Complete Rectal Prolapse in Adults
Fig. 10.1 Complete rectal prolapse Fig. 10.2 (a) Prolapsed Hemorrhoids, (b) complete rectal prolapse 10.4 Diagnosis The diagnosis of rectal prolapse is clinical and is confirmed by proper history and…
GASTOINESTINAL SURGERY
Rectovaginal Fistulas
Fig. 7.1 Low RV fistula Fig. 7.2 High RV fistula Middle fistulas are found between the two (Fig. 7.3). Fig. 7.3 Mid-RV fistula A perineal surgical approach is more suited…
Benign Tumors of the Anorectum
Fig. 15.1 Inflammatory cloacogenic polyp Fig. 15.2 Microphotograph of inflammatory cloacogenic polyp 15.2.2 Keratoacanthoma This is a benign skin lesion, associated with excessive exposure to sunlight, which can occur rarely…
Anal Fissure
Fig. 4.1 Typical chronic anal fissure 4.2 Epidemiology Fissure in ano is one of the common benign anorectal conditions and can occur at any age. It commonly affects the younger…
Pelvic Floor Dysfunction
Fig. 11.1 Muscles and ligament of the pelvic floor. 1 uterosacral ligament, 2 levator plate, 3 longitudinal muscle of anus, 4 perineal body, 5 rectovaginal fascia, 6 muscle of perineal…
Pilonidal Disease
Fig. 6.1 Classical position for pilonidal sinus Fig. 6.2 Hair from pilonidal sinus (courtesy of Pankaj Garg, India) 6.4 Differential Diagnosis Furuncle, carbuncle, anal fistula (Fig. 6.3a, b), hidradenitis suppurativa,…
Benign Ulcers of the Anorectum
(i) Anal fissures (xvi) Rectal endometriosis (ii) Hemorrhoidal and varicose ulcer (xvii) Injury: (iii) Ulcer with mucosal prolapse Self-inflicted (iv) Crohn’s disease and ulcerative colitis Iatrogenic (v) Proctitis: Anal intercourse…
Anorectal Injuries
Grade Type of injury Description of injury I Hematoma Contusion or hematoma without devascularization Laceration Partial-thickness laceration II Laceration Laceration <50% of circumference III Laceration Laceration >50% of circumference IV…
Surgical Anatomy of Anal Canal and Rectum
Fig. 1.1 Anatomy of anorectum It is angulated at junction with the rectum because the pull of the sling-like action of puborectalis muscle forms anorectal angle (Fig. 1.2). It lies…
Physiology of Defecation
Fig. 2.1 Reflex mechanisms involved in defecation process The internal sphincter, the external sphincter, and the levator ani constitute the motor components. The internal sphincter unconsciously maintains continence by its…
