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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A series of 90 patients with intussusception of the rectum (internal procidentia) has been studied. In 11 per cent of the patients there was also an enterocele and in 3 per cent, a large proctocele. Forty patients were operated upon by the Ripstein procedure. Indications for operation were, in most cases, incontinence for gas and/or feces. Seventy-five per cent of the preoperatively incontinent patients were, at follow-up 2 to 10 years after operation, continent. When indications for surgery were pain and or a sensation of obstruction, the results were poor; most of these patients had unchanged symptoms postoperatively, and some even had increased symptoms. There was one postoperative death. Of 50 patients treated conservatively during a period of 2 to 10 years, only two had to be operated upon: one due to the development of a rectal prolapse and the other due to severe pain and an increased sensation of obstruction.
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PMID:Intussusception of the rectum-internal procidentia: treatment and results in 90 patients. 114 81

A non-direct ureteral lesion following operations on the colon and rectum is described. The complication was observed 10 to 64 days postoperatively, and is characterized by a unilateral or bilateral, relatively long stenosis. A total of 8 cases are presented: 7 of ulcerative colitis and one, a rectal prolapse. The main symptoms were unilateral abdominal or lumbar pain, moderate fever, and a pronounced ureteral stenosis revealed at i.v. urography. In 7 cases, full restitution occurred after antibiotic treatment, supplied by ureteral catheterisation in 4 cases, while operation was necessary in one case. The discrepancy between the seriousness of the roentgenological picture and the good final result of conservative treatment was striking.
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PMID:Reversible ureteral stenosis as a delayed complication of operation on the colon and rectum. 115 69

We report for the first time the treatment of rectal prolapse by laparoscopically assisted anterior resection. A 52-year-old woman, institutionalized for the last 10 years after diffuse cerebral injury secondary to toxic shock syndrome, developed rectal prolapse. A long life span is anticipated for this otherwise healthy middle-aged woman. Anterior resection was selected as treatment because of the low, long-term rates of recurrence of rectal prolapse. Approximately 2 1/2 ft of sigmoid colon and proximal rectum were resected. The anastomosis was constructed using a double-stapling technique. After surgery, the patient experienced virtually no pain and received only a single injection of pain medicine in the postoperative period. She was started on clear liquids on the first postoperative day and a regular diet on the second. She passed flatus on postoperative day 2 and stool on day 5. She was discharged 7 days after the operation. We believe that laparoscopically assisted anterior resection offers a promising new option for the treatment of rectal prolapse.
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PMID:Laparoscopically assisted anterior resection for rectal prolapse. 134 37

The effect of abdominal rectopexy on bowel function is difficult to assess in retrospective studies because preoperative bowel habit cannot be determined accurately. This study examined bowel symptoms and physiologic tests of anorectal function prospectively in 23 patients before and at three months after rectopexy. Rectopexy eliminated complete prolapse in all and stopped bleeding in 16 of 18 patients. Incontinence improved significantly. Constipation (less than 3 bowel actions per week or straining for more than 25 percent of defecation time) was relieved in 4 of 11 affected patients but developed in 5 of the 12 who were not constipated preoperatively. Since the median bowel frequency was 21 motions per week before surgery and 17 afterward, the main determinant of constipation was straining. Abdominal pain was relieved after rectopexy in 6 of 12 patients but developed in 3 of 13 who were pain-free before surgery. Three patients (13 percent) had a first-degree relative with rectal prolapse. Perineal descent decreased significantly. Maximal anal resting pressure increased significantly, but this did not correlate significantly with improved continence. Twenty-one patients (91 percent) could expel a 50-ml balloon preoperatively; 18 of those 21 could still do so postoperatively. The two patients who could not expel the balloon preoperatively were able to do so postoperative. This study shows that rectal prolapse is associated with profoundly abnormal defecation and abdominal pain. While abdominal rectopexy improved continence, it may improve or worsen other bowel symptoms, including constipation.
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PMID:Abdominal rectopexy for complete prolapse: prospective study evaluating changes in symptoms and anorectal function. 173 83

A review of 21 patients with protruded lesions in solitary ulcer syndrome of the rectum confirmed by resection is presented. Symptoms were usually the passage of blood and mucus per rectum, alteration of bowel habit, anorectal pain and rectal prolapse. Solitary or multiple polypoid lesions were found within 15 cm of the anal margin and were usually sited anteriorly. Fifteen of the patients were men and 8 were women with a mean age of 37.1 years. The diagnosis was made on the basis of histopathology; 1) fibrous obliteration of muscle fibers, 2) reactive hyperplasia of the mucous membrane with villous configuration or mild pseudoinvasion. These changes have been observed in complete rectal prolapse, colonic intussusception, and localized colitis cystica profunda, suggesting a common pathogenesis. The histological findings were almost the same as in the ulcerative lesions of this syndrome except for remarkable regenerative hyperplastic changes such as a relatively high incidence of mucous cell proliferation, dilatation of glands and serrate change in the cases showing protrusion. In the pathogenesis, the occult mucosal prolapse in association with excessive straining may be of particular importance, so that the lesions might be termed mucosal prolapse syndrome of the rectum.
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PMID:Protruded variants in solitary ulcer syndrome of the rectum. 326 Nov 11

Over a 2 1/2 year period a prospective study was undertaken to evaluate the occurrence and symptoms of rectal intussusception (internal procidentia). The condition was found in 28 female patients. 17 patients were operated on due to severe obstruction during defaecation, perineal pain, solitary rectal ulcer syndrome, and partial incontinence. The endopelvic findings were similar to those encountered in patients with complete, external rectal prolapse, and the operative procedure was identical (rectal mobilization, elevation, fixation, with rectosigmoid resection in most cases). Results were favorable. Conservative treatment seemed to be adequate in 7 of the 11 remaining patients.
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PMID:[Internal rectal prolapse]. 338 80

Rectal prolapse is a frequent complication after pull-through operations for high imperforate anus. Mucosal prolapse causes soiling, occasional bleeding, and pain. Simple resection of the redundant mucosa is unsatisfactory and leads to frequent recurrences or strictures. In 1982, Millard and Rowe reported a technique designed to correct rectal prolapse using two perineal flaps, thus providing a skin-lined anal canal. We have operated on two patients using the same technique. A three-flap anoplasty was used in nine other patients. With an average follow-up of 13 months, none of out patients presented recurrence of the prolapse or a significant stenosis. This procedure is safe and physiologically sound. The skin-lined anal canal provides some sensation where it is lacking. The functional and esthetic results are gratifying and we are now using the three-flap anoplasty as a primary procedure in the correction of high imperforate anus.
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PMID:Multiple-flap anoplasty in the treatment of rectal prolapse after pull-through operations for imperforate anus. 381 97

Proctitis cystica profunda is an uncommon benign rectal condition with a range of appearances that has led to confusion in nomenclature. In a personal series of 28 patients with histologically proven proctitis cystica profunda, over 50 per cent had associated rectal prolapse. Cure of the prolapse cured the proctitis cystica profunda in 80 per cent of the patients only. Direct surgical excision (local or segmental) has not been successful and two patients have required a stoma for relief of pain.
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PMID:Proctitis cystica profunda. Incidence, etiology, and treatment. 669 41

A black girl was born with flexion contractures and experienced pain on movement by 1 week of age. She subsequently developed perioral papules, gingival hyperplasia, perianal nodules, torticollis, diarrhea, rectal prolapse, and inability to open her mouth. Her skin became increasingly sclerodermatous, and velvety, hyperpigmented plaques arose over bony prominences. A skin biopsy specimen showed hyaline material in the papillary dermis with lack of elastic fibers. Ultrastructural examination revealed fibrillogranular material around fibroblasts and blood vessels. This child had the clinical, histologic, and ultrastructural features of infantile systemic hyalinosis. This disorder has not been described in a black infant. Previous case reports of infantile systemic hyalinosis are reviewed and unusual features of our case are discussed.
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PMID:Infantile systemic hyalinosis in a black infant. 751 19

In the present work the Authors have studied 19 patients with occult rectal prolapse evaluating symptoms and functional results after posterior abdominal rectopexy. Symptoms of internal rectal procidentia appear as a definite syndrome. In our patients pain upon defecation, this being often localized to the perineal and sacral region, was observed in 14 on 19 cases, while fecal incontinence was present in 5 cases (29%) and rectal bleeding in 8 (44%). These compliances are relieved by the anatomical correction of the rectal intussusception, but the preexisting functional disorders in the mechanism of defecation appear to be unaffected by rectopexy. (Sensation of obstruction 11 cases (58%) preop. e 9 cases (53%) postop.).
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PMID:[Occult rectal prolapse: functional results after rectopexy]. 792 91


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