INTRODUCTION. Pain is probably the most common symptom of lesions situated in the anorectal region. The anal canal is abundantly supplied with sensory nerves and lesions produce pain of varying severity. On the other hand, the sensory nerve supply of the rectum is poor and disease confined to this region may have progressed considerably before causing very much discomfort. This point is of impo...

PATIENT Male, 64 FINAL DIAGNOSIS: Metastatic anorectal melanoma with endotracheal metastasis Symptoms: Fatigue • weight loss • hematochezia • cough MEDICATION None Clinical Procedure: Biopsy of anal mass • rigid bronchoscopy Specialty: Internal medicine • oncology • pulmonology. OBJECTIVE Rare disease. BACKGROUND Anorectal melanoma is a rare cancer with a poor prognosis. The mean survival...

BACKGROUND Anorectal melanoma is a rare disease with a poor prognosis. Because survival is determined by distant failure, many centers have adopted sphincter-sparing excision for primary tumor control. However, this approach is associated with high rates of local failure (∼50%). In this study, the authors report their 20-year experience with sphincter-sparing excision combined with radiation th...

In recent years, an increasingly detailed picture of gastrointestinal dysfunction in the setting of Parkinson's disease has emerged. Abnormalities of function may occur at virtually all levels of the gastrointestinal tract. Weight loss, dental deterioration, salivary excess, dysphagia, gastroparesis, decreased bowel movement frequency, and anorectal dysfunction all may occur. The pathophysiolog...

BACKGROUND During my study of constipation, I encountered patients who had achalasia of the esophagus (AE) as well. The possibility of an existing relationship between the 2 conditions was studied. METHOD Investigations to study the anorectal motility in 9 AE patients included: the intestinal transit time, anorectal manometry, rectoanal inhibitory reflex, defecography and electromyography (EM...

The objective of this study was to identify group B streptococcus (GBS) colonization rates and compare detection efficiency of selective versus non-selective culture media and anorectal versus vaginal cultures in women with preterm labor and preterm-premature rupture of membranes (PROM). A prospective cohort study of 203 women was performed. Two vaginal and two anorectal samples from each woman...

Pilonidal disease is a common anorectal problem that typically affects young people. Numerous surgical procedures have been described, but treatment failure and disease recurrence are frequent, leading to considerable morbidity in these otherwise healthy patients. To manage this problem successfully, surgeons must consider the pathogenesis and presentation of the disease and weigh the advantage...

Functional disorders of the anus and rectum affect 10–20% of the population. Tests of anorectal function can provide useful information regarding the pathophysiology of disorders that affect continence and defecation or those that cause anorectal pain. Currently, several tests are available for evaluating anorectal function (Table 1). Often, they complement each other, but among the various tes...

BACKGROUND Although thyroid disorders are present in approximately 3% of pregnant women, little is known about the association between maternal thyroid disease and birth defects. METHODS We assessed the association between maternal thyroid disease, thyroid medication use, and 38 types of birth defects among 14,067 cases and 5875 controls in the National Birth Defects Prevention Study, a multi...