no individual help is given. A time consuming nutrition and defaecation history has to be taken to establish nutritional support. This attention gives confidence to the patient and helps a great deal in the treatment. A checklist of the therapy of constipation and summarizing tables on different types of fibres are included. Additional conservative treatments are pelvic exercises and biofeedback training. Operative therapy is directed towards etiology of the disorder. Therefore many different methods exist and their diagnose related indication are discussed.

Anal Canal↗
PubMed1976

Colonoscopic polypectomy.

The colonoscopic management of 86 patients with polypoid lesions of bleeding from the colon of intermittent nature is discussed. There were 145 polyps found in 85 of these patients. Adenomatous polyps occurring in the sigmoid colon above the reach of the standard sigmoidoscope was the most common finding and pathological diagnosis. Adenocarcinoma of the colon occurred in two patients and invasive carcinoma of a polyp was found in three other patients. Five other patients had polyps that demonstrated a carcinoma in situ. The definitive treatment of these complicated polyps is outlined. The importance of barium enema examination on follow-up of polyp and carcinoma patients and on patients with polyps found at standard sigmoidoscopy is stressed. The possibility of colonoscopic follow-up in lieu of colectomy and ileoproctostomy is suggested for patients with multiple polyps of the colon who do not belong to the familial polyposis group.

Adenocarcinoma↗
PubMed1996

[A clinical and pathological analysis of 20 cases of lymphal follicular rectitis].

Lymphal follicular rectitis (LFR) recognized in recent years is a kind of benign lesion localizing in rectum. The lack of specific clinical and endoscopic manifestation causes the difficulty in its diagnosis. It was easily confused with ulcerative rectitis, even there were some cases which were misdiagnosed malignant rectal lymphoma. A retrograde analysis was made in our study in the 176 cases of pathologically diagnosed chronic rectitis between January 1993 and July 1994 in our hospital. Among the 176 cases, 20 were certain to be LFR (2 formerly diagnosed, 18 confirmed in the retrograde study). Endoscopic manifestations are as following: (1) granuliform proliferation, eminence and roughness can be seen in rectal mucosa with hyperemia, edema and vague vessels. The lesion is either diffused or localized. (2) single or multiple smooth polypoid apperances can be observed in rectal mucosa, which are 0.2-0.4 cm in diameter, and its pathological characteristics under microscope are: obvious lymphal follicular hyperplasia in the mucosa. A protecting zone and clear reactive germinal center in the hyperplastic follicules, coalescence of follicules occupying more than half of the lamina propria, a large amount of lymphocytes, some are in karyokinesis phase, some infiltrate the mucosa musculis and vessels proliferation in the hyperplastic lymphal tissue, scattered plasma cells, no neutrophil, no eosinophil and no abscess, which is quite different from ulcerative rectitis. Clinical manifestations of the group include: 7 intermittent hematochezia, 4 abdominal pain associated with alternative constipation and diarrhea, 2 mucous stool, 1 tenesmus, 1 pyohemofecia, 2 abdominal distension and 6 asymptomatic. From our study, the diagnosis of LFR mainly depends on its endoscopic polymorphic characteristics and specific histopathologic appearences. And it is important to differentiated LFR from other rectal diseases with lymphal tissue proliferation.

Adolescent↗
PubMed1997

[Perineal surgical approach in the treatment of some disorders of the rectoanal function (fecal incontinence and obstructive constipation)].

A global experience in the surgical perineal approach to the treatment of alterations of recto-anal function (fecal incontinence and obstructed defection) is reported. Surgical techniques and results in four cases of fecal incontinence operated and surgical treatment of 14 patients suffering from obstructed defecation, due to organic obstacles (4 cases) or functional abnormalities (rectocele 10 cases) are discussed. Indications, surgical techniques as well as the obtained results are described.

Aged↗
PubMed1976

[25 years without reactions to a grown-in laparitimy gauze].

We report the remarkable history of a case with intraperitoneal retention of a gauze sponge, left in place for 24 years without any symptoms. The foreign body was removed in a selective operation after being detected by routine gynecologic examination. The rare and unusually fortunate course is discussed.

Female↗
PubMed1998

[The use of anorectal manometry and dynamic proctography in patients for diagnosis of solitary rectal ulcer syndrome].

BACKGROUND: Solitary rectal ulcer syndrome is caused by rectal prolapse and/or anismus. The diagnosis by physical examination, or using endoscopy or radiology alone is difficult. AIM: To evaluate the diagnostic utility of videoproctography and anorectal manometry in solitary rectal ulcer syndrome. PATIENTS AND METHODS: We studied six patients (5 women/1 man; 21-66 years) with rectal lesions suggestive of solitary rectal ulcer. By videoproctography, we measured the changes in the anorectal angle and the shape of the rectal wall during voiding. By manometry, we measured the resting pressure of the anal canal, and the pressure during maximal voluntary contraction and during straining. RESULTS: Proctography showed a rectal prolapse in 5 patients (non-exteriorized in 4). Both manometry and proctography demonstrated the normal relaxation of puborectalis and external sphincter during straining in 4 patients, manometry found sphincteric weakness in two of these patients. Both manometry and proctography evidenced anismus in a patient with rectal prolapse. CONCLUSION: The high prevalence of rectal prolapse in our patients allows us to recommend proctography in patients with morphological lesions suggestive of solitary rectal ulcer. The manometric examination identifies patients at risk of developing incontinence. Both techniques contribute to ascertain the presence of anismus and are indispensable in the selection of the adequate treatment for patients with solitary rectal ulcer.

Adult↗
PubMed1976

Findings in patients with diverticulosis and diverticulitis of the colon.

During the period from 1957 up to and including December 1975, the surgical clinic of Nijmegen admitted 82 patients with the diagnoses of diverticulosis and diverticulitis of the colon: the diagnosis of diverticulosis was made in 16 cases; in 17 diverticulitis was diagnosed and these patients were treated by conservative methods. Forty-nine patients were subjected to operation for diverticulitis. Of the patients treated conservatively, none died; of those treated by operation, three (6%) died. There were nine patients with peritonitis and three with ileus who required emergency surgery. As a matter of principle these patients were treated in several stages; none of them died.

Adult↗
PubMed1998

Anorectal pathology in AIDS.

Anorectal complaints are common in persons with AIDS and are being seen increasingly because advances in therapy for HIV, such as the new antiretroviral protease inhibitors, have resulted in longer life expectancy for those with HIV infection. In the past, many patients with HIV infection were seen at referral centers; now, however, primary care physicians as well as gastroenterologists and surgeons in the community are managing and caring for these patients. For this reason, it is important for clinicians to recognize the spectrum of anorectal disease in patients with AIDS, as well as its appropriate evaluation and management.

AIDS-Related Opportunistic Infections↗