2. Epidemiology:
•Approximately 11 people have rectal
diseases among 10000 population/
•But, after primary medical examination
in 25% people are determinated rectal
diseases
3. 1 - Gear Line;
2 - perianal skin;
3 - Anal-cutaneous line;
4 - lower rectal venous plexus;
5 - Bundle of Parks;
6 - Superior rectal venous plexus;
7 - Circular layer of muscular coat
rectum;
8 - Longitudinal layer
muscle membrane of the rectum.
Anatomy of rectum
4. Surgical anatomy of the rectum
Locking the muscles of the rectum (bottom view)
5. Congenital anomalies of the rectum
Non-tumoral diseases of the rectum
Tumors of the rectum
Diseases of the rectum
6. Disease of Hirschsprung (aganglionar megacolon)
Congenital atresias of the anus and rectum
Congenital anomalies of the rectum
7. Anomalies of the anus and rectum is known to occur in
0,2 ° / oo of all newborns. Among the most frequent:
anal stenosis, anal atresia, atresia, the anus and rectum
and rectal atresia
Congenital atresias of the anus and rectum
8. Depending on whether over or under
pubococcygeal line blockage is located, distinguish
deep (aproctia) or high-obstruction (atresia, the
anus and rectum). Under the new nomenclature
adopted in Melbourne in 1970, and still produce an
intermediate form.
Classification and diagnosis
9. Congenital anomalies of the rectum
Congenital anomalies of the rectum: a) stenosis anus, b) atresia anus, and
c) atresia anus and rectum, r) atresia of the rectum
10. To estimate the height of the obstruction is a lateral
X-ray radiography in the baby's head is down (in
Wangen-steen-Rice). From the distance the air, filling
the blind pocket on a metal plate glued in place the
anus, conclude about the height of obstruction
Diagnostics
12. Congenital atresias of the anus and rectum
Operation in atresia of the anus and rectum through abdomen-surface access and
Rehbein Siepliens. To access between the sacral bone and intestine, ureter directly to
form a tunnel (a), through which extend a plastic tube (b), which through the hole in
the bottom of the blind pocket stretch in the abdominal cavity (в)
13. Hemorrhoids
Anal fissure, papillary hypertrophy
Anorectal abscess and anal fistula
Archoptosis and the failure of the sphincter
Non-tumoral diseases of the rectum
14. Hemorrhoids - expansion of the
cavernous cells of the rectum, the most
common colo Proctoscope pathology.
Hemorrhoid suffers approximately 12 - 13
out of 100, and its share in the overall
structure of diseases of the rectum is 40%.
The disease occurs almost equally
common among men and women aged 30-
50 years.
Hemorrhoids
18. Ligation of hemorrhoids with rubber rings
2 cm proximal from the
anus
Causes necrosis and
scarring of the lining of the
rectal wall, thus reducing
the relapse
96% of asymptomatic for a
month
19. Operation by Milugan - Morgan
Operation by Parks
Operation by Rijih
Surgical treatment
21. Among all the diseases of the rectum
anal fissure is the frequency of the
third place (11.7%) after colitis and
hemorrhoids. Fissures are more
common in women (60%) aged 30 to
50 years. Usually, the crack has a
length of 2 cm, width 2-3 mm. Most
often anal fissure is located in the
posterior commissure anus, due to
traumatization of the zone during
defecation. Maybe a few cracks in
this case, the most common
localization of - anterior and
posterior commissure ("mirror" the
crack). The direction of the
longitudinal cracks.
Rectal anal fissure
22. Anal fissure, pectenoz, papillary hypertrophy
Anal fissure with
caruncle and
hypertrophied anal
warts
23. About anal fissure say if the boundary of chronic
ulcers anus, more or less deep penetration into the
anal canal. With a long-term deep fissures,
accompanied by a chronic inflammatory process,
there is strong, prone to wrinkle, scar tissue, which
increasingly constricts the anal canal. This is called
pectenoziz.
Anal fissure, pectenoz, papillary hypertrophy
24. Anal fissure, pectenoz, papillary hypertrophy
Internal sphincterotomy. a) Dissection of the crack and the internal sphincter, and
b) the same schematic, c) a small external wound after the removal of Tongue
25. The simplest method for the treatment -
infiltration of the tissues around the colon
causing inflammation of the drug.
Failure of the sphincter
26. Failure of the sphincter.
Fixing fallen rectum "assemblies"
and "reverse intussusception"
27. In admittion of patient with rectum disease
general practitioner must perform followings:
1. Careful picking of anamnesis;
2. To perform rectoromanoscopy;
3. To perform colonoscopy;
4. Taking in laboratory methods of research;
5. As appropriate direct the patient in surgery in-
patient department.
Tactics of GP
