Rectum

The rectum is the final section of the large intestine; starts in the pelvis at level II - III sacral vertebrae. Skirting along the front surface of the sacrum and coccyx, rectum opens on the perineum anal hole (see the anus). In the rectum distinguish pelvic (adampulawy), ampullary (USD) and anorectal (the anal canal) departments. The length of the rectum 13-16 see Blood supply: top (unpaired), middle and lower (paired) pryamokishechnye artery; venous blood flowing into the system of portal vein and inferior Vena. Innervation - the hypogastric plexus, pelvic and private parts nerves.
Research methods rectum: a rectal examination (see), sigmoidoscopy (see), x-ray examination. All studies rectum is carried out after preliminary preparation: the night before the patient should not eat, cleansing enema put in the evening and in the morning.
Damage to the rectum: the gap sphincter, anal canal, the front wall of the rectum during descent act, fractures of the pelvis; wounds wall glass enema tip, etc. there are of damage to the rectum without disturbing the integrity of the peritoneum (vnebrachnyi) and accompanied by damage of the peritoneum, and sometimes abdominal organs, first of all of the intestinal loops. Gunshot wounds rectum are rarely isolated, often combined with damage to the bladder, ureters, guts, sometimes pelvic bones.
On damaged during delivery the rectum, the doctor immediately puts the seams. In all other cases of injury rectal - immediate hospitalization to the surgical Department. The surgical intervention depends on the location and type of damage (when intra-abdominal shown urgent chrevosechenie). When all intra-abdominal and significant vnebrachnyi wounds rectum impose anus praeternaturalis (see).
Diseases of the rectum: hemorrhoids (see)fall out of the rectum (see), proktit (see), paraproctitis (see), cracks and fissures, amoebiasis (see).
Tuberculosis rectal infection comes hematogenous route possible and direct transfer (subject to scratches and cracks in the rear of passage), or move to nearby structures ovarian, prostate cancer; treatment - see Tuberculosis.
The actinomycosis is manifested in the form of multiple infiltrations around the anus, which softened and opened multiple fistula. Treatment: excision of the affected tissues.
Parasites. When trichocephalosis (see) trichuris sometimes parasitize in the colon, including the rectum. The head end of the body they are embedded in the mucous membranes, causing proctitis (see). Mature females pinworms descend from the upper intestine, crawl out from the anus, causing itching. Sometimes they are embedded in the mucous membrane of the rectum, there erosion, minor bleeding. The inhabitants of tropical countries in hemorrhoidal veins parasite Schistosoma (see the Schistosomiasis), eggs which pass through the wall of thick guts in their clearance. There colitis and proctitis.
Benign tumors of the rectum: fibroma, fibroids, hemangiomas; the latter are accompanied by bleeding. The polyp is developing in any part of the rectum (Fig.); sometimes long time clinically apparent. The first symptom may be a pain when urinating.

polyposis rectum
Polyposis rectum (rectoskopia).

From malignant tumors of the rectum occurs cancer, rarely sarcoma. Cancer occurs more frequently in 40-60 years, affects all departments of the rectum, but more often ampullary (cancer of the glandular structures, in the form of cauliflower or ulcers with black edges) and adampulawy (cancer skirsnio structure, koltseobrazno narrows the lumen of the intestine). Sometimes develops from polyps. Symptoms early in the disease of the poor, as there are frequent urge for a bowel movement, tenesmus (see), the mucus, which may be bloody; develops slowly bowel obstruction (see). Timely diagnosis of cancer of the rectum is often impeded by the fact that patients connect ucaschenne the urge, the allocation of blood and mucus in bowel movements with hemorrhoids or dysentery (especially in summer) and treated with home remedies. When such complaints are sick be made digital examination of the rectum; when polyp or tumor, the patient should be immediately sent to the surgeon or oncologist.
Treatment of tumors of the rectum surgery. Polyp removed by electropedia or produce the electrocoagulation. When the location of a malignant tumor within 6-7 cm from the anus usually produce the extirpation of rectum and put in the left iliac region anus praeternaturalis; when a tumor is above 8 cm repetiruyut area of the intestine with the imposition of anastomosis end to end. Patients with anus praeternaturalis need in the postoperative period in careful observation and care.