Transanal advancement of the anterior rectal wall for vaginal fistulas involving the lower rectum

1980 ◽  
Vol 23 (4) ◽  
pp. 236-241 ◽  
Author(s):  
John R. Hilsabeck
Keyword(s):  
Rectal Wall ◽  
Anterior Rectal Wall ◽  
Lower Rectum

scholarly journals 868 The management of acute lower gastrointestinal bleeding using a Sengstaken-Blakemore tube

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Iskandarani ◽  
M Fadel ◽  
P Boshier ◽  
A M Howell ◽  
P Tekkis ◽  
...  
Keyword(s):  
Rectal Bleeding ◽  
Rectal Wall ◽  
Anal Verge ◽  
Gastrointestinal Haemorrhage ◽  
Alternative Methods ◽  
Anterior Rectal Wall ◽  
Gastric Balloon ◽  
Lower Rectum ◽  
Balloon Tamponade ◽  
Endoscopic Clips

Abstract Introduction Acute lower gastrointestinal haemorrhage can potentially be life-threatening. We present a case of a massive rectal bleed which was managed successfully with a balloon tamponade device designed for upper gastrointestinal haemorrhage. Presentation of case A 75-year-old gentleman, with a history of human immunodeficiency virus and cirrhosis with portal hypertension, presented with bright red rectal bleeding. Investigations showed a low haemoglobin level (74 g/L) and deranged clotting. Oesophago-gastro-duodenoscopy demonstrated no fresh or altered blood. Flexible sigmoidoscopy revealed active bleeding from a varix within the anterior rectal wall 4 cm from the anal verge. Efforts to stop the bleeding, including endoscopic clips, adrenaline injection and rectal packing, were unsuccessful and the patient became haemodynamically unstable. A Sengstaken-Blakemore tube was inserted per rectum and the gastric balloon was inflated to tamponade the lower rectum. The oesophageal balloon was then inflated to hold the gastric balloon firmly in place. A computed tomography angiogram demonstrated no evidence of haemorrhage with balloon tamponade. After 36 h, the balloon was removed with no further episodes of bleeding. Discussion The application of a balloon tamponade device should be considered in the management algorithm for acute lower gastrointestinal bleed. Advantages include its rapid insertion, immediate results and ability to measure further bleeding after the catheter has been placed. Conclusions Sengstaken-Blakemore tube per rectum may effectively control massive low rectal bleeding when alternative methods have been unsuccessful.

scholarly journals Radiobiological Evaluation of Dosimetric Plans for Stereotactic Radiotherapy for Prostate Cancer According to Fractionation Regimen

2019 ◽  
Vol 100 (5) ◽  
pp. 263-269
Author(s):  
E. S. Sukhikh ◽  
I. N. Sheyno ◽  
L. G. Sukhikh ◽  
A. V. Taletskiy ◽  
A. V. Vertinskiy ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Total Dose ◽  
Rectal Wall ◽  
Tumor Control ◽  
Anterior Rectal Wall ◽  
Tumor Control Probability ◽  
Equivalent Uniform Dose ◽  
Dose Volume Histograms ◽  
Dose Volume ◽  
Fractionation Regimen

Objective. To determine the most effective irradiation regimen (total dose and dose per fraction) for hypofractionated treatment for prostate carcinomas according the TCP/NTCP radiobiological criteria.Material and methods. Using the tomographic information of five patients with low-risk prostate adenocarcinoma as an example, the authors devised dosimetric radiation therapy plans using the volumetric modulated arc therapy (VMAT) procedure. They considered the range of total doses of 33.5 to 38 Gy administered in 4 and 5 fractions. Based on the equivalent uniform dose concept proposed by A. Niemierko and on the computed differential dose volume histograms, the investigators modeled local tumor control probability (TCP) values, by taking into account the uncertainties of main radiobiological parameters, and estimated normal tissue complication probabilities (NTCP) for the anterior rectal wall as the organ most at risk of irradiation. An effective dosimetric plan was selected according to the UTCP criterion and the probability of complication-free tumor control, i.e. TCP (1 – NTCP).Results. The results of modeling the UTCP criterion show that with a higher total dose, the TCP value increases and so does the NTCP value, therefore the optimal radiation therapy plans are to irradiate with a total dose of 34 Gy over 4 fractions or with a dose of 36–37 Gy over 5 fractions. The difference between the fractionation regimens is that the UTCP value is achieved with a higher TCP value over 4 fractions and with a lower load on the rectal wall over 5 fractions.Conclusion. The choice of a specific fractionation regimen should be determined from the calculated values of differential dose volume histograms for each patient, as well as from radiobiological criteria, such as TCP, NTCP and UTCP.

scholarly journals Primary prostatic extragastrointestinal stromal tumor: a case report and literature review

2018 ◽  
Vol 46 (10) ◽  
pp. 4343-4349 ◽  
Author(s):  
Yong-hao You ◽  
Yi Zhang
Keyword(s):  
Literature Review ◽  
Rectal Wall ◽  
Smooth Muscle Actin ◽  
Treatment Method ◽  
Stromal Tumor ◽  
Anterior Rectal Wall ◽  
Muscle Actin ◽  
Pelvic Tumor ◽  
Extragastrointestinal Stromal Tumor ◽  
Spindle Cells

Objective This study was performed to discuss the characteristics, diagnosis, and treatment of primary prostatic extragastrointestinal stromal tumor (EGIST). Methods The case history data of a patient with an EGIST were analyzed and discussed with a literature review. Results The patient was diagnosed with a pelvic tumor, possibly malignant. We ascertained the diagnosis by exploratory surgery and pathological biopsy. The tumor was present in the prostate and infiltrated and pressed against the anterior rectal wall. Pathological biopsy showed that the tumor comprised spindle cells, which were also present at the junction of the tumor and prostate tissue. Immunohistochemically, the tumor cells were positive for CD117, DOG-1, CD34, and smooth muscle actin and negative for S100 and desmin; Ki-67LI was about 10%. These results support the diagnosis of primary prostatic EGIST. Conclusion The rarity and nonspecific clinical manifestation of prostatic EGIST facilitate misdiagnosis. Diagnosis mainly depends on imaging examination and characteristic histopathological and immunohistochemical features, and GIST must be excluded. Surgery is the main treatment method, and imatinib is suggested for unresectable and malignant EGISTs.

Laparoscopic Shaving Surgery of Endometriotic Nodule on Anterior Rectal Wall

2015 ◽  
Vol 22 (6) ◽  
pp. S139
Author(s):  
J Bae ◽  
J Choi ◽  
U Jung ◽  
W Lee ◽  
A Koh ◽  
...  
Keyword(s):  
Rectal Wall ◽  
Anterior Rectal Wall

Laparoscopic disk excision and primary repair of the anterior rectal wall for the treatment of full-thickness bowel endometriosis

1994 ◽  
Vol 8 (6) ◽  
pp. 682-685 ◽  
Author(s):  
C. Nezhat ◽  
F. Nezhat ◽  
E. Pennington ◽  
C. H. Nezhat ◽  
W. Ambroze
Keyword(s):  
Rectal Wall ◽  
Primary Repair ◽  
Anterior Rectal Wall ◽  
Full Thickness ◽  
Bowel Endometriosis

Anterior rectal wall excision for endometriosis using the circular stapler

2003 ◽  
Vol 73 (8) ◽  
pp. 647-648 ◽  
Author(s):  
Rodney J. Woods ◽  
Alexander G. Heriot ◽  
Frank C. Chen
Keyword(s):  
Rectal Wall ◽  
Circular Stapler ◽  
Anterior Rectal Wall
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