摘要:

&NA;We report 33 patients with the solitary rectal ulcer syndrome seen between 1975 and 1982. Twenty‐four were women and the median age was 32 years. The principal symptoms were bleeding (89 per cent), chronic constipation (64 per cent), rectal pain (42 per cent), tenesmus (42 per cent), and mucous discharge (45 per cent). Twenty‐eight patients gave a history of straining (85 per cent). A full‐thickness rectal prolapse was present in six patients, an anterior rectal prolapse was observed in 11, and 12 patients had clinical evidence of perineal descent. Defecation was only possible by digital evacuation in six women, and three male patients were passive homosexuals. Manometric studies were performed on 16 patients; eight patients were unable to tolerate rectal distension with 200 cc of air and impaired rectal sensation was present in two. Rectal distention was associated with bursts of involuntary external sphincter activity in three patients, and the distention reflex was absent in six, despite normal ganglia on rectal biopsy. In only four patients was there electromyographic evidence of contraction of the puborectalis during attempted defecation. Fourteen patients were treated by rectopexy; healing of the ulcer occurred in five of six with a full‐thickness prolapse compared with only two of eight without a complete prolapse.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;In five patients, rectal bleeding was ascribed to a patchy or diffuse mucosal colitis affecting the sigmoid colon only. The patients all had well marked localized sigmoid diverticular disease. The histologic features were nonspecific, without any changes suggestive of Crohn's disease. One patient had a short, self‐limited illness, whereas the others had continuing illnesses lasting at least six months. In one patient who underwent sigmoid colectomy, the inflammatory features had disappeared, probably in response to sulphasalazine therapy. It is suggested that this syndrome may be a complication of the muscular disorder that underlies the formation of colonic diverticula.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;Histopathologic comparison of colorectal adenomas removed at St. Mark's Hospital, London, England, and those removed at the University of Tokyo, Japan was performed. There were 1242 lesions in the St. Mark's series and 310 in the University of Tokyo series. All adenomas were removed either by colonoscopic polypectomy or hot biopsy. The indications and methods of colonoscopic removal were similar in the two series. Age distribution of the patients showed a younger peak incidence in the University of Tokyo series compared with the St. Mark's patients. The percentage of adenomas larger than 1 cm, of tubulovillous or villous type, and with moderate or severe dysplasia were greater in the St. Mark's series than in the University of Tokyo series. Percentages of adenomas with mild, moderate, or severe dysplasia in each category of size did not differ between the two series. In view of the fact that there is a high colorectal cancer risk in England and medium cancer risk in Japan, our results give further epidemiologic support to the concept of the adenoma‐carcinoma sequence.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;A preoperative schedule based on three principles: rigorous mechanical cleansing of the intestine, nutrition for four days with a formula diet (Biosorbin MCT), and short‐time systemic prophylaxis with doxycycline has been tested in a prospective study of 252 patients who underwent elective colorectal surgery. There were 11 wound infections, most of them of minor importance (4.4 per cent). Intra‐abdominal abscesses occurred intwo patients, both successfully reoperated, giving an overall incidence of septic complications of 5.1 per cent. The schedule was easy for the staff to administer, well tolerated by the patients, and inexpensive. The complication rate is probably as low as could be anticipated with this type of surgery.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;Manometric studies of internal sphincter responses were carried out on 15 patients−14 with rectal prolapse and one with mucosal prolapse with proctitis cystica profunda. In all 12 patients studied preoperatively, the internal sphincter reflexes (inhibitory reflex) were absent or markedly obtunded. Anterior resection was performed on three of the patients in whom preoperative and postoperative manometric studies could be carried out. In one, the inhibitory reflex returned to normal after successful corrective surgery and in one, absence of the reflex persisted after anterior resection and this patient eventually had recurrent rectal prolapse.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;The results of 27 patients who underwent rectal excision with primary perineal closure with continuous closed irrigation of the pelvis are presented. The perineal wound healedper primamwithin three weeks in 85 per cent of the patients. This technique is a comfortable and safe method of handling the perineal wound.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;Sixty‐six patients were operated upon for third‐ or fourth‐degree hemorrhoids during the period of January 1982 through November 1983. A single injection of epidural morphine was given for relief of postoperative pain. Eighty‐three point three per cent of the patients needed no other analgesics and 16.7 per cent required only mild analgesics. There were no complications observed after surgery.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID