By Eli D., M.D. Ehrenpreis
Even though rectal and perianal court cases are one of the most typical obvious through basic care physicians, surgeons, and gastroenterologists, the wide range of problems linked to those proceedings are, generally, poorly understood. also, a number of more recent diagnostic resonance imaging, are actually being hired for the overview of those problems. eventually, new pharmacotherapies, together with immunosuppressants and topical cures in addition to new surgical remedies, have emerged. those are defined in a transparent, elementary demeanour.
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Additional info for Anal and Rectal Diseases Explained
3 Barium enema Description of procedure A barium enema is a radiographic examination of the colon (see Figure 1). It is performed using either a single column of barium sulfate instilled into the colon, or a barium instillation combined with air to perform an air–contrast study. Indications Evaluation of symptoms suggestive of colonic disease, such as constipation, rectal bleeding, irritable bowel syndrome, and unexplained diarrhea. Complete evaluation of the colon for colorectal cancer screening or surveillance when colonoscopy is contraindicated or cannot be safely or adequately performed.
Finally, the patient is asked to strain and attempt to evacuate the barium. Continuous video fluoroscopy is the preferred method of obtaining data. Static views are also obtained and the anatomic position of the pubococcygeal line is determined. Lateral films are utilized to measure the anorectal angle between the anal canal and the horizontal axis of the rectum (located approximately 2 cm above the ischial tuberosity). This technique can identify changes in the anorectal angle, alteration of anorectal anatomy, and abnormal mobility of the pelvic floor with the aforementioned maneuvers.
Lateral rectoceles demonstrated on dynamic proctography. Figure 4. Oblique view of an anovaginal fistula seen on dynamic proctography. Figure 5. Pubococcygeal tear with herniation of rectal tissue (arrow) demonstrated on dynamic proctography. Hernia was only seen when the patient bore down with contrast in place during dynamic study. 33 Chapter 2 Complications Patient discomfort and barium impaction. Additional comments Dynamic proctography should be performed in a center where the staff have experience with the procedure.
Anal and Rectal Diseases Explained by Eli D., M.D. Ehrenpreis