Historical Perspective Evidence of rectal prolapse (rectal procidentia) exists from ancient times. The first described mortality from rectal prolapse was in the 4th century. The initiating cause of prolapse is elusive. The path to rectal prolapse generally occurs slowly over…
Fistulas between the genitourinary tract and the digestive tract present a particular conundrum for the surgeon. Not only are they uncommon, but the technical aspects of repair in conjunction with managing etiology appropriately present a multidisciplinary challenge to even the…
The pelvic floor is the anatomic region bounded anteriorly by the pubis, posteriorly by the sacrum, laterally by the ischial and iliac bones, superiorly by the peritoneum, and inferiorly by the levator ani and coccygeus muscles, which form the pelvic…
Constipation is one of the most frequently experienced gastrointestinal complaints and one of the most common indications for medical consultation. It is estimated that more than 4 million patients in North America suffer from constipation, and laxatives are annually prescribed…
Fecal incontinence (FI) is the inability to maintain voluntary control of the passage of gas, liquid, or solid stool through the anus. Although FI is not a life-threatening condition, it is certainly a life-altering condition. The associated embarrassment, subsequent coping…
Endorectal and endoanal ultrasound (ERUS and EAUS, respectively) examinations are used to diagnose benign and malignant abnormalities of the rectum and anus. ERUS has been used extensively for local staging of rectal cancer and continues to have a significant role…
The management of rectal cancer has changed dramatically in the last 5 years. Review of national databases has clearly outlined the wide variations in overall survival rates, rates of local recurrence, and rates of permanent colostomies. Championed by many in…
Since its acceptance for clinical use in 1970, colonoscopy has become the mainstay in the prevention, diagnosis, and treatment of colonic pathology. Even with the development of new diagnostic technologies, such as computed tomography (CT) colonography, only colonoscopy allows for…
The human colon serves to absorb water and electrolytes, store intraluminal contents until elimination is socially convenient, and salvage nutrients after bacterial metabolism of carbohydrates that have not been absorbed in the small intestine. These functions are dependent on the…
Knowledge of the developmental anatomy of the digestive tract is the first step in understanding operative anatomy of the colon, rectum, and anus. The surgical approach to removing portions of the digestive tract requires an understanding of the anatomical planes…