Traumas y neoplasias anorectales

Dr. Benjamín Robles Mariscal

Dr. Héctor Manuel Virgen AyalaPonente: Angélica López Villegas

UNIVERSIDAD DE GUADALAJARACENTRO UNIVERSITARIO DE CIENCIAS DE LA SALUD

CLINICAL SURGERY DEPARTAMENT

NOPLASIA Y TRAUMATISMO ANORECTAL

ANATOMY AND PHYSIOLOGY

INCONTINENCE

Et

iolo

gy

MuscleTrauma

Incompetence

NeuralCourt

Stretch

WEXNER SCALE

Type Never Rarely Sometimes Usually Always

Gas 1 2 3 4 5

Liquid 1 2 3 4 5

Solid 1 2 3 4 5

Compress 1 2 3 4 5

Social impact 1 2 3 4 5

DIAGNOSIS

Manometry

Ultrasonography

Electromyography

TREATMENTOverlapping SphincteroplastyDietary regulation and biofeedback

Sacral nerve stimulator Transposition of the gracilis

Artificial sphincter Colostomy

ANORECTAL TRAUMA

TYPES OF COLORECTAL LESIONS

• Sharps.

• Blunt

• Iatrogenic• Barium enema

• Intrasurgical

• Colonoscopic

• Foreign object injury

SHARP LESION

BLUNT TRAUMA

IATROGENIC INJURY

Intrasurgical injury Early identificationUse of barium Derivación fecal

Colonoscopic perforation Size of lesion

FOREIGN OBJECT

TREATMENT

Mechanism of injury

Lapse of time between injury and surgery

Hemodynamic status

Stability of patient

Degree of peritoneal contamination

ANAL MARGIN TUMORS.

SQUAMOUS CELL CARCINOMA

BASAL CELL CARCINOMA.

BOWEN’S DISEASE

PAGET’S DISEASE

TUMORS IN THE ANAL CANAL.

EPIDERMOID CARCINOMA

MELANOMA