Hemorrhoids are varicose dilatations of the radicals of the superior or inferior plexus of the hemorrhoidal veins. Varicosities are accompanied, in varying degrees, by hypertrophy and round cell infiltration of the perivascular connective tissue. Approximately 50% of the population is…
Rectal cancer appears to be a different disease than colon cancer. Mortality from rectal cancer in the United States is slowly decreasing, even though the incidence is slowly increasing. This indicates that early detection and treatment of rectal polyps may…
Gastrointestinal (GI) polyposis is the presence of multiple polypoid lesions in the GI tract ( Fig. 100.1 ). Numerous syndromes have now been classified ( Box 100.1 ). Open full size image Fig. 100.1 Familial Polyposis of the Large Intestine.…
Colon Polyps A colon polyp is any elevation of the colon mucosal surface ( Fig. 99.1 ). It may be of any size, sessile or pedunculated, and benign or malignant. Benign polyps are categorized as neoplastic, nonneoplastic, and submucosal. Neoplastic…
Microscopic colitis is a syndrome in which patients have (1) chronic diarrhea, (2) normal findings on colonoscopy and a normal-appearing mucosa, (3) histologic evidence of increased cellular infiltrate in the lamina propria, and (4) either (a) full-blown lymphocytic colitis with…
Pharmacologic agents used for the treatment of inflammatory bowel disease (IBD) are similar for both ulcerative colitis (UC) and Crohn disease, with two major differences. Rectally instilled topical agents are effective in UC, but usually not in Crohn disease, and…
Anorectal Crohn disease may consist of fissures, ulcers, abscesses, fistulae, strictures, edematous skin tags, and benign skin tags ( Fig. 96.1 ). The overall prevalence is 36%, but it is 46% when the colon is involved and only 25% when…
Crohn disease is a transmural inflammation of the gastrointestinal (GI) tract characterized by granulomas. It involves primarily the colon and the ileum (regional enteritis) but may involve any part of the GI tract ( Fig. 95.1 ). Approximately 40% of…
A classification of inflammatory bowel disease (IBD) based on scientific data has not gained acceptance. An early attempt was made to classify IBD according to two categories: (1) ulcerative colitis (UC) and Crohn disease; and (2) collagenous colitis, eosinophilic enteritis,…
The surgical treatment of choice for patients requiring colectomy for ulcerative colitis or familial adenomatous polyposis (FAP) is restorative proctocolectomy with ileal pouch anal anastomosis (IPAA). The “pouch” is an ileal reservoir that acts as a neorectum to store fecal…