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Treatment The rectum is examined under general anaesthetic with a finger and a sigmoidoscope. If ...

Tuberculous proctitis This is nearly always associated with active pulmonary tuberculosis or tube...

Types of carcinoma spread Local spread Local spread occurs circumferentially rather than in a lon...

Signs To examine the rectum the patient is most conveniently posi- tioned in the left lateral or ...

Stages of progression Dukes classified carcinoma of the rectum into three stages ( Figure 79.16 )...

Treatment of rectal polyps All rectal polyps should be biopsied or removed for histological analy...

Proctitis due to specific infections Clostridium difficile An acute form of proctocolitis caused b...

RECTAL POL YPS The rectum, along with the sigmoid colon, is the most frequent site of polyps (an...

Radiation proctitis Radiation therapy is used in the treatment of cervical, prostate and rectal ...

Pelvic exenteration When carcinoma of the rectum has spread to contiguous organs, a more radical ...

Polyps relevant to the rectum Hyperplastic polyps These are small, pinkish, sessile polyps, 2–4 /...

Proctitis due to Crohn’s disease Crohn’s disease can occasionally a ff ect the rectum, although cl...

PROLAPSE Mucosal prolapse The mucosa and submucosa of the rectum may protrude outside the anus f...

Palliative colostomy This is indicated only in cases giving rise to intestinal obstruc - tion, or...

Pathogenesis Colorectal cancer originates from premalignant precursor lesions in the epithelial l...

PROCTITIS The patient is usually middle-aged and complains of defecatory frequency with the pass...

Lymphogranuloma venereum The modes of infection are similar to those of gonococcal proctitis bu...

Neuroendocrine tumours Neuroendocrine tumours (NETs) of the rectum constitute 19% of all gastro...

Learning objectives To understand: The anatomy of the rectum and its relationship to surgical •...

Liver resection Single or multiple well-localised liver metastases can now be resected with relat...