Search results for "Rectum"
showing 10 items of 172 documents
Differences in ano-neorectal physiology of ileoanal and coloanal reconstructions for restorative proctectomy
2010
Objective Restorative proctectomy with straight coloanal anastomosis (CAA) and restorative proctocolectomy with ilealpouch-anal anastomosis (IPAA) are options for maintaining bowel integrity after rectal resection. The aim of this study was to compare clinical function and anorectal physiology in patients treated with CAA and IPAA. Method Three-dimensional vector-manometry and neorectal volumetry were performed in straight CAA [53 patients (34 male)] and IPAA [61 patients (39 male)] for ulcerative colitis. Function was assessed using a 14 day incontinence diary. Results Function was similar in both groups, but neorectal compliance and threshold volumes for sensation, urge and maximum tol…
Prognostic evaluation of biofeedback response in patients treated for anorectal malformation
2015
Abstract Purpose Functional bowel outcome in patients with anorectal malformation often is poor. For fecal incontinence resulting from sphincter dysfunction, biofeedback (BFB) training appears to be effective. The aim of study was to investigate the bowel function in incontinent children treated for ARM, using a clinical score, a manometric and pelvic magnetic resonance evaluation, in order to establish predictive parameters of response after BFB. Methods 25 children (median age of 6.5years) with true fecal incontinence were evaluated by clinical score, anorectal manometry and magnetic resonance imaging (MRI). According to these evaluations patients were divided in 4 groups: group 1 (favora…
Medullary thyroid carcinoma in a 2-month-old male with multiple endocrine neoplasia 2B and symptoms of pseudo-Hirschsprung disease: a case report
2007
A 5-week-old male patient was seen for symptoms suggestive of Hirschsprung disease (abdominal distension, failure to thrive, and explosive defecation). Rectum biopsies revealed an intestinal ganglioneuromatosis, which is usually associated with multiple endocrine neoplasia (MEN) syndrome type 2B. The ensuing molecular genetic analysis revealed a M918T mutation of the RET protooncogene, which is associated with early-onset medullary thyroid carcinoma (MTC). Therefore, total thyroidectomy and central lymphadenectomy were performed at the age of 9 weeks. Histology showed a medullary microcarcinoma. This report of MTC occurrence within the first weeks of life underlines the importance of early …
Intolerance of Cow's Milk and Chronic Constipation in Children
1998
Background Chronic diarrhea is the most common gastrointestinal symptom of intolerance of cow's milk among children. On the basis of a prior open study, we hypothesized that intolerance of cow's milk can also cause severe perianal lesions with pain on defecation and consequent constipation in young children. Methods We performed a double-blind, crossover study comparing cow's milk with soy milk in 65 children (age range, 11 to 72 months) with chronic constipation (defined as having one bowel movement every 3 to 15 days). All had been referred to a pediatric gastroenterology clinic and had previously been treated with laxatives without success; 49 had anal fissures and perianal erythema or e…
Chronic constipation and food intolerance: A model of proctitis causing constipation
2005
OBJECTIVE: Chronic constipation in children can be linked to cow''s milk intolerance (CMI) but the existence of a food intolerance-dependent proctitis is still debated. The aim of this study was to evaluate the histologic data in patients with food intolerance-related constipation. MATERIAL AND METHODS: Fifty-two consecutive patients (22 M, median age 4 years) with chronic constipation unresponsive to common treatment were enrolled. All patients were put on a cow''s milk-free diet for 4 weeks and those uncured on this diet underwent a subsequent 4-week period of oligoantigenic diet. In the patients cured on elimination diet, a subsequent double-blind food challenge was performed to confirm …
Food intolerance and chronic constipation: manometry and histology study
2006
BACKGROUND: Chronic constipation in children can be caused by cows' milk intolerance (CMI), but its pathogenesis is unknown. AIMS: To evaluate the histology and manometry pattern in patients with food intolerance-related constipation. PATIENTS AND METHODS: Thirty-six consecutive children with chronic constipation were enrolled. All underwent an elimination diet and successive double-blind food challenge. All underwent rectal biopsy and anorectal manometry. RESULTS: A total of 14 patients were found to be suffering from CMI and three from multiple food intolerance. They had a normal stool frequency on elimination diet, whereas constipation recurred on food challenge. The patients with food i…
Role of intraoperative ultrasound in the screening of liver metastases from colorectal carcinoma: initial experiences.
1989
The aim of this study was to assess the utility of intraoperative ultrasound (IOUS) in the diagnosis and management of liver metastases from colorectal carcinoma. IOUS was performed on a consecutive series of 70 patients undergoing surgery for colorectal carcinoma, with follow-up ranging from 6 to 24 months. In ten cases (14.3%), 13 metastatic tumours were diagnosed; only six of these had been found by preoperative workup and/or surgical inspection. Seven (53.9%) small metastatic liver lesions were identified only by IOUS. None of the lesions diagnosed by IOUS was palpable, and they were all extremely small--ranging from 4 x 6 to 12 x 16 mm. Seventy-three locations were examined in order to…
Transrectal ultrasound guided implantation of the ProACT adjustable continence therapy system in patients with post-radical prostatectomy stress urin…
2006
Purpose: We evaluate the feasibility and potential advantages of ProACT system implantation using transrectal ultrasound rather than fluoroscopy for guidance. Materials and Methods: The transrectal ultrasound guided procedure was done between June and October 2005 in 7 patients with a mean age of 68.4 years (range 53 to 76) with mild to severe stress urinary incontinence after laparoscopic transperitoneal radical prostatectomy. Results: The ProACT system was successfully implanted in all cases without perioperative complications. Time needed to complete the overall procedure was 15 to 30 minutes. All transrectal ultrasound studies performed during the mean followup of 4.2 months (range 2 to…
Review of the anatomic concepts in relation to the retrorectal space and endopelvic fascia: Waldeyer’s fascia and the rectosacral fascia
2008
Objective A precise anatomical study of the fascias within the retrorectal space is reported, analyzing and clarifying the anatomical concepts previously employed to describe Waldeyer’s and the rectosacral fascia. Method The pelvis was dissected in 15 cadavers (10 males and five females). All specimens were divided in the median sagittal plane including the middle axis of the anal canal, to allow a correct visualization of and access to the retrorectal space. Results The retrorectal space was limited anteriorly by the rectum and posterior mesorectum covered by a fine visceral fascia, and posteriorly by the sacrum covered by the parietal presacral fascia. The rectosacral fascia divided th…
Trans-visceral migration of retained surgical gauze as a cause of intestinal obstruction: a case report
2008
AbstractIntroductionA retained surgical sponge in the abdomen is uncommon although it is likely that this finding is underreported in the medical literature. The intravisceral migration of retained surgical gauze is even rarer, as demonstrated by the very few cases reported.Case presentationThree years after undergoing anterior resection of the rectum, a 75-year-old man presented with symptoms of small bowel obstruction. Plain abdominal radiography and CT showed a radio-opaque marker; a foreign body was suspected, probably a piece of retained surgical gauze. An ileotomy of about 5 cm. was performed to confirm this diagnosis and remove the gauze.ConclusionAlthough rare, retained gauze in the…