Anal Verge and Low Rectal Bleeding

1986 ◽  
Vol 8 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Paul F. Jaques ◽  
Duane D. Fitch
Keyword(s):  
Rectal Bleeding ◽  
Anal Verge

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 Successful surgical treatment of intractable post-radiation rectal bleeding

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Rezvan Mirzaei ◽  
Bahar Mahjoubi ◽  
Jalil Shoa ◽  
Roozbeh Cheraghali ◽  
Zahra Omrani
Keyword(s):  
Surgical Treatment ◽  
Rectal Bleeding ◽  
Rectal Wall ◽  
Anal Verge ◽  
Metastatic Breast ◽  
Main Role ◽  
Anal Region ◽  
Diverting Stoma ◽  
Radiation Colitis ◽  
Post Radiation

Patients will typically present symptoms of chronic post-radiation colitis and proctitis 8-12 months after finishing their treatment. Endoscopic methods play the main role the treatment of bleeding caused by post-radiation colitis and proctitis. Surgical treatment is required for remained approximately 10% of patients. Here we present a 64 year old female with metastatic breast cancer, who was referred to us for intractable rectal bleeding. Total colonoscopy and rigid rectosigmoidoscopy revealed proctitis, rectal and sigmoidal telangiectasis, multiple necrotic ulcers between 15 to 30 cm from the anal verge, and also huge ishemic ulcer with patchy necrotic areas about 10 cm from the anal verge. This abnormal irradiated part was resected and then mucosectomy of the remnant rectum, both transabdominally and transanally was done. We performed pull-through technique of normal proximal colon to anal region through the remnant rectal wall and finally did coloanal anastomosis. Diverting stoma was not made because of anastomosis in anal region. With this technique we can achieve benefits such as avoidance of harsh dissection in a frozen pelvis and its consequences, we can avoid intra-abdominal anastomosis, there is no need to a diverting stoma and, most important of all, definite bleeding control.

scholarly journals Two cases of primary leiomyosarcoma of sigmoid colon treated with laparoscopic surgery: a case report and a review of literature

2021 ◽  
Author(s):  
Ali-Mohammad Bananzadeh ◽  
Maral Mokhtari ◽  
Maryam Sohooli ◽  
Ramin Shekouhi
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Laparoscopic Surgery ◽  
Sigmoid Colon ◽  
Rectal Bleeding ◽  
Anal Verge ◽  
Muscularis Propria ◽  
Laparoscopic Approach ◽  
Oncologic Outcome ◽  
Primary Leiomyosarcoma

Abstract Background Leiomyosarcoma (LMS) of the colon is an unbelievably rare and highly invasive tumor arising from the muscularis propria of the gastrointestinal tract. After the introduction of the oncogenic role of KIT by immunohistochemistry (IHC), the reported cases of gastrointestinal leiomyosarcoma were limited. True LMS of the colon is such a rare disorder that there isn’t enough description of its nature. The classical colon LMS presents with a vast majority of non-specific symptoms including mild abdominal pain, fresh/obscure rectal bleeding, and weight loss. Case presentation: we experienced two extremely rare cases of colonic LMS. First patient was a 48-year-old man referred to our surgical outpatient clinic with mild intermittent abdominal pain and occasional rectal bleeding. After the initial investigation patient underwent colonoscopy that was suggestive of a large polypoid mass in 15 centimeters from the anal verge. Histopathology and Subsequent immunohistochemistry were in favor of LMS of sigmoid colon, and he underwent Laparoscopic anterior resection. The second patient was a 49-year-old man with 3-month history of fatigue, melena, and unintentional weight loss. Colonoscopy revealed a large circumferential mass in sigmoid colon 40 cm from the anal verge with the diagnosis of LMS. He underwent Laparoscopic left hemicolectomy. Conclusion: Herein, we reported two rare cases of primary leiomyosarcoma of sigmoid colon treated with laparoscopic surgery. The tumors were surgically removed via laparoscopic approach. Overall, colonic LMS is a highly invasive neoplasm with poor oncologic outcome.

scholarly journals UNCOMMON ANORECTAL PATHOLOGY: ANORECTAL MELANOMA

2021 ◽  
Vol 9 (01) ◽  
pp. 147-149
Author(s):  
Fatima Boukis ◽  
◽  
Imane Boujguenna ◽  
Anass Fakhri ◽  
Hanane Rais ◽  
...  
Keyword(s):  
Rectal Bleeding ◽  
Poor Prognosis ◽  
Malignant Tumors ◽  
Anal Verge ◽  
Common Symptom ◽  
Anorectal Melanoma ◽  
Histological Variants ◽  
Aggressive Tumor ◽  
Irregular Mass ◽  
Anorectal Pathology

Anorectal melanoma (AM) is a rare and aggressive tumor, characterized by a poor prognosis. It accounts for 0.4–1.6% of all melanomas, and only 1% of anorectal malignant tumors [1]. It is difficult to diagnose due to the hidden site and nonspecific symptoms, occurring usually at a late stage. The most common symptom is rectal bleeding. There are various histological variants of AM. There is currently no consensus of treatment the typical therapeutic approach remains surgical resection however, this is not associated with improved overall survival [2,3]. We present a case of a 52-year old male complaining of rectal bleeding and pain for about 4 months, which were attributed to hemorrhoids. Rectal examination revealed an irregular mass near the anal verge. Biopsies were taken for analysis, they were fixed in 10% formalin, paraffin embedded and routinely stained with Hematoxylin– Eosin. Immunohistochemical investigations were done by using antibodies against cytokeratin (CK), P40, HMB45 and Melan A.

A RARE CAUSE OF RECTAL BLEEDING

2018 ◽  
Author(s):  
LE Zamora Nava ◽  
G Grajales-Figueroa ◽  
AI Ramirez Polo ◽  
F Valdovinos Andraca
Keyword(s):  
Rectal Bleeding

THINK ABOUT KLIPPEL-TRENAUNAY SYNDROME IN RECURRENT RECTAL BLEEDING PRESENTATION – CASE REPORT

2020 ◽  
Author(s):  
I Lolic ◽  
V Milivojević ◽  
VM Zarić ◽  
N Jocić ◽  
D Popovic ◽  
...  
Keyword(s):  
Case Report ◽  
Rectal Bleeding ◽  
Klippel Trenaunay Syndrome

Rare cause of rectal bleeding

2006 ◽  
Vol 44 (05) ◽  
Author(s):  
K Földházi ◽  
T Németh ◽  
J Hamvas
Keyword(s):  
Rectal Bleeding

OUTCOME OF SPHINCTER PRESERVING RECTAL RESECTION FOR LOW RECTAL CANCER

2017 ◽  
pp. 36-40
Author(s):  
Vinh Quy Truong ◽  
Anh Vu Pham ◽  
Quang Thuu Le
Keyword(s):  
Rectal Cancer ◽  
Functional Outcomes ◽  
Low Anterior Resection ◽  
Rectal Resection ◽  
Anal Verge ◽  
Low Rectal Cancer ◽  
Central Hospital ◽  
Mesorectal Excision ◽  
Pull Through ◽  
Stage T1

Purpose: To evaluate the functional outcome of sphincter-preserving rectal resection for low rectal cancer. Materials and Methods: From April 2009 to January 2016, there are 52 patients who underwent sphincter-preserving rectal resection with total mesorectal excision with low rectal cancer (<6cm from the anal verge) at Hue Central Hospital, Hue, Vietnam. Results: the average age 62.7 ± 12.8, the distance of tumor from anal verge include four group (≤ 3cm 1.9%; 3 to ≤ 4cm 17.3%; 4 to ≤ 5cm 34.6%; > 5 cm). T stage T1/ T2/T3: 1.9%/28.8%/69.2%. The following time is 33.8 ± 18.9 month. Overall recurrence was 13/18(27.1%), local recurrence was 5 (10.4%). Total survival was 40.5 ± 2.9 month. Technique: intersphincteric preservation 14 (26.9%), low anterior resection 17 (32.7%) and pull-through procedure 21 (40.4%). The distance of anatomosis from anal verge: from 1 to ≤ 2 cm:14 (26.9%); from 2 to ≤ 3cm: 21 (40.4%); from 3 to ≤ 4 cm: 17 (32.7%). Bowels movement of 3 month: 4.7 ± 3.2 and 12th month: 2.7 ± 1.6 (p< 0.01). Conclusions: Sphincterpreserving rectal resection using may provide a good continence and oncologic safety. The patients are acceptable with the results of functional outcomes. Key words: Low rectal cancer, sphincter-preserving

Do We Have Another Option to Treat Bleeding Hemorrhoids? The Emborrhoid Technique: Experience in 16 Patients

2020 ◽  
Vol 15 ◽  
Author(s):  
Elisabetta Moggia ◽  
Giuseppina Talamo ◽  
Gaetano Gallo ◽  
Gaetano Gallo ◽  
Matteo Barattini ◽  
...  
Keyword(s):  
Rectal Bleeding ◽  
Hemorrhoidal Disease ◽  
Severe Bleeding ◽  
Conventional Surgery ◽  
Short Term ◽  
Selective Embolization ◽  
Invasive Techniques ◽  
Bleeding Hemorrhoids

Background: Hemorrhoidal disease is very common in western countries and rectal bleeding is the main symptom complained by patients. Nowadays the ultimate goal of treatment is to block the bleeding with minimally-invasive techniques to minimize post-procedural pain. Objective: The aim of this study is to assess the preliminary results of the emborrhoid technique (embolization of the superior rectal arteries branches) as a new tool for the proctologist to treat severe bleeding hemorrhoids causing anemia. Many categories of patients might benefit from this treatment, such as patients not eligible for conventional surgery, patients not responding to conventional treatment and fit patients with severe bleeding who refused endorectal surgical therapy. Method: From May 2017 to November 2018 a total of 16 patients with chronic rectal bleeding due to hemorrhoids underwent super-selective embolization of the superior rectal arteries at the department of General Surgery in La Spezia, S. Andrea Hospital, Italy. Median age was 59 years. 14 patients were males (87.5 %). Results: No post-procedural and short-term complications were observed at maximum follow up (12 months). The reduction of rectal bleeding with improvement of the quality of life was obtained in 14 patients (87.5%). Conclusion: Our study, although small in number, demonstrates that embolization of superior rectal arteries with coils to treat severe bleeding due to hemorrhoids is safe and effective and does not lead to immediate complications.

Method for prolonged ambulatory monitoring of high-amplitude propagated contractions from colon

1991 ◽  
Vol 261 (2) ◽  
pp. G263-G268 ◽  
Author(s):  
M. D. Crowell ◽  
G. Bassotti ◽  
L. J. Cheskin ◽  
M. M. Schuster ◽  
W. E. Whitehead
Keyword(s):  
Bowel Movement ◽  
Anal Verge ◽  
Ambulatory Monitoring ◽  
High Amplitude ◽  
X Ray ◽  
Pressure Transducers ◽  
Peristaltic Activity ◽  
Bowel Prep ◽  
Asymptomatic Individuals ◽  
State Pressure

This study monitored high-amplitude propagated contractions (HAPCs) in ambulating subjects over a 24-h period using a new ambulatory recording system. Twelve healthy volunteers aged 34 +/- 5.96 yr participated. Approximately 12 h after a Colyte bowel prep, a small catheter (OD less than 3 mm), containing three solid-state pressure transducers spaced 5 cm apart, was positioned by flexible sigmoidoscope at 40-50 cm from the anal verge. A battery-operated data recorder sampled the pressure at each port at 1 Hz and stored the values on all ports if any port exceeded 75 mmHg. At the conclusion of the 24-h period, an X-ray was taken to confirm the location of the catheter. Fifty-four percent of all HAPCs preceded a bowel movement by less than or equal to 1 h. Forty-nine percent of all HAPCs occurred within 1 h after a high-fat meal, and 33% occurred within 1 h of morning awakening. Reverse propagated waves, not previously described in the colon, were observed in three individuals. Spontaneous high-amplitude caudally propagated contractions occur 6.9 +/- 1.5 times/24 h in the sigmoid colon in ambulating asymptomatic individuals and are temporally related to defecation and meals. Peristaltic activity is decreased during sleep. This recording technique was reliable and well tolerated in all participants.

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