Etiology Pilonidal disease is a common infection that occurs around hair-containing sinuses in the natal cleft. It usually presents in young men, and if it is not managed correctly, it tends to persist or recur. The disease and its treatments…
Definition Any communication between the rectum/anus and the vagina/perineal skin is classically referred to as a rectovaginal fistula (RVF). RVF is an accepted term for any fistula that originates in the distal rectum and anus and is connected to the…
Introduction An anal fistula is an abnormal communication between the inside of the anus and epithelium outside the anus. The most common anal fistula is an anocutaneous fistula, which is the subject of this chapter. Etiology Anal glands have an…
Abscesses in the anorectal region occur in all age groups and are a common, distressing problem. Predisposing factors include diabetes, Crohn disease, previous perianal surgery, and impairment of immunity, including human immunodeficiency virus (HIV); however, most abscesses occur spontaneously in…
Introduction An anal fissure is a linear tear in the lining of the anal canal that usually becomes symptomatic because it exposes the internal anal sphincter and causes painful spasms in that muscle. An anal fissure is a common condition…
Hemorrhoids are vascular cushions that lie close to the anus and are subject to the stresses and strains of defecation. They are normal structures that become symptomatic when thrombosis or prolapse develops as a result of either a congenital weakness…
Anatomy of the Colon and Rectum Colon The colon can be divided embryologically into the midgut (the transverse colon and portions proximal to it) and the hindgut (the distal half of the colon). The length of the colon is approximately…
COVID-19 and Health Care Delivery in a Pandemic Michael S. Burnim, MD Brian T. Garibaldi, MD BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in Wuhan, Hubei, China in December 2019. Within a matter of months, it caused the…
Eras Protocols for General Surgery Omaira Azizad, MD Girish P. Joshi, MBBS, MD INTRODUCTION Enhanced recovery after surgery (ERAS) pathways, introduced more than 25 years ago, represent a paradigm shift in perioperative care that involves integration of evidence-based, multimodal, multidisciplinary interventions that…
Initial Assessment and Resuscitation of the Trauma Patient Jessie Ho, MD Hasan B. Alam, MD INTRODUCTION According to the Centers for Disease Control and Prevention (CDC), unintentional injuries are the leading cause of death in Americans under the age of 45 years,…