摘要:

AbstractIncarceration or strangulation of the penis by an encircling object is an uncommon clinical presentation. This paper describes a simple method to deal with such an emergency in which no special skill is required and no immediate or long‐term morbidity related to the treatment occur

ISSN:0007-1323    

DOI:10.1002/bjs.1800750112

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractBetween 1970 and 1985 (inclusive), 66 patients presented with complete rectal prolapse; 59 (89 per cent) were treated by extended abdominal rectopexy. Forty‐four patients (75 per cent) have been followed for more than 2 years: all cases were cured of their complete prolapse, no patients died, and major complications were few. Constipation (47 per cent) and incontinence (19 per cent) caused serious problems for many patients postoperativel

ISSN:0007-1323    

DOI:10.1002/bjs.1800750113

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractOf 122 patients with fistulae in ano operated upon in a 5‐year period, 19 (15.6 per cent) were found to have tubercular fistulae on histopathological examination. There was no characteristic clinical picture and concomitant pulmonary tuberculosis was present in only three patients. Histological examination of the excised fistula is mandatory for the diagnosis of anal tuberculosis. There were no cases of Crohn's disease of the anal regio

ISSN:0007-1323    

DOI:10.1002/bjs.1800750114

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractIt has been reported that microtransducer‐tipped catheters (transducer) produce reliable reproducible measurements which correlate well with water‐filled balloon systems. Maximum resting pressure (MRP) and maximum voluntary contraction pressures(MVC) were compared using a standard station pull‐through technique in 12 patients. There was a poor correlation for both MRP: microballoon, 115 cmH2O (60–160 cm H2O); transducer 60 (20–110), r = 0.62, P<0.05, and MVC: microballoon, 202 (60–375); transducer, 175 (60–210), r = 0.42, n.s. To determine whether this was due to radial variation in pressures measured by the transducer, we studied a further 39 patients with both systems. At each station, transducer measurements were made at each of four quadrants. We found better correlation for MRP: microballoon, 100 (40–175); transducer, 66 (34–120), r = 0.72, P<0.001, and MVC: microballoon, 225 (55–650); transducer, 180 (50–470), r = 0.87, P<0.001, but a significant radial variation for the transducer where rotation reduced MRP pressure measurements by 21 per cent (0–600 per cent), and MVC 17 per cent (0–76 per cent). Moreover there was a significant difference between anterior and posterior MRP in the upper anal canal, anterior 35 (5–80) versus posterior 25 (10–60), P<0.05. These results account for the poor correlation between random positioning of the microtransducer‐tipped catheter and indicate that radial orienta

ISSN:0007-1323    

DOI:10.1002/bjs.1800750115

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractIt has been suggested that sampling of rectal contents by the anal canal may play a role in the continence mechanism. To investigate this concept we studied 18 patients with faecal incontinence and 18 age and sex matched controls. A microtransducer catheter was positioned so that pressures were recorded from the rectum, the junction of the upper and middle thirds of the anal canal and the lower anal canal. Recordings were taken at rest and while distending the rectum with air in a balloon, and then with air injected freely into the rectum. Sampling (equalization of the rectal and upper anal canal pressures) was seen to occur spontaneously in 16 of the controls and only 6 of the incontinent group (P<0.02) and induced sampling occurred at a higher rectal volume in the incontinent group than in controls for freely injected air (P<0.002). Defective anorectal sampling may be an important contributory factor in the pathogenesis of anorectal incontinence.

ISSN:0007-1323    

DOI:10.1002/bjs.1800750116

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800750117

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThe most important factor associated with a good result in the surgical treatment of neurogenic faecal incontinence by postanal repair is considered to be restoration of the obtuse anorectal angle. Sixteen patients (14 F:2 M; median age 59 years) with neurogenic faecal incontinence confirmed by a raised fibre density in the external anal sphincter underwent postanal repair. Pre‐ and postoperative manometric assessment was performed in 16 and radiological assessment in 12. Normal ranges for these parameters were established in age and sex matched control subjects. Continence was improved in 14 (88 per cent) patients, 6 (38 per cent) of whom regained normal continence, at a minimum of 15 months follow‐up. A successful outcome was associated with no significant change in basal (pre‐operative 35 (10–85) cmH2O, postoperative 44 (12–105) cmH2O; n.s.) or voluntary (pre‐operative 43 (5–150) cmH2O, postoperative 32 (12–180) cmH2O; n.s.) components of anal canal pressure. There was a small but significant increase in sphincter length (pre‐operative 2 (0–3) cm, postoperative 2.5 (0–3.5) cm; P<0.01). There was no significant change in the anorectal angle at rest (pre‐operative 96 (90–110) degrees, postoperative 107 (79–118) degrees; n.s.) in the patients in whom continence was restored and five of these patients had resting anorectal angles within the normal range (75–94 degrees). Thus postanal repair need not be restricted to patients with widening of the anorectal angle since its beneficial effects do not appear to be relat

ISSN:0007-1323    

DOI:10.1002/bjs.1800750118

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractAnorectal function tests were performed in 280 consecutive patients, who were referred for evaluation of different anorectal disorders. The relationship between the estimated anal sphincter pressure on digital palpation and the measured pressure on anal manometry was investigated and the interrelationship between anal manometry, rectal capacity and the saline infusion test was defined. A significant correlation (P<0.001) was found between digitally and manometrically measured anal sphincter pressure. Considering the relationship between the three specific anorectal function tests, only manometry and the saline infusion test correlated to some extent (P<0.01). This study shows that digital palpation is helpful in anorectal function investigation, but to establish the exact anal pressures, anal manometry is mandatory. Furthermore, the poor correlation observed indicates that single tests represent different aspects of anorectal function and therefore they need to be performed together.

ISSN:0007-1323    

DOI:10.1002/bjs.1800750119

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractThere is little information on the natural history of anal fissure in Crohn's disease. The case notes of all new patients with Crohn's disease attending one hospital between 1977 and 1983 were reviewed: there were 61 patients with this diagnosis and an unhealed anal fissure as the only anal lesion. of these 61 patients the fissure healed in 42 (69 per cent) during medical treatment of the intestinal disease. Ten patients (16 per cent) developed other anal lesions and in the remaining nine patients the fissure remained unhealed at the time of rectal excision (six) or last out‐patient attendance (three). Activity of the fissure did not reflect disease activity elsewhere in 11 cases in whom healing of the fissure occurred despite progressive intestinal disease subsequently requiring resection. This study validates the policy of conservative management of anal fissure in Crohn's disease with anal surgery (required in 9.8 per cent of patients in this series) being reserved for the development of other anal diseas

ISSN:0007-1323    

DOI:10.1002/bjs.1800750120

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractA retrospective clinical and pathological study of 15 cases associated with schistosomiasis drawn from 1920 patients undergoing appendicectomy is discussed. The average age of the patients was 31.6 years with a 12:3 male predominance. Hepatomegaly, past or present jaundice, or splenomegaly were not observed. One patient had a previous history of similar right lower quadrant pain for several days. Eighty per cent of the cases showed an inflammatory reaction on pathological examination. In the remaining 20 per cent no inflammation was seen, but there was severe congestion mainly involving the subserosal blood vessels. Schistosoma haematobiurn was present in 80 per cent of the cases.

ISSN:0007-1323    

DOI:10.1002/bjs.1800750121

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY