Anorectal disorders pdf

This issue of the Surgical Clinics of North America covers a broad spectrum of anorectal disease such as basic anatomy, physiology, and testing of the anorectal region, as well as the most current diagnostic and management strategies for many of the common anorectal conditions encountered by surgeons including hemorrhoids, anal. Imaging is now central to the investigation and management of anorectal and pelvic floor disorders.

This has been brought about by technical developments in imaging, notably, three-dimensional ultrasound and magnetic resonance imaging MRI , which allow high anatomical resolution and tissue differentiation to be presented in a most usable fashion.

Get Common Anorectal Disorders Books now! Patients with perianal diseases such as dermatitis do not just visit the dermatologist; they are seen by family doctors, internists, pediatricians, general surgeons, gynecologists, and urologists. This book is truly multi-disciplinary, introducing the surgical specialties to medical proctology and related fields.

The procedures described allow effective management of both common. Diseases of the rectum and anus are common phenomena. Its prevalence in the general population is probably much higher than that seen in clinical practice, since most patients with symptoms referable to this part do not seek medical attention.

As a doctor of first contact, the family practitioners frequently face. This is the first comprehensive book exclusively dedicated to anorectal physiology and the importance of diagnostic tools in guiding the evaluation and treatment of anorectal dysfunction. As many of these.

Anal and Rectal Diseases: A Concise Manual provides a succinct reference on the subject for clinicians, including primary care physicians, gastroenterologists, general surgeons, physician's assistants and nurse practitioners. Presented in a consistent structural style that provides both a general summary of individual topics within the field along with additional details.

Dr Umar and Dr Crowell have no relevant conflicts of interest to disclose. National Center for Biotechnology Information , U. Gastroenterol Hepatol N Y. Amy E. Umar , MD, and Michael D. Crowell , PhD. Author information Copyright and License information Disclaimer. Address correspondence to: Dr Amy E. Scottsdale, AZ Tel: E-mail: ude. This article has been cited by other articles in PMC. Abstract Anorectal disorders result in many visits to healthcare specialists.

Keywords: Hemorrhoid, anal fissure, fecal incontinence, pruritus ani, proctalgia fugax, rectoanal abscess, fistula, excessive perineal descent. Hemorrhoids Hemorrhoids are an extremely common condition, affecting approximately 10 million persons per year. Open in a separate window. Figure 1. Anal Fissures An anal fissure is a tear in the anoderm distal to the dentate line and can be acute or chronic.

Figure 2. An acute anal fissure with the appearance of a fresh laceration. Figure 3. A chronic anal fissure showing a sentinel pile at the distal end of the fissure. Anorectal Abscesses and Fistulae Anorectal abscesses and fistulae are anorectal disorders that are thought to be a spectrum of the same disease. Figure 4. Fecal Incontinence FI is a debilitating, embarrassing, and potentially devastating disorder. Proctalgia Fugax Proctalgia fugax is a functional gastrointestinal disorder characterized by severe and self-limiting anorectal pain.

References 1. Sanchez C, Chinn BT. Clin Colon Rectal Surg. Practice parameters for the management of hemorrhoids revised Dis Colon Rectum. Sleisenger andFordtrans Gastrointestinal and Liver Disease. Philadelphia, PA: Saunders Elsevier; Thrombosed external hemorrhoids: outcome after conservative or surgical management.

Dis Colon Rectum. Comparison of hemorrhoidal treatment modalities. A meta-analysis. Complications of rubber band ligation of symptomatic internal hemorrhoids.

Long-term outcome and efficacy of endoscopic hemorrhoid ligation for symptomatic internal hemorrhoids. World J Gastroenterol. Fleshman J, Madoff R. In: Cameron J, editor. Current Surgical Therapy. Philadelphia, PA: Elsevier; Comparison of hemorrhoidal treatments: a meta-analysis. Can J Surg. Stapled hemorrhoidopexy is associated with a higher long-term recurrence rate of internal hemorrhoids compared with conventional excisional hemorrhoid surgery.

Stapled hemorrhoidopexy versus milli-gan-morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg. Long-term outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy: a meta-analysis of randomized controlled trials.

Arch Surg. Anal fissure. Benign anorectal: anal fissure. Relationship between anal pressure and anodermal blood flow. The vascular pathogenesis of anal fissures. Ischaemic nature of anal fissure.

Br J Surg. Computer-generated profiles of the anal canal in patients with anal fissure. Nonsurgical therapy for anal fissure. Cochrane Database Syst Rev. Long-term results of lateral internal sphincter-otomy for chronic anal fissure with particular reference to incidence of fecal incontinence. A randomised, prospective, double-blind, placebo-controlled trial of glyceryl trinitrate ointment in treatment of anal fissure.

Glyceryl trinitrate ointment for the treatment of chronic anal fissure: results of a placebo-controlled trial and long-term follow-up. Manometric effect of topical glyceryl trinitrate and its impact on chronic anal fissure healing.

Ezri T, Susmallian S. Topical nifedipine vs. A prospective, randomized, double-blind study comparing the efficacy of diltiazem, glyceryl trinitrate, and lidocaine for the treatment of anal fissure in children. Pediatr Surg Int. Botulinum toxin vs glyceryltrinitrate for the medical management of chronic anal fissure: a meta-analysis.

Colorectal Dis. Comparison of topical glyceryl trinitrate with diltiazem ointment for the treatment of chronic anal fissure: a randomized clinical trial. Acta Chir Belg. Practice parameters for the management of anal fissures 3rd revision Dis Colon Rectum.

Randomized clinical trial comparing botulinum toxin injections with 0. Conservative and surgical treatment of chronic anal fissure: prospective longer term results. J Gastrointest Surg. Abcarian H. Anorectal infection: abscess-fistula. Sainio P. Fistula-in-ano in a defined population. Incidence and epidemiological aspects. Ann Chir Gynaecol. Practice parameters for the treatment of perianal abscess and fistula-in-ano revised Dis Colon Rectum.

A diagnostic accuracy meta-analysis of endoanal ultrasound and MRI for perianal fistula assessment. Halland M, Talley NJ. Fecal incontinence: mechanisms and management.

Curr Opin Gastroenterol. Fecal incontinence in females older than aged 40 years: who is at risk? Fecal incontinence in Wisconsin nursing homes: prevalence and associations. Rao SS. Pathophysiology of adult fecal incontinence. Advances in diagnostic assessment of fecal incontinence and dyssyner-gic defecation.

Clin Gastroenterol Hepatol. AGA technical review on anorectal testing techniques. Bharucha AE. Update of tests of colon and rectal structure and function. J Clin Gastroenterol. Perfect for medical researchers, gastroenterologists, general practitioners, internal medicine doctors and general surgeons, this title will provide diagnosis and treatment options for all patients suffering from anorectal disorders. Identifies frequent, but not well understood, anorectal disorders, including ulcers, constipation, dyssynergic defecation, tumors and malformations Condenses the basic and practical aspects of anorectal disorders for better treatment of patients Includes clinical cases that summarize chapter content in a clinical context.

Investigation of anorectal disorders has become a very wide field reaching from case history and simple plain radiography to advanced techniques such as defecography, nuclear medicine, endosonography, computed tomography, and magnetic resonance imaging. The place and value of defecography, thedynamic demonstration of bowel evacuation, have not previously been clearly defined.

In this highly illustrated volume, radiologists experienced in thisfield describe techniques, radiation risks, and the interpretation of normal and abnormal findings using the aforementioned techniques of investigation. Anorectal surgeons and gastro- enterologists also participatein the discussion of indications and the influence of abnormal findings on patient management. This book will be helpful as a practical guide tothe choice, performance, and interpretation of the appropriate investigationfor a patient with functional anorectal disorders.

As such it represents an excellent addition to the library of every physician and specialist withan interest in anorectal disease. This fully revised new edition focuses on the clinical, diagnostic, and therapeutic aspects of conditions encountered by the coloproctologist and gastroenterological surgeon, who are faced with an increasing number of precise and specific treatment modalities.

This book is a comprehensive guide to anorectal surgery. Beginning with an introduction to embryology, anatomy and physiology, the following sections discuss the evaluation and clinical examination of patients with anorectal disorders.

Each of the subsequent chapters describes the clinical manifestations, diagnosis and treatment for a different condition. Nearly full colour images and tables and useful tips assist understanding. Key points Step by step guide to anorectal surgery Discusses clinical manifestations, diagnosis and treatment for many conditions Nearly colour images, tables and useful tips Includes two interactive DVD ROMs demonstrating surgical procedures. This issue of the Surgical Clinics of North America covers a broad spectrum of anorectal disease such as basic anatomy, physiology, and testing of the anorectal region, as well as the most current diagnostic and management strategies for many of the common anorectal conditions encountered by surgeons including hemorrhoids, anal fissures, abscess and fistula.

Also presented are new techniques in the management of pilonidal disease, perianal infections including HIV and condyloma, pruritis ani, and anal stenosis--difficult conditions that often are frustrating for patient and surgeon alike. Two articles are dedicated to the current management of anorectal Crohn's disease and rectovaginal fistulas, including the evolving multidisciplinary approach.

In addition, advances in the evaluation and current management of retrorectal tumors and anal neoplasms including the role of local excision and transanal endoscopic microsurgery for selected rectal tumors are covered. Rounding out this issue are approaches to the difficult situation of anorectal trauma including foreign body management, as well as two articles dedicated to the evaluation of pelvic floor disorders and fecal incontinence. Compatible with any devices.

Patients with perianal diseases such as dermatitis do not just visit the dermatologist; they are seen by family doctors, internists, pediatricians, general surgeons, gynecologists, and urologists. This book is truly multi-disciplinary, introducing the surgical specialties to medical proctology and related fields. The procedures described allow effective management of both common and less common diseases, including all the secondary problems that may arise.

With increasing travel and increasing immunosuppression, parasitic intestinal diseases are now seen in every type of practice. The standard diagnostic procedures described herein reduce costs in therapy. This new reference in proctology and perianal skin disease gives detailed descriptions of clinical features, laboratory diagnosis, and treatment strategies. It will empower a wide variety of physicians to manage these disorders more effectively.

Imaging is now central to the investigation and management of anorectal and pelvic floor disorders. This has been brought about by technical developments in imaging, notably, three-dimensional ultrasound and magnetic resonance imaging MRI , which allow high anatomical resolution and tissue differentiation to be presented in a most usable fashion.

Three-dimensional endosonography in anorectal conditions and MRI in anal fistula are two obvious developments, but there are others, with dynamic st- ies of the pelvic floor using both ultrasound and MRI coming to the fore. This atlas provides an easy way to gain a detailed understanding of imaging in this field.