Medical Archive

Embryology and Anatomy

Embryology / 1175 Anatomy / 1176 Congenital Anomalies / 1179

Normal Physiology

Fluid and Electrolyte Exchanges / 1179 Short-Chain Fatty Acids / 1179 Colonic Microflora and Intestinal Gas / 1179 Motility, Defecation, and Continence / 1180

Clinical Evaluation

Clinical Assessment / 1180 Endoscopy / 1180 Imaging / 1181 Physiologic and Pelvic Floor Investigations / 1181 Laboratory Studies / 1182 Evaluation of Common Symptoms / 1183

General Surgical Considerations

Resections / 1185 Anastomoses / 1189 Ostomies and Preoperative Stoma Planning / 1191 Functional Results / 1193 Anesthesia Considerations / 1194 Operative Preliminaries / 1194

Inflammatory Bowel Disease

General Considerations / 1195 Ulcerative Colitis / 1197 Crohn’s Disease / 1198 Indeterminate Colitis / 1201

Diverticular Disease

Inflammatory Complications (Diverticulitis) / 1201

Hemorrhage / 1203 Giant Colonic Diverticulum / 1203 Right-Sided Diverticula / 1203

Adenocarcinoma and Polyps

Incidence / 1203 Epidemiology (Risk Factors) / 1203 Pathogenesis of Colorectal Cancer / 1204 Polyps / 1205 Inherited Colorectal Carcinoma / 1206 Prevention: Screening and Surveillance / 1208 Routes of Spread and Natural History / 1209 Staging and Preoperative Evaluation / 1209 Therapy for Colonic Carcinoma / 1212 Therapy for Rectal Carcinoma / 1213 Follow-Up and Surveillance / 1215 Treatment of Recurrent Colorectal Carcinoma / 1215 Minimally Invasive Techniques For Resection / 1216

Other Neoplasms

Rare Colorectal Tumors / 1216 Retrorectal/Presacral Tumors / 1217 Anal Canal and Perianal Tumors / 1217

Other Benign Colorectal Conditions

Rectal Prolapse and Solitary Rectal Ulcer Syndrome / 1218 Volvulus / 1219 Megacolon / 1220 Colonic Pseudo-obstruction (Ogilvie’s Syndrome) / 1221 Ischemic Colitis / 1221 Infectious Colitis / 1222

Anorectal Diseases

Hemorrhoids

Anal Fissure

Anorectal Sepsis and Cryptoglandular Abscess

Perianal Abscess

Ischiorectal Abscess

Intersphincteric Abscess

Supralevator Abscess

Perianal Sepsis in the Immunocompromised Patient

Necrotizing Soft Tissue Infection of the Perineum

Fistula In Ano

Rectovaginal Fistula

Perianal Dermatitis

Sexually Transmitted Diseases

Pilonidal Disease

• Epidemiology
  • M/c in individuals age 15-30, particularly young males, obese individuals, those with sedentary lifestyles or occupations, and those with deep gluteal clefts.
• Pathophysiology
  1. Develops when an edematous, infected hair follicle in the intergluteal region becomes occluded.
  2. The infection spreads subcutaneously and forms an abscess, which can rupture and create a pilonidal sinus tract.
  3. As the patient sits or stands, hair and debris are forced into the sinus tract, resulting in recurrent infections and foreign-body reactions.
• Clinical features
  • Fluctuant mass 4-5 cm cephalad to the anus in the intergluteal region.
  • Subacute pain over the midline sacrococcygeal, frequently worsened by activities that stretch the overlying skin (eg, bending down)
  • With mucoid and bloody drainage
• Treatment
  • Drainage of abscesses and collected debris followed by excision of sinus tract.
  • Despite longer healing times, open closure is preferred d/t decreased recurrence rates.

Hidradenitis Suppurativa

Trauma

Penetrating Colorectal Injury / 1233 Blunt Colorectal Injury / 1234 Iatrogenic Injury / 1234 Anal Sphincter Injury and Incontinence / 1235 Foreign Body / 1235

The Immunocompromised Patient

Human Immunodeficiency Virus

Immunosuppression for Transplantation

The Neutropenic Patient