By Prof. Dr. Peter Otto, Prof. Dr. Klaus Ewe (auth.)
The first part of this paintings is dedicated to a attention of the sensible points of the proctoscopic exam and therefore provides the symptoms for appearing a proctologic evaluate, the knowledge that could be bought from the patient's scientific heritage, an instance of a preprinted info shape to be used within the recording of the physician's findings, the coaching and positioning of the sufferer, and the initial exam of the anus together with the electronic rectal exam. The tools had to practice proctoscopy are simple, and the elemental instruments are low-cost. The tools presently to be had don't relatively vary from one another other than in minor information. within the textual content, consequently, we now have in basic terms defined the prototype tools, and information about the professional posed merits of any specific device might be bought from its manufac turer. The concluding section of the textual content describes how the proctoscopic and colonoscopic examinations are played. The atlas itself is a topographical stratification of a few of the illnesses that could contain the perianal quarter, the anus, and the adjoining parts of the big bowel in addition to their type in response to morphologic standards, for instance, inflammatory bowel ailments and tumors. when you consider that many pathologic findings within the rectum and sigmoid colon are corresponding to these within the top parts of the massive bowel, a duplication of those proctoscopic and colonoscopic illustrations has been avoided.
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23. ). The same instrument is also available from ACMI, Machida, Wolf, and Storz. 3 Examination Technique The examination is conducted with the patient recumbent. For sigmoidoscopy some examiners also recommend the knee-elbow or knee-chest position. It is preferable to have two people conduct the examination with the assistant slowly introducing the instrument while observing the field through the teaching attachment (see Sect. 2). During high colonoscopy it is usually necessary, especially in the sigmoid area, to straighten the instrument.
Gastroenterol. : The classification of fistula in ano. In: Progress in Proctology. Hoferichter, J. ). : Intersphincteric abscess. Br. Med. J. : Office management of pilonidal disease and anorectal lesions. Am. Fam. : Die proktologische Sprechstunde, 4th ed. : Die anorektalen Fisteln, 2nd ed. : New classification of fistulas and its application to the operations. Am. J. Proctol. : Diseases of the colon and anorectum. Vol. 2. Philadelphia, London: Saunders 1959 13 Anitis - Cryptitis - Papillitis Inflammatory processes within this transitional zone cannot be separated from one another and often occur together.
Fig. 28. Schematic representation of the arterial vasculature of the hemorrhoidal knots (knee-elbow position). Arising from the branches of the arteria rectalis superior, which lies at the level of the linea dentata (5 cm distance from the anal ring), these protrude at 2: 00, 5: 00, and 9: 00 o'clock. Through further branching of the vessels at 2: 00 and 9: 00 o'clock, additional so-called satelitic knots may develop. 50 Stage I Stage II Stage III Fig. 29. Schematic presentation of hemorrhoid staging.
Atlas of Rectoscopy and Coloscopy by Prof. Dr. Peter Otto, Prof. Dr. Klaus Ewe (auth.)