BOOK
Disorders of the Anorectum and Pelvic Floor, An Issue of Gastroenterology Clinics, E-Book
David J. Maron | Steven D. Wexner
(2013)
Additional Information
Book Details
Abstract
This issue provides important updates on the management of disorders of the anorectum and pelvic floor. Expert authors provide information on hemorrhoidal issues, anorectal anatomy and imaging techniques, fissure and anal stenosis, rectal prolapse, and anal abscess and fistula. Other articles are devoted to sexually transmitted and infectious diseases, treatment of radiation proctitis, and pruiritis ani. Readers will come away with a full understanding of the current strategies for diagnosis and management of these disorders.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Disorders of the Anorectum and Pelvic Floor\r | i | ||
| Copyright\r | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Gastroenterology Clinics of North America | xi | ||
| Preface\r | xiii | ||
| Dedication | xv | ||
| Anorectal Anatomy and Imaging Techniques | 701 | ||
| Key points | 701 | ||
| Embryology | 701 | ||
| Rectal anatomy | 702 | ||
| Anal anatomy | 704 | ||
| Anorectal imaging | 705 | ||
| Endorectal/Endoanal Ultrasound | 705 | ||
| Magnetic Resonance Imaging | 707 | ||
| Defecography | 708 | ||
| References | 709 | ||
| Anorectal Physiology and Testing | 713 | ||
| Key points | 713 | ||
| Introduction | 713 | ||
| Anorectal physiology | 714 | ||
| Sensory Physiology | 714 | ||
| Motor Physiology | 714 | ||
| Anorectal testing | 715 | ||
| Digital Rectal Examination | 716 | ||
| Anal Manometry | 717 | ||
| Endoanal Ultrasound | 718 | ||
| Defecography | 720 | ||
| Balloon Expulsion Test | 721 | ||
| MRI | 722 | ||
| Pudendal Nerve Terminal Motor Latency | 722 | ||
| Electromyography | 725 | ||
| Colonic Transit Studies | 725 | ||
| Summary | 726 | ||
| References | 726 | ||
| Anal Fissure and Stenosis | 729 | ||
| Key points | 729 | ||
| Introduction: background, etiology, and pathophysiology | 729 | ||
| Anatomic and Physiologic Background | 729 | ||
| Physiology of IAS Muscle Contraction | 730 | ||
| Epidemiology | 730 | ||
| Etiology | 731 | ||
| Constipation and low-fiber diet | 731 | ||
| Trauma during pregnancy | 731 | ||
| Internal anal sphincter hypertonicity/spasm | 731 | ||
| Symptoms | 731 | ||
| Examination | 731 | ||
| Treatment | 732 | ||
| Acute Anal Fissures | 732 | ||
| Chronic Anal Fissures | 732 | ||
| Medical management | 732 | ||
| Nitric Oxide Donors | 732 | ||
| Calcium-Channel Blockers | 737 | ||
| Nifedipine | 737 | ||
| Botulinum Neurotoxin A | 740 | ||
| Role and mechanism of action | 740 | ||
| Application | 741 | ||
| Surgical treatment of anal fissure | 744 | ||
| Anal Dilation | 744 | ||
| Lateral Internal Sphincterotomy | 744 | ||
| Mucosal Advancement Flaps for Fissure | 744 | ||
| Anal stenosis | 745 | ||
| Diagnosis | 745 | ||
| Examination | 745 | ||
| Nonoperative Management | 745 | ||
| Operative Management | 748 | ||
| General and important technical considerations | 748 | ||
| Advancement flaps (sliding flaps) | 749 | ||
| Island flaps (adjacent tissue transfer flaps) | 749 | ||
| Rotational flaps | 749 | ||
| Special situations | 750 | ||
| Stricturotomy, stricture release, and stricturoplasty | 750 | ||
| Sphincterotomy | 752 | ||
| References | 752 | ||
| Modern Management of Hemorrhoidal Disease | 759 | ||
| Key points | 759 | ||
| Introduction | 759 | ||
| Anatomy and pathophysiology | 760 | ||
| Physical examination | 761 | ||
| Hemorrhoidal classification | 761 | ||
| Nonoperative treatment | 763 | ||
| Diet and Lifestyle Modifications | 763 | ||
| Topical and Oral Agents | 763 | ||
| Office Procedures | 764 | ||
| Rubber band ligation | 764 | ||
| Infrared coagulation | 766 | ||
| Cryotherapy | 766 | ||
| Sclerotherapy | 766 | ||
| Operative therapy | 766 | ||
| Operative Management of Hemorrhoids | 766 | ||
| Preparation for Surgery | 767 | ||
| Excisional Hemorrhoidectomy | 767 | ||
| Ferguson | 767 | ||
| Milligan-Morgan or open hemorrhoidectomy | 768 | ||
| Whitehead procedure | 768 | ||
| Outcomes of excisional hemorrhoidectomy | 768 | ||
| Stapled Hemorrhoidopexy | 769 | ||
| Outcomes of stapled hemorrhoidopexy | 769 | ||
| Doppler-Guided Transanal Hemorrhoid Devascularization | 770 | ||
| Outcomes of Doppler-guided transanal hemorrhoid devascularization | 770 | ||
| Summary | 770 | ||
| References | 770 | ||
| Anal Abscess and Fistula | 773 | ||
| Key points | 773 | ||
| Introduction | 773 | ||
| Anal anatomy | 773 | ||
| Anal abscess | 774 | ||
| Symptoms | 775 | ||
| Diagnosis | 775 | ||
| Treatment | 776 | ||
| Complications | 777 | ||
| Fistula | 777 | ||
| Other classification schemes | 779 | ||
| Symptoms | 779 | ||
| Diagnosis | 779 | ||
| Treatment | 779 | ||
| Fistulotomy | 780 | ||
| Fistulectomy | 780 | ||
| Setons | 781 | ||
| Fibrin Glue | 781 | ||
| Fistula Plugs | 781 | ||
| LIFT Procedure | 781 | ||
| Endorectal Advancement Flap | 782 | ||
| Summary | 782 | ||
| References | 782 | ||
| Chronic Pelvic Pain | 785 | ||
| Key points | 785 | ||
| Introduction | 785 | ||
| Definition of CPP | 785 | ||
| Epidemiology of CPP | 786 | ||
| Relevant history for patients with CPP | 786 | ||
| Physical examination | 787 | ||
| Common causes for CPP | 788 | ||
| Gynecologic | 790 | ||
| Endometriosis | 790 | ||
| Pelvic congestion | 790 | ||
| Vulvodynia, vaginitis, and vulvar vestibulitis syndromes | 790 | ||
| Urologic | 791 | ||
| Chronic prostatitis/chronic pelvic pain (CP/CPP) | 791 | ||
| Interstitial cystitis (IC) | 791 | ||
| Urethral syndrome | 791 | ||
| Gastroenterologic | 791 | ||
| Irritable bowel syndrome (IBS) | 791 | ||
| Chronic proctalgia | 792 | ||
| Proctalgia fugax | 792 | ||
| Musculoskeletal | 792 | ||
| Pelvic girdle pain | 792 | ||
| Levator syndrome | 793 | ||
| Coccygodynia | 793 | ||
| Pelvic floor prolapse | 793 | ||
| Infectious Causes | 793 | ||
| Chronic Pain Syndromes | 794 | ||
| Treatment options for patients without defined cause | 794 | ||
| Challenges facing diagnosis, treatment, and elimination of CPP | 795 | ||
| References | 795 | ||
| Pruritus Ani | 801 | ||
| Key points | 801 | ||
| Introduction | 801 | ||
| Historical perspective | 801 | ||
| Etiology of itch | 802 | ||
| Secondary causes | 802 | ||
| Inflammatory Diseases | 802 | ||
| Psoriasis | 803 | ||
| Atopic dermatitis | 803 | ||
| Seborrheic dermatitis | 804 | ||
| Lichen planus | 804 | ||
| Lichen sclerosis | 805 | ||
| Nonsexually Transmitted Infectious Diseases | 805 | ||
| Candida | 805 | ||
| Parasitic infections | 806 | ||
| Herpes zoster | 806 | ||
| Systemic Diseases | 806 | ||
| Uremic pruritus | 806 | ||
| Premalignant and Malignant Diseases | 806 | ||
| Intraepithelial neoplasia | 806 | ||
| Paget disease | 807 | ||
| Anorectal Causes | 807 | ||
| Primary causes | 808 | ||
| Summary | 810 | ||
| Acknowledgments | 811 | ||
| References | 811 | ||
| Rectal Prolapse and Intussusception | 837 | ||
| Key points | 837 | ||
| Epidemiology | 838 | ||
| Causes | 838 | ||
| Complications from untreated prolapse | 839 | ||
| Clinical evaluation | 839 | ||
| Differential diagnosis | 840 | ||
| Classification | 841 | ||
| Ancillary studies | 841 | ||
| Colonoscopy | 842 | ||
| Ultrasound | 842 | ||
| Fluoroscopy | 842 | ||
| Dynamic Pelvic Magnetic Resonance Imaging | 843 | ||
| Colonic Transit Marker Studies | 843 | ||
| Anorectal Manometry | 843 | ||
| Pudendal Nerve Terminal Motor Latency | 843 | ||
| Electromyography | 844 | ||
| Management | 844 | ||
| Nonoperative Therapy | 844 | ||
| Operative Repair | 844 | ||
| Abdominal versus perineal | 845 | ||
| Perineal approaches | 845 | ||
| Abdominal procedures | 847 | ||
| Suture rectopexy | 847 | ||
| Mesh repairs | 848 | ||
| Resection rectopexy (Frykman-Goldberg procedure) | 850 | ||
| Ventral rectopexy | 850 | ||
| Minimally invasive approaches | 851 | ||
| Internal Intussusception | 852 | ||
| Summary | 852 | ||
| Supplementary data | 853 | ||
| References | 853 | ||
| Dedication | 862 | ||
| Constipation and Pelvic Outlet Obstruction | 863 | ||
| Key points | 863 | ||
| Introduction | 863 | ||
| Definition | 863 | ||
| Cause and pathology | 864 | ||
| Constipation subtypes | 864 | ||
| Initial evaluation | 864 | ||
| History and Physical | 864 | ||
| Testing | 865 | ||
| Treatment | 865 | ||
| Medical Treatment | 865 | ||
| Colonic Inertia | 866 | ||
| Surgical options | 866 | ||
| Pelvic outlet obstruction | 868 | ||
| Functional outlet obstruction | 869 | ||
| Short-segment Hirshsprung | 869 | ||
| Pelvic Dyssynergy | 869 | ||
| Biofeedback | 869 | ||
| Botulinum toxin | 870 | ||
| SNS | 870 | ||
| Mechanical outlet obstruction | 870 | ||
| Internal Intussusception | 870 | ||
| Enterocele/Sigmoidocele | 871 | ||
| Rectocele | 871 | ||
| Stapled Transanal Rectal Resection Procedure | 873 | ||
| Stomas | 873 | ||
| Summary | 873 | ||
| Supplementary data | 874 | ||
| References | 874 | ||
| Sexually Transmitted and Anorectal Infectious Diseases | 877 | ||
| Key points | 877 | ||
| Sexually transmitted and infectious diseases of the anus and rectum | 878 | ||
| General Presentation and Initial Management | 878 | ||
| Reporting | 878 | ||
| Prevention | 878 | ||
| Most common pathogens and treatments | 879 | ||
| Gonorrhea | 879 | ||
| Infection with N gonorrhoeae can Facilitate HIV Transmission with more than a 3-Fold Increase in HIV Transmission Among MSM | 879 | ||
| Chlamydia | 880 | ||
| LGV | 880 | ||
| Syphilis | 881 | ||
| Donovanosis (Granuloma Inguinale) | 882 | ||
| Chancroid | 882 | ||
| HSV | 883 | ||
| HIV | 884 | ||
| Human Papillomavirus | 885 | ||
| Giant Condyloma (Buschke-Löewenstein) | 887 | ||
| Molluscum Contagiosum | 887 | ||
| Summary | 889 | ||
| References | 889 | ||
| Anal Squamous Intraepithelial Neoplasia | 893 | ||
| Key points | 893 | ||
| Introduction | 893 | ||
| Historical perspective | 894 | ||
| Epidemiology and incidence | 894 | ||
| Predictive factors for progression to high-grade AIN and invasive carcinoma | 895 | ||
| HPV and its role in AIN and invasive SCC | 895 | ||
| The evolution of the nomenclature and grading | 896 | ||
| Pathology of AIN | 897 | ||
| Anal cytology | 899 | ||
| Treatment of AIN | 901 | ||
| Identification | 902 | ||
| Clinical Identification | 902 | ||
| Identification by Screening | 902 | ||
| Nonoperative treatment | 903 | ||
| Expectant Management | 903 | ||
| Topical Treatments | 904 | ||
| Photodynamic Therapy | 904 | ||
| Vaccination | 904 | ||
| Operative treatment | 905 | ||
| Wide Local Excision | 905 | ||
| Targeted Destruction | 905 | ||
| Surveillance | 907 | ||
| References | 907 | ||
| Management of Radiation Proctitis | 913 | ||
| Key points | 913 | ||
| Introduction | 913 | ||
| Definitions | 914 | ||
| Histologic and clinical features of acute versus chronic radiation proctitis | 914 | ||
| Classification | 915 | ||
| Diagnosis | 915 | ||
| Prevention | 915 | ||
| Treatment | 916 | ||
| Medical therapies | 917 | ||
| Butyrate | 917 | ||
| Amino Salicylic Acid Derivatives | 917 | ||
| Sucralfate | 917 | ||
| Metronidazole | 917 | ||
| SCFA Enemas | 918 | ||
| Vitamin A | 918 | ||
| Formalin | 918 | ||
| Hyperbaric Oxygen | 918 | ||
| Endoscopic therapies | 919 | ||
| Endoscopic Dilation | 919 | ||
| Endoscopic Lasers and Cryoablation | 919 | ||
| Endoscopic Bipolar and Heater Probe | 919 | ||
| Endoscopic APC | 920 | ||
| Endoscopic Radiofrequency Ablation | 920 | ||
| Surgical therapies | 920 | ||
| Fecal Diversion | 920 | ||
| Repair/reconstruction | 921 | ||
| Proctectomy/pelvic Exenteration | 921 | ||
| Summary | 921 | ||
| References | 921 | ||
| Index | 927 |