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Hemorrhoids
Published in Charles Theisler, Adjuvant Medical Care, 2023
Hemorrhoids are dilated veins (submucosal vascular tissue) in the rectum and distal anal canal. Hemorrhoids develop when the venous drainage of the anus is altered, causing the venous plexus and connecting tissue to dilate. This connective tissue, when weakened, leads to descent or prolapse of the hemorrhoids.1 Affected veins become more swollen due to increased pressure from pregnancy, being overweight, or from chronic constipation, or straining at the stool.
Transanal Total Mesorectal Excision for Rectal Cancer
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
The first step in assessing a patient for taTME is a thorough history and physical examination. Many patients with rectal cancer are asymptomatic, but symptoms may include rectal bleeding, rectal pain, tenesmus, change in bowel habits or stool caliber, weight loss, nausea, or fatigue. Prior pelvic surgery, such as prostate or gynecological surgery, and/or pelvic radiation can affect TME dissection planes and increase the complexity of transanal dissection and the risk of wrong-plane surgery. Information about baseline urinary and sexual function are important to document because of the risks of pelvic autonomic nerve injury associated with TME. Likewise, a history of fecal incontinence is critical in preoperative evaluation, as fecal incontinence would preclude a patient from sphincter preservation surgery. A comprehensive medical history should identify other medical conditions that may warrant additional assessment to optimize the patient prior to surgery. Diabetes, obesity, immunosuppression, and smoking have been associated with anastomotic leak in taTME and should be addressed before surgery [20]. Laboratory studies should include complete blood count, electrolyte panel, coagulation studies, and type and screen. Serum carcinoembryonic antigen (CEA) should be obtained to facilitate postoperative surveillance.
The Digestive (Gastrointestinal) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
After one to six hours in the small intestine, the chyme passes through the ileocecal valve into the cecum, the first part of the large intestine. Here the process of water and salt removal begins, converting liquid waste into feces. The large intestine, which frames the longer, but more compact, small intestine, consists of cecum, ascending colon, transverse colon, descending colon, and sigmoid colon. The appendix extends from two to six inches out from the side of the cecum, but it serves no known active role in the digestive process in humans. The terminal portions of the large intestines are the rectum, anal canal, and anus.
Prolapsed anorectal malignant melanoma presenting as hemorrhoids
Published in Baylor University Medical Center Proceedings, 2023
Busara Songtanin, Kenneth Nugent, Sameer Islam
A 71-year-old woman with known internal hemorrhoids presented to the hospital with rectal bleeding for 3 months. She felt a “mass” inside her rectum that occasionally protruded and bled. She also complained of right upper quadrant pain and “lumps” for 3 weeks. She denied nausea, vomiting, weight loss, and changes in appetite. Her vital signs were within normal limits. Physical examination showed hepatomegaly, and rectal exam revealed an irregular mass with blood on the glove after palpation. Laboratory tests showed a hemoglobin of 9.6 g/dL; aspartate transaminase, 25 U/L; alanine transaminase, 17 U/L; alkaline phosphatase, 319 U/L (35–104 U/L); and lactate dehydrogenase, 401 U/L (135–214 U/L). Ultrasound of the abdomen showed multiple lesions in the right and left lobes of the liver, with the largest 8.3 cm in diameter. Computed tomography of the abdomen with contrast showed hepatosplenomegaly with numerous solid lesions involving the liver consistent with diffuse metastatic disease and thickening of the rectal wall.
Herbal remedies used by traditional healers to treat haemorrhoids in Tabora region, Tanzania
Published in Pharmaceutical Biology, 2022
David Sylvester Kacholi, Halima Mvungi Amir
Haemorrhoids, also called piles, are swollen veins in the anus and lower rectum. The ailment is mainly caused by increased pressure in the veins due to straining when trying to have a bowel movement, or any activity that causes strain. As pressure increases, blood pools in the veins increase, which causes them to swell, thus stretching the surrounding tissue (Peery et al. 2015). The most common and severe effects of haemorrhoids are perianal thrombosis, and incarcerated prolapsed internal haemorrhoids with subsequent thrombosis (Carey and Whelton 2018). The disease is considered a significant cause of morbidity and has economic as well as social impacts on society (Riss et al. 2012). The economic impact includes a burden on health systems and loss of working days, while social impact is linked to lifestyles, for instance, interpersonal, food and hygiene, and sexual habits (Rubbini and Ascanelli 2019). Moreover, the disease causes physical and psychological distress (Khan et al. 2015), and considerably affects the patient’s quality of life due to bleeding occurring with or without defaecation, anal pain, and itching (Guttenplan 2017).
Risk factors associated with breakdown of perineal laceration repair after vaginal birth
Published in Journal of Obstetrics and Gynaecology, 2022
Long Cui, Huizhu Zhang, Lun Li, Chi Chiu Wang
This is a retrospective case-control study of postpartum women who delivered in Guangzhou Women and Children’ Medical Center between April 2018 and April 2019. The Institutional Review Board of the Guangzhou Women and Children’s Medical Center approved this study (no. 2019121223090409). Case subjects were defined as women who presented with a breakdown of perineal laceration after either spontaneous or instrumental vaginal birth. The definition of breakdown is perineal laceration including superficial separation or full thickness dehiscence of the vulvovaginal skin or mucosa with or without involvement of anal sphincter and/or anal mucosa (Garcia-Lausin et al. 2019; Goldaber et al. 1993). Equal number of cases and patients were included (Table 1). Especially, perineal abscess and perirectal abscess were diagnosed and differentiated by looking externally at the anus and through a digital rectal exam. In this study, when the vaginal bleeding stops, blood-soaked items were weighed, and the dry weight of the items was subtracted to obtain blood loss volume.