A new method for study of the rectum using transvaginal ultrasound with water enema
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Enema
Obstructed defecation
Objective To examine the effect of low temperature enema with Chinese herbal drugs on preventing radioactive rectum damage in patients with cervical cancer.Methods One hundred patients with cervical cancer treated by after-loading radiology therapy were randomly divided into two groups.In addition to routine nursing care,the patients in the experimental group received low-temperature enema with Chinese herbal drugs once a day for three days.The radioactive rectum damage was compared between the two groups within three days,three months and six months after therapy.Results The incidence of grade-1 and grade-2 radioactive rectum damage in the experimental group within three days after therapy was significantly lower than that of control group.The incidence and degree of radioactive rectum damage in the experimental group at three months and six months after therapy were significantly lower than that of control group(P=0.000).Conclusions Low-temperature enema with Chinese herbal drugs can effectively prevent radioactive rectum damage in patients with cervical cancer treated by after-loading therapy.
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Objective: To define whether volume of water, administered during water enema CT (WE-CT) for local staging of rectal cancer, may be reduced without compromising the diagnostic value of the examination. Materials and Methods: 29 patients with rectum cancer underwent preoperative WE-CT. Contrast-enhanced CT (equilibrium phase) measurements were performed after i. v. injection of smooth muscle relaxant and rectal administration of 400 - 500 ml lukewarm tap water. Quality of the obtained scans was evaluated and the images were analyzed for depth of tumor invasion. Results of the CT examinations were compared to findings at surgery. Results: Despite reduced dose of water enema, 19/29 examinations were of excellent quality, 6/29 good, and 4/29 poor, but still diagnostic. We achieved sensitivity (90.1), specificity (70.1) and accuracy (86.2) in differentiating tumors confined to the bowel wall from those extending beyond it. Conclusion: Large volume of water enema administered during CT examination of the rectum may cause complaints and increases the risk of complications. Our results prove that using lower amount of water does not impair the quality of examination and accuracy of local staging of rectum carcinomas.
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Anorectal disorders that disturb normal defecation are described, especially intussusception of the rectum (internal procidentia). A review of 190 patients, half of whom were treated operatively and the other half conservatively, is presented. Diagnostic procedures, symptoms, and indications for operations are evaluated. We believe that intussusception of the rectum is a relatively common cause of difficult emptying of the rectum and, when the correct diagnosis is established, operation presents a fair chance for improvement.
Rectal prolapse
Colorectal Surgery
Defecography
Obstructed defecation
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Objective This paper explores the clinical treatment results by means of removing petal of rectum to repair congenital vagina fistula. Methods First, design the removable petal of rectum, free its mucosa completely and repair the mouth of rectum fistula without intense force. Close the deficiency of rectum wall as well as vagina wall respectively and sew them up at different levels. Results Twelve cases were successfully treated and cured by operation. They were paid a follow-up visit to for 1 to 9 years. There was no recurrences of that disease and no symptoms of incontinence of anus among them. Conclusion The treatment for the low-level congenital rectum vagina fistula by removing petal of rectum is proved to be successful. This way of treatment can be popularized. It' s crucial to the success of operation to have sufficient preparations for intestinal tract before operation and standardize the manipulations during operation.
Anus
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In cases of abdomino-perineal excision of the rectum, a monobloc excision of the posterior vaginal wall and the rectum is performed. The flaps thus formed are rotated and sutured to the side-walls of the cavity. The perineal fat is approximated and the skin sutured. The "new vagina" is packed. The vaginal epithelium covers in less than three weeks the posterior raw area reconstituting a normal vagina. The packing is irrigated daily with an antiseptic. Postoperative cares are more easier.
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Internal intussusception of the rectum is the funnel-shaped infolding of the rectum during straining to defecate. Patients present with multiple symptoms; most commonly rectal pressure and pain in association with constipation and straining. Defecography (videofluoroscopy during defecation) is the method of choice for diagnosing this problem. Rectal mobility from the sacrum, infolding of the rectum and sphincter relaxation can be used to grade the findings on defecography (Grade I-IV). The optimal therapy for internal intussusception of the rectum is unknown because the cause of the problem is unknown. Conservative management is recommended in all but the most severely symptomatic patients.
Defecography
Obstructed defecation
Rectal prolapse
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Objective To investigate the stapled trans-anal rectal resection(STARR) and Altemeir's resection for rectum prolapse in spinal cord injury(SCI) patients.Methods Anus bowel disease of 260 SCI patients were investigated,21 cases with rectum prolapse who were invalid for nonoperative treatment chose Altemeir's resection or STARR depending on the degree of rectum prolapse.They were recorded according to International Spinal Cord Injury Bowel Function Based and Extension Set before and 12 months after operation.Results 85 SCI patients were with rectum prolapse(32.7%),21 patients complicated with constipation and mixed hemorrhoid,19 with rectal mucous membrane prolapse(7 cm),4 with rectal internal mucous intussusception,2 were completely rectum prolapse(7 cm).Rectum prolapse of Ⅰ degree was found in 13 cases,Ⅱ in 5 cases,and Ⅲ in 3 cases.Patients with Ⅰ or Ⅱ degrees rectum prolapse accepted STARR,those with Ⅲ degrees accepted Altemeir's resection.No serious complication was found.Self-report of intestinal dysfunction affecting the quality of life during the 12 months after operation significantly decreased(P0.01),so as the need of drawing out defecate with hands(P0.01),the usage of liner,plug,or antidiarrheal(P0.001).The symptom such as endless defecate feeling,abdominal distension,abdominal pain,abdominal discomfort were significantly alleviated(P0.05).Conclusion STARR and Altemeir's resection are both safe and effective operation for rectum prolapse in SCI patients.
Rectal prolapse
Obstructed defecation
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Objective Objective This paper explores the clinical treatment results by means of removing petal of rectum to repair the low and mid-level vagina fistula.Methods First,design the removable petal of rectum,free its mucosa completely and repair the mouth of rectum fistula without intense force.Results Twelve cases were successfully treated and cured by operation.They were paid a follow-up visit to for 1 to 3 years.There was no recurrences of that disease and no symptoms of incontinence of anus among them.Conclusion The treatment for the low and mid-level rectum vagina fistula by removing petal of rectum is proved to be successful.The way of treatment can be popularized.It,s crucial to the success of the operation to have sufficuient preparations for intestinal tract before opertion and standardize the manipulations during operation.
Anus
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The aim of the study was to estimate the prevalence of fungi in monofocal and multifocal infections in pregnant women. 251 pregnant women were examined for presence of fungi in vagina, oral cavity and rectum. Fungal strains were recovered in 259 out of 753 samples (49.2% of all pregnant women). Presence of fungi in vagina was associated with the invasion of oral cavity and/or rectum in 98% of all women. Monofocal vulvovaginal mycosis was found only in 1.9% of the cases. Bifocal infections depended on the ontocenoses: vagina - oral cavity (32.1%); vagina--rectum (7.5%); oral cavity--rectum (13.2%). Trifocal infections (vagina - oral cavity--rectum) occurred in 58.5% of all examined women.
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Enema
Transverse colon
Ascending colon
Descending colon
Aminosalicylic acid
Mesalazine
Large intestine
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