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Topic: Anorectal

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	THE MERCK MANUAL, Sec. 3, Ch. 35, Anorectal Disorders
		The anal canal is derived from invagination of the ectoderm, and the rectum, from invagination of the entoderm.
		The sphincteric ring encircling the anal canal is composed of the fusion of the internal sphincter, the central portion of the levators, and the components of the external sphincter.
		Lymphatics from the anal canal pass to the internal iliac nodes, the posterior vaginal wall (in women), and the inguinal nodes, whereas lymphatic return from the rectum is along the superior hemorrhoidal vascular pedicle to the inferior mesenteric and aortic nodes.
	www.merck.com /pubs/mmanual/section3/chapter35/35a.htm (433 words)

	Anorectal Malformations - Children's Hospital of Philadelphia
		Anorectal malformations are birth defects (problems that happen as a fetus is developing during pregnancy).
		Anorectal malformations cause abnormalities in the way a child has a bowel movement.
		Children with more complex variations of anorectal malformation may have need to participate in a bowel management program in order to help them have control over their bowel movements and prevent constipation.
	www.chop.edu /consumer/your_child/condition_section_index.jsp?id=-8608 (1438 words)

	Anorectal Disease (Site not responding. Last check: 2007-10-08)
		Anorectal disease pertains to those illnesses located in the anal and rectal portions of the large intestine.
		Hemorrhoids are large, saclike blood vessels similar to varicose veins located in and around the anus (the opening of the anal canal) and lower rectum (the portion of the large intestine just proximal to the anal canal).
		An anorectal abscess is an infected cavity filled with pus found near the anus (the opening of the anal canal) or rectum (the portion of large intestine just proximal to the anal canal).
	www.uphs.upenn.edu /surgery/clin/gi/anorect.html (453 words)

	Anorectal Malformation (Site not responding. Last check: 2007-10-08)
		Anorectal malformations cause abnormalities in the way a baby has a bowel movement.
		Children who had the type of malformation that involves an anal membrane or a narrow anal passage are usually able to gain good control over their bowel movements after repair of an anorectal malformation.
		Children with more complex variations of an anorectal malformation may have need to participate in a bowel management program in order to help them have control over their bowel movements and prevent constipation.
	www.healthsystem.virginia.edu /uvahealth/peds_hrnewborn/aom.cfm (1451 words)

	Anorectal physiology laboratory, 3 D ultrasound, images, diagnostics
		Anorectal physiology is the study of the function of the lower bowel, the anus and the anal sphincter mechanism.
		The imaging equipment in the Anorectal Physiology Lab are utilized to look at the anal canal anatomy for anal sphincter tears, chronic anal infections, rectal/anal tumors, staging of rectal/anal cancers, follow-up for cancer recurrence, evaluation of loss of bowel control, and other disorders.
		Anorectal reflexes and sensation are tested during the same examination.
	www.surgery.usc.edu /divisions/cr/anorectalphysiologylaboratory.html (456 words)

	Anorectal Malformations (Site not responding. Last check: 2007-10-08)
		An anorectal malformation is a condition in which the rectum fails to separate properly during development and does not migrate into its proper position on the perineum.
		Anorectal malformations occur as a spectrum of abnormalities that ranges from very mild conditions in which the anus is situated only a few millimeters in front of its normal location, to severe anomalies with no visible anus.
		The nature and severity of the anorectal malformation, as well as the presence of any associated conditions will determine the surgical treatment that is required.
	www.hmc.psu.edu /childrens/healthinfo/a/anorectal.htm (769 words)

	Anorectal anomaly - Family factsheets - GOSH and ICH
		A high anorectal anomaly is where the bowel has a closed end and does not connect with the anus or it connects with another part of the body through a passage called a fistula.
		If your child has a high anorectal anomaly with a fistula, the faeces will be able to pass out of the body, usually through the vagina in girls or through the urethra in boys.
		An anorectal anomaly is usually diagnosed soon after birth, on examination, or when the baby fails to pass meconium.
	www.gosh.nhs.uk /factsheets/families/F050032 (1896 words)

	Imperforate Anus / Anorectal Malformations, Cincinnati Children's Hospital Medical Center (Site not responding. Last check: 2007-10-08)
		Anorectal malformations / imperforate anus are defects that occur during the fifth to seventh weeks of fetal development.
		Children who have had anorectal malformations / imperforate anus generally gain bowel control more slowly, and depending on the type of malformation and its surgical repair, some children may not be able to gain good bowel control.
		Children who have had an anorectal malformation that involves a rectoperineal fistula are usually able to gain good control over their bowel movements after surgical repair.
	www.cincinnatichildrens.org /health/info/abdomen/diagnose/anorectal-malformations-imperforate-anus.htm (1535 words)

	Anal Stenosis and Anorectal Malformations - DrGreene.com (Site not responding. Last check: 2007-10-08)
		Anorectal anomalies occur in about 1 of every 4,000 live births and include a wide spectrum of defects -- some are minor and easily treated, some are complex and very difficult to manage.
		The most frequent anorectal defect seen in boys is the recto-urethral fistula, or a communication between the rectum and the lower part of the urethra.
		For all anorectal malformations there is a very good correlation between the degree of development of the sacral bone with the final bowel and bladder functioning after correction.
	www.drgreene.com /21_803.html (796 words)

	Postgraduate Medicine: Enema-induced anorectal injuries
		Although rare, enema-induced anorectal injuries are easily avoided, but when an injury does occur, successful treatment often hinges on how quickly the problem is detected.
		The key steps in treating patients with anorectal injuries are recognizing the injury, controlling local tissue damage, and, if necessary, diverting the fecal stream.
		Because the rectum inclines posteriorly just proximal to the anorectal junction, healthcare personnel should aim enema tips in the posterior direction after initial insertion, to avoid injury to the anterior rectal wall (3).
	www.postgradmed.com /issues/2002/01_02/thiele.htm (1560 words)

	Anorectal disorders
		Anorectal disorders are a group of medical disorders that occur at the junction of the anal canal and the rectum.
		Anorectal abscesses are characterized by pus-forming infections in the anorectal region.
		An anorectal fistula is an abnormal opening or channel from the anorectal area to another part of the body.
	www.healthatoz.com /healthatoz/Atoz/ency/anorectal_disorders.jsp (690 words)

	Anorectal Malformations (Site not responding. Last check: 2007-10-08)
		Anorectal malformations (also called imperforate anus) are a variety of congenital disorders in boys and girls that involve imperfect formation of the rectum and anus and sometimes involve a connection between the rectum and genitourinary system.
		Some will require placement of a colostomy in the newborn period to allow stool to exit the body if there is no connection of the rectum to the skin (a fistula) near the scrotum or vagina.
		When a regimen is found that results in no soiling, we then consider placement of an 'appendicostomy," a procedure that brings the appendix to the abdominal wall to allow for the colon to be cleaned out from the top by insertion of a tube rather than by enema.
	www.hmc.psu.edu /pediatricsurgery/services/anorectal.htm (340 words)

	eMedicine - Imperforate Anus: Surgical Perspective : Article by Marc A Levitt, MD (Site not responding. Last check: 2007-10-08)
		Anorectal malformations comprise a wide spectrum of disease affecting boys and girls and can involve malformations of the distal anus and rectum, as well as the urinary and genital tracts.
		The prevalence of this anomaly increases with increasing height and complexity of the anorectal anomaly.
		Anorectal abnormalities in 90% of male patients can be repaired with a posterior sagittal approach alone, whereas 10% require an additional abdominal component (with laparotomy or laparoscopy) to mobilize a very high rectum.
	www.emedicine.com /ped/topic2923.htm (7316 words)

	NGC - NGC Summary
		It has been estimated that 90 percent of anorectal cases may be suitable for ambulatory surgery.
		A wide variety of anorectal conditions including condylomata, fissures, abscesses, fistulas, tumors, hemorrhoids, pilonidal disease, and various miscellaneous conditions have been shown to be amenable to surgery on an outpatient basis.
		With appropriate communication, ambulatory anorectal surgery may be performed with a high degree of patient satisfaction.
	www.guideline.gov /summary/summary.aspx?view_id=1&doc_id=5654 (1499 words)

	Anorectal Malformations
		The first important matter that parents must learn about anorectal malformations is that there is a very large spectrum of defects and that each one is different from the other However, there are certain categories or types of defects with similar prognosis and management.
		As most parents know, children with anorectal malformations are predisposed to suffer from associated defects (mainly urinary tract, as well as spine and sacrum).
		There are two main categories of anorectal malformations: those that require a protective colostomy and those that do not.
	www.tefvater.org /html/anal.html (667 words)

	777 - Abstract (11th CROI) (Site not responding. Last check: 2007-10-08)
		Rates of anorectal cancer in the general population are low, but increased ARC rates in HIV-infected persons have been reported in case series and in limited cohorts.
		We analyzed data from a large cohort of persons with HIV to determine if anorectal cancer rates are higher than in the general population, and to identify factors associated with incident anorectal cancer.
		We standardized ASD anorectal cancer rates on age, and on age and sex, to a standard population from the SEER data.
	www.retroconference.org /2004/cd/Abstract/777.htm (373 words)

	Anorectal Malformation - My Child Has - Children's Hospital Boston
		Anorectal malformation may be seen with some of these genetic syndromes or other congenital problems:
		In up to one-third of children with an anorectal malformation, a neurologic injury to the spinal cord is associated with it.
		Children with more complex variations of anorectal malformation may need to participate in a bowel management program in order to help them achieve control over their bowel movements and prevent constipation.
	www.childrenshospital.org /az/Site584/mainpageS584P0.html (1560 words)

	Acute effects of therapeutic irradiation for prostatic carcinoma on anorectal function -- Yeoh et al. 43 (1): 123 -- Gut
		The incidence of anorectal symptoms after radiotherapy (RTH) for localised pelvic malignant disease is unclear.
		Anorectal pressures were initially recorded for 10 minutes under resting conditions to ensure that steady state pressures
		A retrospective study of the effects of pelvic irradiation for gynaecological cancer on anorectal function.
	gut.bmjjournals.com /cgi/content/full/43/1/123 (3060 words)

	Find Anorectal at myEweb.com
		Anorectal symptoms and complaints are common and may be caused by a wide spectrum of conditions.
		Anorectal Malformations - A Parent's Guide is a color brochure produced by PTN and distributed free of charge to physicians, nurses and...
		Many anorectal problems, including fissures, fistulae, abscesses, or irritation and itching (pruritus ani), have similar symptoms and are...
	myeweb.info /web/index.php?qry_str=Anorectal (143 words)

	The Pull-thru Network's Home Page (Site not responding. Last check: 2007-10-08)
		was organized as a chapter of the United Ostomy Association in 1988 by a group of families whose children were born with an anorectal malformation.
		Today, the PTN is one of the largest organizations in the world dedicated to the support and information needs of the families of children born with imperforate anus, cloaca, cloaca exstrophy, bladder exstrophy, VATER Syndrome, Hirschsprung’s Disease and other related birth anomalies.
		Anorectal Malformations – A Parent’s Guide is a color brochure produced by PTN and distributed free of charge to physicians, nurses and hospitals.
	www.pullthrough.org (549 words)

	Acute hyperglycaemia affects anorectal motor and sensory function in normal subjects -- Russo et al. 41 (4): 494 -- Gut
		The pathogenesis of anorectal dysfunction, which occurs frequently in patients with diabetes mellitus, is poorly
		Anorectal motor and sensory function was measured using a sleeve/sidehole catheter incorporating a balloon, and
		The number of spontaneous anal relaxations was greater at 12 mmol/l than at 8 and 4 mmol/l glucose (p<0.05 for both).
	gut.bmjjournals.com /cgi/content/abstract/41/4/494 (438 words)

	SSAT - 2000 Abstract: 2235: The Influence of Faecal Diversion (Hartman Procedure) on Anorectal Motility and Perception. (Site not responding. Last check: 2007-10-08)
		However anorectal function following restoring intestinal continuity is frequently disturbed,especially when Hartman’s reversion is delayed.In order to establish the main predictive factors influencing postoperative anorectal dysfunction,anal sphincters manometry and rectal barostat study were performed in 12 patients(8male and 4 female)with complicated diverticular disease(pericolic abscess or acute phlegmon).
		Methods: Anorectal vectorvolume manometry,and rectal barostat study were performed in each patient before and after Hartman’s procedure, as well as following restorative surgery(Hartman’s reversion) using Synectics Motility System and Synectics SVS Barostat.
		Complete diagnostic workup including anorectal volume manometry and rectal barostat study can select the patients with expected anorectal dysfunctions before restoration of intestinal continuity.
	www.ssat.com /cgi-bin/abstracts/00ddw/2235.cgi?affiliation= (387 words)

	Anorectal abscess Information on Healthline
		An anorectal abscess is a collection of pus in the anal or rectal region.
		Infection of an anal fissure (cleft or slit), sexually transmitted infections, and blocked anal glands are common causes of anorectal abscesses.
		Abscesses may occur in an area that is easily accessible for drainage, or higher in the rectum.
	www.healthline.com /adamcontent/anorectal-abscess (522 words)

	Presentation of Low Anorectal Malformations Beyond the Neonatal Period -- Kim et al. 105 (5): 68 -- Pediatrics
		Anorectal malformations are usually diagnosed at birth, but some patients have presented to this institution beyond the early
		of all patients presenting to this hospital with anorectal malformations.
		Anorectal malformations are a group of congenital conditions comprising a spectrum in severity from imperforate anal membrane
	pediatrics.aappublications.org /cgi/content/full/105/5/e68 (1565 words)

	MDchoice.com - Emergency Medicine
		The experienced clinician can usually infer a correct diagnosis from the patient's history, although he or she should not rely on that alone.
		With the possible exception of patients who have extremely painful anal fissures, all patients with anorectal symptoms should at least undergo anoscopy.
		A painful swelling in the anorectal area is the sign of an abscess.
	mdchoice.com /emed/main.asp?template=0&page=detail&type=3&id=911 (1637 words)

	The surgical management of anorectal diseases in AIDS and pre-AIDS patients.
		The incidence of anorectal disease was 34 percent.
		Fifty-two patients (15 percent) presented with anorectal complaints prior to the diagnosis of AIDS, ARC, or AIDS-P. Over 50 percent of these patients were dead within 7.4 months.
		Identification of these high-risk groups prior to any anorectal surgery is imperative to avoid unacceptable surgical complications.
	www.aegis.com /aidsline/1987/feb/M8720241.html (403 words)

	Anorectal Malformations Caused by Defects in Sonic Hedgehog Signaling -- Mo et al. 159 (2): 765 -- American Journal of ...
		Anorectal Malformations Caused by Defects in Sonic Hedgehog Signaling -- Mo et al.
		Summary of anorectal malformations observed in mutant mice with various defects in Shh signaling.
		Lambrecht W, Lierse W: The internal sphincter in anorectal malformations: morphologic investigations in neonatal pigs.
	ajp.amjpathol.org /cgi/content/full/159/2/765 (4689 words)

	anorectal diseases
		All of the surgeons in the Department of Colorectal Surgery have extensive training and experience in the management of anorectal disease.
		The typical symptoms of patients suffering from anorectal disease include: bleeding, pain, discharge and itch (or pruritus).
		Anorectal sepsis and fistula - Patients may have severe pain and swelling caused by an abscess in the anal region.
	cms.clevelandclinic.org /digestivedisease/body.cfm?id=45 (533 words)

	Surgical Treatment of Anorectal Diseases, Mayo Clinic in Rochester, Minn.
		Surgical Treatment of Anorectal Diseases at Mayo Clinic in Rochester, Minn.
		It is staffed by fully trained colon and rectal surgeons who are highly skilled in the diagnosis and management of simple and complicated colon and anorectal problems.
		Colon and rectal surgeons work closely with gastroenterologists and radiologists to correctly and efficiently diagnose complicated anorectal conditions and to determine whether medical or surgical therapy is best.
	www.mayoclinic.org /colorectalsurgery-rst/anorectaldiseases.html (435 words)

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