Colorectal surgery is associated with a greater risk for infections than most other surgical specialties and is considered an outlier for surgical site infections (SSIs). In addition to SSI, as with other types of surgical operations, patients undergoing colectomy are…
Introduction Crohn disease (CD) has a propensity for involvement of the terminal ileum and colon but also can occur throughout the gastrointestinal tract. When it occurs in the esophagus, stomach, and duodenum, it presents challenges in diagnosis and management. The…
Extent of the Problem Small bowel obstruction is a common problem that is responsible for more than 1 million inpatient hospital days and more than $1 billion in health care costs per year in the United States. In some European…
Introduction Colonic diverticula are false diverticula—that is, pockets composed of mucosa and submucosa that have herniated through weaknesses in the colon wall at the points where intramural vasa recta penetrate the inner circular muscle of the bowel ( Fig. 48-1,…
Introduction When a total proctocolectomy is required, the ileal pouch–anal anastomosis (IPAA) procedure is favored over an end ileostomy because the IPAA allows continence with defecation by the normal route. The procedure can be performed with favorable results for patients…
Introduction Despite major advances in the medical treatment of ulcerative colitis (UC), surgery is still frequently required. Because the aim of surgery is to cure the disease, elimination of all colorectal mucosa is ideal. This operative strategy may need to…
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…