DOCSLIB.ORG

Idiopathic Muscular Strictures Ofthe Sigmoid Colon

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Idiopathic Muscular Strictures Ofthe Sigmoid Colon Gut, 1968, 9, 325-331 Gut: first published as 10.1136/gut.9.3.325 on 1 June 1968. Downloaded from Idiopathic muscular strictures of the sigmoid colon C. CASSANO AND A. TORSOLI1 From the Istituto di Clinica Medica Generale (II) dell' Universita?, Rome (Italy) In a paper dealing with diverticular disease, Morson sigmoid which was harder and more fibrous than the rest (1963) stated that four out of 155 specimens of of the large bowel. This narrowing was also evident in sigmoid colon removed at St. Mark's Hospital, the air-contrast film (Fig. la). London, for 'diverticulitis' showed an increase of On opening the specimen, the caecum, right transverse, the muscular left colon, and the rectum were normal. The sigmoid thickness of the wall without any showed reduction of the lumen in its entire length except detectable diverticula. There were no signs of at one point where a circumscribed dilatation of the wall inflammation in the wall, and the muscular ab- was seen. The mucosa had redundant folds with a normality could be compared to that seen in patients longitudinal pattem (Fig. lb); the walls showed a con- with diverticulosis. From this observation, he siderable increase in the thickness of the muscular layer suggested that the muscular thickening could precede except at the dilatation where it was thinner than the the appearance of diverticula or predispose to the surrounding parts (Figs. la, lc). occurrence of diverticulosis. This hypothesis seems Microscopically (Figs. lc, 2a, 3a) the mucosa and the to have been confirmed by Arfwidsson (1964) who submucosa were normal and showed some signs of found initial intramural diverticula in cases of spastic colon with remarkable thickening of the musculature. The muscular involvement of the colon in diverticulitis has also been pointed out by Celio (1952) who compared the myopathic com- ponent of the disease to the hypertrophic stenosis http://gut.bmj.com/ of the pylorus. Idiopathic muscular strictures of the large bowel in human beings have not been described until now. In the horse, segmental muscular stenosis has been mentioned in the oesophagus and small intestine (Helmke, 1939). We have observed two cases of muscular stricture of the sigmoid not related to on October 1, 2021 by guest. Protected copyright. diverticular or other diseases. It seems helpful to give a brief description of our experience. CASE REPORTS FIG. la. Case 1. X-ray air-contrast picture of the isolated colon, showing the normal aspect of the ascending CASE 1 This is a necropsy study of a 21-year-old woman tract and the stricture of the sigmoid with remarkable who died of renal failure. She had never complained of thickening of the wall: there is a break between the digestive trouble; her bowels had always been regular. stenotic sigmoid and the normal rectum and at about the After the necropsy the large bowel was fixed in dis- middle of the sigmoid a circumscribed dilatation of the tension with 10% saline formaldehyde at a pressure of wall. 70 cm of water. After fixation, radiographs were taken FIG. lb. Macroscopic appearance ofthe specimen between with air contrast, and transverse sections of the large the normal descending colon and the narrowed sigmoid; bowel, embedded in paraffin and sectioned at 5 microns, in the narrowed sigmoid, thickening of the wall and were stained with haematoxilyn and eosin, Mallory, many mucosal folds with a longitudinal pattern. and Pas. Mforbid anatomy All the large intestine from the FIG. Ic. Transverse sections of the sigmoid colon (4 x) ileo-caecal valve to the anal canal was studied. The at the level ofthe dilatation ofthe wall. The thinning of the outside of the fixed specimen showed a stricture in the longitudinal musculature and the almost complete dis- appearance of the circular musculature are noted. Also 'Aided by a grant from the Consiglio Nazionale delle Ricerche the mucosal folds are missing at this level. 325 6 326 C. Cassano and A. Torsoli Gut: first published as 10.1136/gut.9.3.325 on 1 June 1968. Downloaded from FIG. 2a FIG. 2b FIG. 2a. Case 1. Transverse section of the sigmoid colon (x 24), showing the increase in thickness of both muscular layers. FIG. 2b. Normal aspect ( x 80) ofthe ganglion cells ofAuerbach's plexus. vascular congestion and a few focal collections of Physical examination showed a fit woman with a neutrophilic granulocytes. Thickening of both circular normal abdomen. The colon, increased in consistency and longitudinal musculature could be easily recognized and slightly painful, was felt in the left iliac fossa. The and was more evident in the inner layer. The musculature laboratory tests did not show any abnormal pattern. was also normal. appeared to be normal in structure, but in some sections Proctosigmoidoscopy http://gut.bmj.com/ oedema was evident. The ganglions of Auerbach's The gastrointestinal transit time, studied by means of plexus seemed to be cytologically normal and more radiopaque markers (Halls, 1965; Hinton, 1967), revealed numerous in the narrowed portion of the bowel than in that after 10 days all the markers were still retained in those adjacent. The serous membrane showed a normal the large intestine; the greater number seemed to be aspect. situated in the left colon above the sigmoid (Fig. 4a). At the level of the dilatation of the wall (Fig. Ic), X-ray examination of the large intestine by double- the mucosa was flattened, the mucosal folds had dis- contrast enema (Figs. 4b, 5a, b) showed a segmental appeared and the muscular layer was thin. The dilatation stricture in the descending and sigmoid colon and the involved about one third of the entire circumference and rectosigmoid junction. The change of luminal calibre on October 1, 2021 by guest. Protected copyright. its radius was wider than that of the common diverticula. was gradual, cranially, but clear cut at the distal end. The picture resembled in some way the sacculations that The outline of the wall appeared to be normal everywhere at times can be seen in the sclerodermic colon. and also in the stenotic tract. A provisional diagnosis of muscular stricture of the CASE 2 A 53-year-old woman had suffered from sigmoid colon was made. It was believed that this constipation from the age of 13. At first the bowels were stricture could be the cause of the constipation and open at intervals of a few days, then at longer periods, surgical treatment was suggested. till she had to use laxatives and enemas. Nevertheless At laparotomy the sigmoid appeared normal, with a she had stopped using laxatives during the last few years slightly reduced calibre. A left hemicolectomy was per- because they were no longer effective. Lately the con- formed, and the surgical specimens were fixed according stipation had become worse and she began to suffer from to the procedure described in the previous case. After a tight, painful sensation in the left hypochondrium. fixing the sigmoid was found to be stenotic; it felt harder This seemed apparently related to the intestinal stasis. than the descending colon. She complained also of headache, abdominal distension, Upon opening the specimen a stricture of the sigmoid and listlessness; all this had worsened in the last two was evident and the radiological changes of intestinal years. calibre, gradual in the upper end and clear cut in the An x-ray examination of the large intestine taken lower one, were confirmed. A noticeable corrugation of about 10 years ago revealed that the calibre of the sigmoid the mucosa was seen, the folds having sometimes no was slightly reduced. However, there were no detectable definite orientation, sometimes a transverse direction changes in the wall. (Fig. 6). Thickening of the muscular layer was seen Idiopathic muscular strictures of the sigmoid colon 327 Gut: first published as 10.1136/gut.9.3.325 on 1 June 1968. Downloaded from FIGS. 3a - 3b. Transverse sections ofthe sigmoid colon ( x 4) in the first, and second case ofmuscular stricture. In case 1, both layers ofthe musculature have increased in thickness. In case 2, the thickening involves only the circular layer. The mucosa and the submucosa have a normal aspect; several mucosalfolds are evident. FIG. 3b http://gut.bmj.com/ on October 1, 2021 by guest. Protected copyright. FIG. 3c. Transverse sections of a normal sigmoid colon ( x 4) of a 45-year-old man. The thickness of the muscular wall is shown for comparison FIG. 3c with the above findings. (Fig. 3b). Microscopically (Figs. 7 and 8) mild congestion After the operation the patient's symptoms disappeared of the mucosa and submucosa was seen. The muscularis and her bowel movements returned to normal. mucosae seemed slightly thicker, with an irregular pattern of its muscular cells. The circular muscle was DISCUSSION remarkably thickened, while the taeniae appeared to be quite normal. No diverticula were found. The ganglia of the myenteric plexus appeared to be numerous and more Our cases show a hitherto unknown muscular voluminous in the stenotic portion, but were structurally involvement of the sigmoid colon. The most import- normal. No changes in the serosa were noted. No part ant finding is the considerable increase in thickness of the wall components showed signs of inflammation or of the musculature with a consequent remarkable degeneration. reduction in calibre of the damaged segment. In 328 C. Cassano and A. Torsoli Gut: first published as 10.1136/gut.9.3.325 on 1 June 1968. Downloaded from FIG. 4a FIG. 4b FIG. 4a. Case 2. X-ray film 10 days after the administration ofradiopaque markers which are still retained in the large http://gut.bmj.com/ intestine; most of them are situated above the sigmoid.
Load more

Recommended publications
  • The Anatomy of the Rectum and Anal Canal
    BASIC SCIENCE identify the rectosigmoid junction with confidence at operation. The anatomy of the rectum The rectosigmoid junction usually lies approximately 6 cm below the level of the sacral promontory. Approached from the distal and anal canal end, however, as when performing a rigid or flexible sigmoid- oscopy, the rectosigmoid junction is seen to be 14e18 cm from Vishy Mahadevan the anal verge, and 18 cm is usually taken as the measurement for audit purposes. The rectum in the adult measures 10e14 cm in length. Abstract Diseases of the rectum and anal canal, both benign and malignant, Relationship of the peritoneum to the rectum account for a very large part of colorectal surgical practice in the UK. Unlike the transverse colon and sigmoid colon, the rectum lacks This article emphasizes the surgically-relevant aspects of the anatomy a mesentery (Figure 1). The posterior aspect of the rectum is thus of the rectum and anal canal. entirely free of a peritoneal covering. In this respect the rectum resembles the ascending and descending segments of the colon, Keywords Anal cushions; inferior hypogastric plexus; internal and and all of these segments may be therefore be spoken of as external anal sphincters; lymphatic drainage of rectum and anal canal; retroperitoneal. The precise relationship of the peritoneum to the mesorectum; perineum; rectal blood supply rectum is as follows: the upper third of the rectum is covered by peritoneum on its anterior and lateral surfaces; the middle third of the rectum is covered by peritoneum only on its anterior 1 The rectum is the direct continuation of the sigmoid colon and surface while the lower third of the rectum is below the level of commences in front of the body of the third sacral vertebra.
    [Show full text]
  • Sporadic (Nonhereditary) Colorectal Cancer: Introduction
    Sporadic (Nonhereditary) Colorectal Cancer: Introduction Colorectal cancer affects about 5% of the population, with up to 150,000 new cases per year in the United States alone. Cancer of the large intestine accounts for 21% of all cancers in the US, ranking second only to lung cancer in mortality in both males and females. It is, however, one of the most potentially curable of gastrointestinal cancers. Colorectal cancer is detected through screening procedures or when the patient presents with symptoms. Screening is vital to prevention and should be a part of routine care for adults over the age of 50 who are at average risk. High-risk individuals (those with previous colon cancer , family history of colon cancer , inflammatory bowel disease, or history of colorectal polyps) require careful follow-up. There is great variability in the worldwide incidence and mortality rates. Industrialized nations appear to have the greatest risk while most developing nations have lower rates. Unfortunately, this incidence is on the increase. North America, Western Europe, Australia and New Zealand have high rates for colorectal neoplasms (Figure 2). Figure 1. Location of the colon in the body. Figure 2. Geographic distribution of sporadic colon cancer . Symptoms Colorectal cancer does not usually produce symptoms early in the disease process. Symptoms are dependent upon the site of the primary tumor. Cancers of the proximal colon tend to grow larger than those of the left colon and rectum before they produce symptoms. Abnormal vasculature and trauma from the fecal stream may result in bleeding as the tumor expands in the intestinal lumen.
    [Show full text]
  • 6-Physiology of Large Intestine.Pdf
    LARGE INTESTINE COLON MOTILITY Color index • Important • Further explanation 1 Contents . Mind map.......................................................3 . Colon Function…………………………………4 . Physiology of Colon Regions……...…………6 . Absorption and Secretion…………………….8 . Types of motility………………………………..9 . Innervation and motility…………………….....11 . Defecation Reflex……………………………..13 . Fecal Incontinence……………………………15 Please check out this link before viewing the file to know if there are any additions/changes or corrections. The same link will be used for all of our work Physiology Edit 2 Mind map 3 COLON FUNCTIONS: Secretions of the Large Intestine: Mucus Secretion. • The mucosa of the large intestine has many crypts of 3 Colon consist of : Lieberkühn. • Absence of villi. • Ascending • Transverse • The epithelial cells contain almost no enzymes. • Descending • Presence of goblet cells that secrete mucus (provides an • Sigmoid adherent medium for holding fecal matter together). • Rectum • Anal canal • Stimulation of the pelvic nerves1 from the spinal cord can cause: Functions of the Large Intestine: o marked increase in mucus secretion. o This occurs along with increase in peristaltic motility 1. Reabsorb water and compact material of the colon. into feces. 2. Absorb vitamins produced by bacteria. • During extreme parasympathetic stimulation, so much 3. Store fecal matter prior to defecation. mucus can be secreted into the large intestine that the person has a bowel movement of ropy2 mucus as often as every 30 minutes; this mucus often contains little or no 1: considered a part of parasympathetic in large intestine . fecal material. 2: resembling a rope in being long, strong, and fibrous 3: anatomical division. 4 ILEOCECAL VALVE It prevents backflow of contents from colon into small intestine.
    [Show full text]
  • COLON RESECTION (For TUMOR)
    GASTROINTESTINAL PATHOLOGY GROSSING GUIDELINES Specimen Type: COLON RESECTION (for TUMOR) Procedure: 1. Measure length and range of diameter or circumference. 2. Describe external surface, noting color, granularity, adhesions, fistula, discontinuous tumor deposits, areas of retraction/puckering, induration, stricture, or perforation. 3. Measure the width of attached mesentery if present. Note any enlarged lymph nodes and thrombosed vessels or other vascular abnormalities. 4. Open the bowel longitudinally along the antimesenteric border, or opposite the tumor if tumor is located on the antimesenteric border, i.e. try to avoid cutting through the tumor. 5. Measure any areas of luminal narrowing or dilation (location, length, diameter or circumference, wall thickness), noting relation to tumor. 6. Describe tumor, noting size, shape, color, consistency, appearance of cut surface, % of circumference of the bowel wall involved by the tumor, depth of invasion through bowel wall, and distance from margins of resection (radial/circumferential margin, mesenteric margin, closest proximal or distal margin). a. If resection includes mesorectum, gross evaluation of the intactness of mesorectum must be included. For rectum, the location of the tumor must also be oriented: anterior, posterior, right lateral, left lateral. b. If a rectal tumor is close to distal margin, the distance of tumor to the distal margin should be measured when specimen is stretched. This is usually done during intraoperative gross consultation when specimen is fresh. c. If the tumor is in a retroperitoneal portion of the bowel (e.g. rectum), radial/retroperitoneal margin must be inked and one or more sections must be obtained (a shave margin, if tumor is far from the radial margin; and perpendicular sections showing the relationship of the tumor to the inked radial margin, if tumor is close to the radial margin).
    [Show full text]
  • Sigmoid-Recto-Anal Region of the Human Gut
    Gut: first published as 10.1136/gut.29.6.762 on 1 June 1988. Downloaded from Gut, 1988, 29, 762-768 Intramural distribution of regulatory peptides in the sigmoid-recto-anal region of the human gut G-L FERRI, T E ADRIAN, JANET M ALLEN, L SOIMERO, ALESSANDRA CANCELLIERI, JANE C YEATS, MARION BLANK, JULIA M POLAK, AND S R BLOOM From the Department ofAnatomy, 'Tor Vergata' University, Rome, Italy and Departments ofMedicine and Histochemistry, RPMS, Hammersmith Hospital, London SUMMARY The distribution of regulatory peptides was studied in the separated mucosa, submucosa and muscularis externa taken at 10 sampling sites encompassing the whole human sigmoid colon (five sites), rectum (two sites), and anal canal (three sites). Consistently high concentrations of VIP were measured in the muscle layer at most sites (proximal sigmoid: 286 (16) pmol/g, upper rectum: 269 (17), a moderate decrease being found in the distal smooth sphincter (151 (30) pmol/g). Values are expressed as mean (SE). Conversely, substance P concentrations showed an obvious decline in the recto-anal muscle (mid sigmoid: 19 (2 0) pmol/g, distal rectum: 7 1 (1 3), upper anal canal: 1-6 (0 6)). Somatostatin was mainly present in the sigmoid mucosa and submucosa (37 (9 3) and 15 (3-5) pmol/g, respectively) and showed low, but consistent concentrations in the muscle (mid sigmoid: 2-2 (0 7) pmol/g, upper anal canal: 1 5 (0 8)). Starting in the distal sigmoid colon, a distinct peak oftissue NPY was revealed, which was most striking in the muscle (of mid sigmoid: 16 (3-9) pmol/g, upper rectum: 47 (7-8), anal sphincter: 58 (14)).
    [Show full text]
  • Colon and Rectum
    AJC12 7/14/06 1:24 PM Page 107 12 Colon and Rectum (Sarcomas, lymphomas, and carcinoid tumors of the large intestine or appendix are not included.) C18.0 Cecum C18.5 Splenic flexure of C18.9 Colon, NOS C18.1 Appendix colon C19.9 Rectosigmoid C18.2 Ascending colon C18.6 Descending colon junction C18.3 Hepatic flexure of C18.7 Sigmoid colon C20.9 Rectum, NOS colon C18.8 Overlapping lesion of C18.4 Transverse colon colon SUMMARY OF CHANGES •A revised description of the anatomy of the colon and rectum better delineates the data concerning the boundaries between colon, rectum, and anal canal. Ade- nocarcinomas of the vermiform appendix are classified according to the TNM staging system but should be recorded separately, whereas cancers that occur in the anal canal are staged according to the classification used for the anus. •Smooth extramural nodules of any size in the pericolic or perirectal fat are con- sidered lymph node metastases and will be counted in the N staging. In contrast, irregularly contoured nodules in the peritumoral fat are considered vascular invasion and will be coded as transmural extension in the T category and further denoted as either a V1 (microscopic vascular invasion) if only microscopically visible or a V2 (macroscopic vascular invasion) if grossly visible. • Stage Group II is subdivided into IIA and IIB on the basis of whether the primary tumor is T3 or T4 respectively. • Stage Group III is subdivided into IIIA (T1-2N1M0), IIIB (T3-4N1M0), or IIIC (any TN2M0). INTRODUCTION The TNM classification for carcinomas of the colon and rectum provides more detail than other staging systems.
    [Show full text]
  • Digestive System A&P DHO 7.11 Digestive System
    Digestive System A&P DHO 7.11 Digestive System AKA gastrointestinal system or GI system Function=responsible for the physical & chemical breakdown of food (digestion) so it can be taken into bloodstream & be used by body cells & tissues (absorption) Structures=divided into alimentary canal & accessory organs Alimentary Canal Long muscular tube Includes: 1. Mouth 2. Pharynx 3. Esophagus 4. Stomach 5. Small intestine 6. Large intestine 1. Mouth Mouth=buccal cavity Where food enters body, is tasted, broken down physically by teeth, lubricated & partially digested by saliva, & swallowed Teeth=structures that physically break down food by chewing & grinding in a process called mastication 1. Mouth Tongue=muscular organ, contains taste buds which allow for sweet, salty, sour, bitter, and umami (meaty or savory) sensations Tongue also aids in chewing & swallowing 1. Mouth Hard palate=bony structure, forms roof of mouth, separates mouth from nasal cavities Soft palate=behind hard palate; separates mouth from nasopharynx Uvula=cone-shaped muscular structure, hangs from middle of soft palate; prevents food from entering nasopharynx during swallowing 1. Mouth Salivary glands=3 pairs (parotid, sublingual, & submandibular); produce saliva Saliva=liquid that lubricates mouth during speech & chewing, moistens food so it can be swallowed Salivary amylase=saliva enzyme (substance that speeds up a chemical reaction) starts the chemical breakdown of carbohydrates (starches) into sugar 2. Pharynx Bolus=chewed food mixed with saliva Pharynx=throat; tube that carries air & food Air goes to trachea; food goes to esophagus When bolus is swallowed, epiglottis covers larynx which stops bolus from entering respiratory tract and makes it go into esophagus 3.
    [Show full text]
  • 9 Role of Rectosigmoid Junction in Fecal Continence Sphincter
    [Frontiers in Bioscience, 4, b9-13, October 1, 1999] ROLE OF RECTOSIGMOID JUNCTION IN FECAL CONTINENCE: AN EXPERIMENTAL STUDY Ahmed Shafik and Olfat El-Sibai Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt TABLE OF CONTENTS 1. Abstract 2. Introduction 3. Material and methods 3.1. Methods 3.2. Manometric studies 3.3. EMG studies 3.4. Balloon expulsion test 3.5 Anesthetization of the neorectum 4. Results 4.1. Basal pressure 4.2.Pressure after anorectal excision and mobilization of sigmoid colon and RSJ 5. Discussion 5.1. Dual fecal control theory 5.2.Clinical application of the RSJ 6. Acknowledgment 7. References 1. ABSTRACT 2. INTRODUCTION The rectosigmoid junction (RSJ) is the part of the To investigate the reason why, during a mass gut which links the sigmoid colon with the rectum (1,2). contraction, the stool moving from the colon to the sigmoid This area is not a mere junction but a segment which varies colon stops short of the rectosigmoid junction (RSJ) instead in length from 3.5 to 4.5 cm (mean length: 3.8 ± 0.7) (3). of passing directly to the rectum, and whether the sigmoid The sigmoid colon is considered a site of fecal storage (4); colon and RSJ share in the anorectal continent mechanism, upon contraction, it delivers the stools to the rectum. As 12 mongrel dogs were studied. Under anesthesia, the the rectum receives the feces, the recto-anal inhibitory anorectum was excised, sigmoid colon and RSJ were reflex is evoked with a resulting rectal contraction, mobilized and the caudal end was anastomosed to the relaxation of the internal anal sphincter and stool perianal skin within the external anal sphincter.
    [Show full text]
  • Hypermetabolic Images of Digestive Tract in Pet-‐Ct
    HYPERMETABOLIC IMAGES OF DIGESTIVE TRACT IN PET-CT, DIFFERENTIAL DIAGNOSIS Verónica Gigirey MD (1), Liliana Servente MD(2), Margarita García Fontes MD(3) (1) Ex assistant (2) Assistant Professor (3) Associate Professor, Hospital de Clinicas, Montevideo, Uruguay. Radiologist physicians, Uruguayan Center of Molecular Imaging (CUDIM) Abstract Positron emission tomograpHy (PET), using 18 F-fluorodeoxyglucose (18 F-FDG) Has been successfully implemented for evaluation of malignant tumors, sHowing HigH sensitivity in detecting tumors in the digestive tract, but with low specificity due to several pHysiological and pathological patterns of FDG uptake in the digestive tract. By combining PET and CT (PET-CT) we can localize and cHaracterize the FDG uptake focus. It is necessary to be familiar with uptake patterns in the digestive tract to differentiate between pHysiological and pathological patterns and within these in order to distinguisH between inflammatory and tumoral alterations. To acHieve this we set the following goals: 1) To describe and cHaracterize pHysiological versus pathological uptake of 18F-FDG in the digestive tract in PET-CT studies. 2) To revise findings of PET-CT studies with 18F-FDG carried out in CUDIM(Uruguayan Center of Molecular Imaging) with oncologic patients wHo present Hyper-metabolic lesions in the digestive tract and its pathological correlation. Correlation with CT and combination of PET-CT can sometimes Help identify the cause in uptake increase and it is recommended that focuses of HigHer uptake in the bowel should be evaluated with endoscopy. Keywords Gastrointestinal tract, focal lesions, 18 F-FDG, PET-CT, Oncology , Pitfalls Revista Imagenología. Vol. XVI. N 1. Oct. 2012 2 HYPERMETABOLIC IMAGES OF DIGESTIVE TRACT IN PET-CT, DIFFERENTIAL DIAGNOSIS 1- Introduction these pHysiological variants and the metabolic uptake patterns since they Combining positron emission migHt lead us to false positive diagnosis tomograpHy (PET) and computed of malignancy.
    [Show full text]
  • Your Bowel Operation Sigmoid Colectomy
    Your Bowel Operation Sigmoid Colectomy Introduction You are having an operation called Sigmoid Colectomy and this booklet aims to help you to understand your condition and this operation. The nurses and doctors looking after you will use diagrams to help explain. If you have any questions or would like them to go over any information again, please ask and they will be happy to do so. Several other booklets are also available and the Nurse Specialists will supply these if you wish - please don’t be afraid to ask. The Specialist Nurses The Colorectal Nurse Specialists at Doncaster Royal Infirmary can be contacted directly on 01302 553141. The Colorectal Nurses work as a team and any one of them will be happy to answer your questions. If you need to contact the colorectal nurse the telephone number is 01302 553141. There may be answerphone; if so, leave your name and telephone number, or between 9am and 4pm, Monday to Friday, you can contact the Colorectal Nurse Specialist by telephoning the hospital on 01302 366666 and asking the switchboard to contact the Colorectal Nurse Specialist on bleep 1420. There is a Glossary at the end of this booklet to help you understand the terms used. We Care WPR20872 April 2015 Review date by: April 2017 Designed by Medical Photography & Graphic Design, DBHFT. 01302 366666 ext. 3736 Understanding digestion To understand the operation you will be having, it is helpful to have some knowledge of how your body works. When food is eaten it passes from the mouth down the gullet (oesophagus) into the stomach, where it is broken down into a semi-liquid.
    [Show full text]
  • Gastrointestinal (GI) Physiology
    Gastrointestinal (GI) Physiology The Major Functions of the Digestive System The digestive system is a group of organs working together to convert food into energy and basic nutrients to feed the entire body. Food passes through a long tube inside the body known as the alimentary canal, gut, or the gastrointestinal tract (GI tract). The alimentary canal is made up of the oral cavity, pharynx, esophagus, stomach, small intestines, and large intestines. Within the pharynx there is the nasopharynx, oropharynx, and laryngopharynx. In addition to the alimentary canal, there are several important accessory organs that help your body to digest food but do not have food pass through them. Organs of the digestive system that lie outside of the GI tract include the liver, gallbladder, and pancreas. To achieve the goal of providing energy and nutrients to the body, six major functions take place in the digestive system: • Ingestion: The first function of the digestive system is ingestion, or the intake of food. The mouth is responsible for this function, as it is the orifice through which all food enters the body. The mouth and stomach are also responsible for the storage of food as it is waiting to be digested. This storage capacity allows the body to eat only a few times each day and to ingest more food than it can process at one time. • Secretion: In the course of a day, the digestive system secretes around 7 liters of fluids. These fluids include saliva, mucus, hydrochloric acid, enzymes, and bile. Bile is a digestive chemical produced in the liver that breaks down fats and neutralizes acidic pH of chyme from the stomach.
    [Show full text]
  • Rectosigmoid Junction Coding Guidelines
    SEER Program Coding and Staging Manual 2012 Coding Guidelines Rectosigmoid Junction C199 Primary Site A tumor is classified as rectosigmoid when differentiation between rectum and sigmoid is not possible. A tumor is classified as rectal if • lower margin lies less than 16 cm from the anal verge or • any part of the tumor is located at least partly within the supply of the superior rectal artery Anatomic Transition from Sigmoid to Rectum In the sigmoid colon, approximately 12 to 15 cm from the dentate line, the tenia coli fuse to form the circumferential longitudinal muscle of the rectal wall. The rectum is defined clinically as the distal large intestine commencing opposite the sacral promontory and ending at the anorectal ring, which corresponds to the proximal border of the puborectalis muscle palpable on digital rectal examination. It extends 16 cm from the anal verge. 1 Glossary Anal verge: The lower (distal) end of the anal canal, junction between the skin of the anal canal and the perianal skin. Anorectal ring: Top (proximal end) of the anal canal Dentate line: An anatomic landmark located between the anal verge and the anorectal ring indicating where the rectum changes to the anal canal. Also called the pectinate line. Tenia coli: (Plural: teniae coli). Any one of three longitudinal bands of smooth muscle in the colon. They extend from the cecum to the sigmoid colon. Each band is approximately 8 mm wide throughout most of the colon. The widths of the teniae increase in the sigmoid colon and eventually fuse into a covering of longitudinal muscle in the rectum.
    [Show full text]