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…
Cysts and tumors of the spleen are uncommonly encountered in clinical practice and continue to present challenges in both surgical work-up and treatment. Perhaps the continuing evolution of surgical traditions associated with splenic maladies can be partly explained by the…
Splenectomy for nontraumatic disorders demands careful risk-benefit analysis and surgical planning. Crucial factors considered include the nature of the underlying disease, the severity of symptoms, alternative therapeutic options, the operative risk, and the success rate of splenectomy. During the past…
Abdominal injury occurs in approximately 10% to 15% of pediatric trauma patients, with the spleen being the most commonly injured intraabdominal organ, accounting for a significant proportion of the management expenses incurred with blunt traumatic injuries. Historically the initial management…
The spleen, an important component of the reticuloendothelial system in normal adults, is a highly vascular solid organ that arises as a mass of differentiated mesenchymal tissue during early embryonic development. The normal adult spleen weighs between 75 and 100 g…
The treatment of spleen disorders in modern surgery requires an extensive knowledge of traditional “open” surgical approaches, minimally invasive surgical procedures, and image-guided interventional techniques that can be tailored to the specific disease. The two sections of this chapter will…