Fig. 21.1 Classification of fistula-in-ano. (a), Intersphincteric. (b), Transsphincteric. (c), Suprasphincteric. (d) Extrasphincteric (With permission from Vasilevsky [2]) Table 21.1 Classification of fistula-in-ano Intersphincteric Simple low tract High blind tract…
Fig. 23.1 Thrombosed external hemorrhoid Thrombosed external hemorrhoids will usually present acutely after a bout of straining, constipation, or diarrhea. The pain will be associated with a swelling that is…
Fig. 20.1 Grade 3 hemorrhoids with attenuated RV septum (Courtesy of Richard Billingham, MD) Table 20.1 Internal hemorrhoidal disease grading (classification) Grade Physical/anoscopic findings I No prolapse II Prolapse with…
% of patients with lymph node metastases SM1 0 % SM2 10 % SM3 25 % Why Do Lesions Recur After Local Excision? Key Concept: Under-staging, tumor biology, and…
Fig. 27.1 Perineal Crohn’s disease in an 8-year-old male showing multiple fistulas Hemorrhoids Key Concept: Hemorrhoids are normally from constipation and should almost always be treated nonoperatively. Hemorrhoids are extremely…
Fig. 31.1 Protecting hands with Kerlix roll and diaper The angle between the body and the thighs of the patients should be kept at near 180°, in order to avoid…
Fig. 6.1 CT scan images of two patients presenting with metastatic involvement of the liver. Image (a) represents a 47-year-old woman with rectal cancer and multiple, bilobar liver lesions. Image…
Fig. 30.1 Draping technique to facilitate exposure to the perineum Initial Survey A survey of the available instrumentation, possible endoscopic or radiologic needs, and additional available staff should be addressed…
Fig. 33.1 (a) Side-to-side four-stapled technique. The linear cutting stapler is introduced through an enterotomy made on the antimesenteric side of the enterectomy staple line. (b) Side-to-side four-stapled technique. The…
Fig. 12.1 Rectocele. Rectal prolapse can also seen at the verge that was easily visualized with straining (Courtesy of M. Shane McNevin, MD) A careful urogynecologic examination is also important,…
