Enteroatmospheric Fistula
Fig. 8.1 Patient with intra-abdominal sepsis and gut ischemia. While there is no EAF present, they are a prime candidate for this complication Fig. 8.2 Patient undergoing cytoreduction and HIPEC….
Complex Pilonidal Disease and Acute and Chronic Perineal Wounds: Point – Counterpoint
Fig. 24.1 (a, b) The Bascom cleft lift procedure. Compressing the buttocks together will allow marking of the diseased area and deep cleft that will require excision (Courtesy of Dr….
Fistula-in-Ano
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…
Chronic Anal Pain
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…
Hemorrhoidal Disease: Postoperative Complications
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…
Local Treatment of Rectal Cancer (TEM Versus TAMIS Versus Transanal Excision)
% 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…
The Pediatric Patient
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…
Laparoscopic Complications
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…
Metastatic Colorectal Cancer
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…
The Intraoperative Consult
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…
