Index of subjects. bilesalt, malabsorption, incontinence in 147

Transcription

1 Index of subjects alcoholism, neuronal damage in 118 Alzheimer dementia, faecal incontinence in 113 anal fissure, manometry in 5 anal retractor, reduction of resting pressure 128 Angelchick prosthesis, treatment for rectal prolapse 170 ano-rectal angle 54, 199 flap-valve theory 34 following low anterior resection 199 function of 135 anticholinergic drugs, use after colo-rectal anastomosis 200 anus achalasia 71 congenital deformities, electromyography 20 Crohn's disease 207 conservative approach 207 diagnosis 210 presentation 208 surgical t ~ e a t208 m e n t treatment 213 dilatation 92 pressure after 128 incontinence after 126 external anal sphincter 134 fistula 129 haemorrhoidal cushions pressure in 142 function of 141 innervation of 41 inperforate, biofeedback treatment for 160 leakage 135 manometry 3-14 water infusion systems 5 force gauge catheter in 6 microtransducer in 6 pull-through technique in 10 water-perfused system in 8-9 myectomy pressure characteristics 3 distribution in 4 idiopathic incontinence 174 intra-anal distribution in 10 normal values 10 resting tone 3, 10 squeeze 4 (ultra-)slow wave pattern 4, 10 resting pressure after sphincter repair 192 resting tone following low anastomosis 201 sensation differentiating 115 in slow transit constipation 44 sensory nerve endings 42 sepsis after sphincter reconstruction 192 solitary rectal ulcer syndrome, discharge 84 sphincter damage 117 function, ileo-anal anastomosis 221 injury 126 reconstruction 128 sphincterectomy, incontinence after 128 squeeze pressure after sphincter repair 192 stenosis after sphincter reconstruction 192 stretch receptors 135 Arndorfer pump 9 Auerbach, plexus of 58 bilesalt, malabsorption, incontinence in 147

2 228 biofeedback, manometry in 13 biofeedback training 91, 153 enhanced sensation in 149 goals 156 incontinence 149 indications for 160 mechanism of 158 medical application 154 outcome 162 phases in 159 principles of 153 requirements for application 154 technical aspects 156 bowel cleansing, in psychogenic constipation 79 cauda equina disc disease 27 lesion, electromyography in 18 lesion, pudendal nerve latency time in 26 meningomyelocoele 114, 162 spinal canal stenosis 27 spondylosis 114 trauma 114 tumour 114 cerebrovascular disease, faecal incontinence in 113 cerebrum, frontal lobe lesion 111 childbirth faecal incontinence after 117 pelvic innervation damage after 114 perineal tear in 117 cholecystokinin 58 cholestyramine, treatment in faecal incontinence 147 codeine 146 colitis cystica profunda 83 colo-anal anastomosis technique 196 carcinoma, local recurrence of 199 faecal incontinence after 130, 198 urgency to defaecate after 198 functional results 198 colo-rectal anastomosis faecal incontinence after 197, 198 functional results 198 importance of remnant length 198 recto-anal distension reflex after 202 reservoir function after 200 sepsis after 198 stapler in 198 urgency to defaecate after 198 colon antiperistaltic contractions 52 argyrophyl plexus 95 colitis cystica profunda 83 contractile electrical complex 57 drug-induced passage delay 146 effect of stress on motility 58 electrical control activity 54 electrical response activity 55 electromyography 52 long spike bursts in 56 short spike bursts in 56 slow wave potentials 54 function of 51 haustrae, segmenting contractions and 53 idiopathic megacolon 95 inertia 71 intrinsic neurons in 57 ] -shaped reservoir, rectum resection 199 manometry relevance of 52 normal pattern in 12 mass movements 53 motility and hormones 56, 58 and pressure 12 neurogenic control of 57 radiology 51 radionuclide in 52 neurotransmitters 56 parasympathetic innervation 57 phasic contractions 55 resection for rectal prolapse 169 Schwann cells 95 segmenting contractions 52 sympathetic innervation 57 transit time study 66, 90 radio-opaque markers 52 colostomy in peri-anal Crohn's disease 211 technique 191 condom catheter, rectal compliance measurement 12 constipation anal resting tone in 77 barium enema in 66 causes 74 classification 67

3 229 colectomy for 95 colonic transit time study in 66 congenital 71 defaecography in 66 definition 63 electromyography in 18, 67 endoscopy in 65 in children, incidence 71 in rectal prolapse, treatment for 169 lumbar sympathectomy for 64 manometry in 13 myenteric plexus in 58 neonatal 96 nerv.e damage in 114 nerve staining in 96 onset of 65 outlet obstruction 54, 64 personality disorders in 77 pot training and 78 psychogenic 71 anal myectomy for 79 anal resting tone in 76 biofeedback training for 79 bowel cleansing for 79 clinical manifestations 72 management 78 manometry in 76 pathogenesis 76 psychiatric counseling in 79 radiology in 75 pudendal nerve latency time in 26 rectal compliance in 67, 77 rectal sensitivity in 76 recto-anal distension reflex 75, 76 slow transit laxatives in 95 myenteric plexus damage in 95 treatment ano-rectal myectomy 98 subtotal colectomy 96 contractile electrical complex 57 coprostasis, impaired sensation in 139 coughing reflex 135 Crohn's disease 207 arthritis in 209 bile salt malabsorption in 147 conjunctivitis in 209 erythema nodosum in 209 extra-intestinal manifestations 209 incontinence in 148 Langhans giant cells in 210 medical treatment 210 sarcoid lesion in 210 surgical repair of anal fistula 213 surgical treatment 210 defaecation intra-abdominal pressure and 54 mechanism 110 normal 35 planned 149 postponed 54 reflex mechanisms 110 defaecography ano-rectal angle 33 balloon 32 bowel preparation 32 contrast medium in in faecal incontinence 39 in rectal intussusception 85, 99 in rectal prolapse 168 perineal descent 33 solitary rectal ulcer in 89 delivery, forceps 121 Delorme procedure 99 denervation 17 deoxycholic acid increased colonic motor index 147 rectal irritability 139 descending perineum syndrome 91, 118 faecal incontinence 118 diabetes mellitus 114 anal sensation in 43 neuronal damage in 118 diarrhoea medical treatment 146 post-irradiation, cholestyramine 148 diphenoxylate 146 electrical control activity 57 electromyography axonal sprouting 21 basal action potentials 19 concentric electrode external anal sphincter lesion 20 fiber density 20, 120 motor unit 20 reinnervation 20 single fiber 119 single fiber electrode 20-22

4 230 sphincter mapping in 20 surface electrode 19 encopresis anal sensation in 43 retentive 71 enuresis 73 epidural anaesthesia 122 episiotomy 122 erythema nodosum, Crohn's disease 209 external anal sphincter electromyography 18 function 141 response to rectal distension 48, 155 faecal incontinence after colo-anal anastomosis 198 altered bowel habit, treatment in 187 biofeedback training in 149, 153, 187 conservative treatment 174 constipation in 27 defaecography in 39 de nervation in 26 following anal dilatation 126 following childbirth 117 following colo-rectal anastomosis 197 following fistula operations 128 following haemorrhoidectomy 129 following ileo-anal anastomosis 130, 220 following surgery for Crohn's disease 212 iatrogenic 128 idiopathic 18 idiopathic, treatment for 173 in Alzheimer dementia 113 in cerebrovascular disease 113 in Crohn's disease in decompensated hydrocephalus 113 in multiple sclerosis 113 in paraplegia 151 in sacral lesion 151 in spina bifida 160 in spinal cord lesion 113, 150 in ulcerative colitis 145 incidence 109 lower motor neuron lesion 114 manometry in 13 medical treatment menopause 28 neurological causes central lesions 111 classification 110 pudendal nerve latency time in 26 rectal prolapse in 167 treatment for 169 sensation in 43 sensory system damage 115 surgical treatment 187 gracilis sling 187 peri-anal suture 170 post -anal repair 170, rectopexy 168 sphincter repair treatment bulk laxatives in 149 cholestyramine in 147 gracilis sling procedure 187 weak perception in 155 faecal soiling 71 following ileo-anal anastomosis 219 faeces, transport in colon 53 familial polyposis, ileo-anal anastomosis in 220 faradism, pelvic floor exercises 192 fissure in ano 65 manometry in 13 sensation in 44 fistula in ano 65 flap-valve theory 34,133,174 flutter-valve theory 133, 199 gastrin 58 glycerin, suppositories used in planned defaecation 149 gracilis sling procedure 187 patient selection 187 haemorrhoidectomy, faecal incontinence after 129,141 haemorrhoids 65 anal sensation in 44 manometry in 5, 13 Hartmann operation, incontinence after 129 Hirschsprung's disease internal anal sphincter in 67 manometry in 13,67,74 nerve staining in 95 recto-anal inhibitory reflex 46 short segment 64 treatment 100 ano-rectal myectomy 100

5 231 ultra short segment 74 hydrocephalus decompensated, incontinence in 113 ileal pouch capacitance 222 compliance 218, 222 compliance related to type of reservoir 222 ileo-anal anastomosis 217 pouchitis 221 ileo-anal anastomosis 217 anal pressure in 218 anal sphincter function in 221 complications, continence after 220 continence and age 220 continence and original diagnosis 220 continence in 218 continence related to technical factors 222 continence, clinical factors relating to 220 faecal soiling in 219 function 219 incontinence after 130 pouch, covering ileostomy 217 pouchitis 221 rectal cuff in 217 recto-anal distension reflex in 221 results 218 self-catheterisation 223 straight versus reservoir 219 urgency to defaecate 218 ileostomy, temporary, covering ileo-anal anastomosis 217 incontinence, urine, classification 110 inflammatory bowel disease, faecal incontinence in 125 internal anal sphincter impaired function 140 recto-anal inhibitory reflex 54 response to rectal distension 48 spontaneous relaxation 141 irradiation bile salt malabsorption in 148 rectal changes 148 irritable bowel syndrome 58 anal sphincter function in 149 bile salt malabsorption in 148 mobility in 56 rectal irritability in 139 laxative, longstanding use in slow transit colon 95 locus coeruleus 113 lomotil146 loperamide 146 increased internal anal sphincter tone 146 use in faecal incontinence 146 low anterior resection, incontinence after 130 lumbar sympathectomy, constipation, treatment 63 manometry anus, see anus colon, see colon equipment motor index 12 rectum, see rectum transducer in 4--5 mastocytosis, faecal incontinence in 151 Mayo repair 190 megarectum, biofeedback treatment in 160 megacolon functional 71 idiopathic 64, 71 idiopathic, colectomy for 95 pressure measurement in 12 melanosis coli 65 metronidazol 212 multiple sclerosis, faecal incontinence in 113 myectomy, ano-rectal, technique 101 myelomeningocele, anal sensation in 43 nerve stimulation techniques nerve latency time neuropathy, peripheral 114 operant conditioning, biofeedback in 154 paraplegia, incontinence, treatment of 151 pelvic floor biopsies of 117 damage after dilatation 127 muscle de nervation 117 pelvic sepsis, following low-anastomosis 199 peri-anal suture, treatment for rectal prolapse 170 perineal descent 27, 114, 135, 139 ano-rectal angle in 28 incontinence in 127 measurement 119

6 232 nerve injury in 28 perineal nerve, lesion 114 perineum solitary rectal ulcer syndrome, pain in 84 trauma 126 trauma, delivery 122 post -anal repair , 187 anaesthesia for 175 influence on anal length 183 influence on anal pressures 184 influence on ano-rectal angle 183 morbidity 181 patient selection 187 post -operative care 180 preparations prior to surgery 174 principles 173 rectal prolapse, treatment for 170 results 181, 187 selection criteria 174 technique 175 posterior rectopexy, rectal prolapse, treatment for 168 puborectalis muscle division of 65, 90, 97 function 54, 117, 134 role in spastic pelvic floor syndrome 97 syndrome 65 pudendal nerve 117 compression childbirth 118 damage 117 damage from childbirth 24 damage in constipation 24 latency time 23 lesion 114 spinal stenosis 24 stretch damage 139 terminal motor latency time 119 pull-through anastomosis 197 quadraplegia, planned defaecation in 150 radiotelemetry 32 rectal prolapse, treatment for constipation 169 recto-anal inhibitory reflex 3, 48, 54, 111, 136, 155 following colo-rectal anastomosis 202 following ileo-anal anastomosis 221 in constipation 75, 76 rectocele defaecography in 102 symptoms 102 treatment 103 rectopexy 99, 168 rectum abdomino-transsphincteric resection 196 anterior wall prolapse 85 capacity 200 capacity measurement 12 carcinoma 195 incontinence and 125 abdomino-perineal resection 195 colo-rectal anastomosis 197 resection, functional result 195 resection, safety margin in 195 treatment for 195 cerebral cortex representation 111 compliance 12 constipation, biopsy in 65 contractile forces 47 contraction in defaecation 35 contractions 136 digitation 88 evacuation in sacral lesions 150 false urgency to defaecate 167 hypoganglionosis 66 idiopathic mega rectum 100 impaction 73 incomplete evacuation of 167 innervation 200 intussusception 35, 85, 88, 98 and incontinence 39 defaecography in 85 diagnosis 98 incidence 99 symptoms 99 treatment 99 invagination 35 irradiation damage 148 irritability 139 manometry in normal pattern in 12 mucosal prolapse 65 neoplasm 65 perception on filling 47 peristalsis in 53, 111 posterior rectopexy 90 pressure in 11 prolapse 18, 35 constipation in, treatment 169

7 233 in solitary rectal ulcer syndrome 85 of anterior wall 35 accompanying findings 166 aetiology in adults 165 aetiology in children 165 Angelchick prosthesis for 170 clinical presentation 166 conservative treatment 168 defaecography in 168 electromyography in 168 endoscopy in 167 history 167 incidence 165 incontinence in 28 incontinence treatment 169 intussusception 166 manometry in 167 pelvic floor weakness in 166 physical examination 167 post -anal repair for 170 psychological abnormalities in 166 rectopexy 168 sensation in 168 surgical treatment 168 treatment, peri-anal suture 170 rectocele 65 resection, colo-anal anastomosis 196 reservoir function 47, 199, 200 saline infusion test 135 sensation 12, 54, 199 foil owing low anastomosis 198, 199 balloon test 46 impaired 139 sensory discrimination 54 solitary ulcer 83 syndrome, prolapse and 84 macroscopy 83 microscopy 83 sphincter preserving operation 195 stretch receptors 136 visco-elastic properties 11, 113 Rehbein procedure 100 retrograde ejaculation, following ileo-anal anastomosis 223 sacral plexus, lesion 114 saline infusion test 128, 146 seepage 141 sensation ano-rectal disturbances in incontinence 114 sigmoid colon motility 54 and constipation 54 and diarrhoea 54 in bile salt malabsorption 147 soiling 128 solitary rectal ulcer syndrome 18, 8 ~ 9 4 biopsy in 89 bowel disorders in 84 causes 84 colonic transit time study in 90 complications 91 constipation 65 defaecation disorders in 88 defaecography in 38, 89 electromyography in 86, 90 outlet obstruction in 88 pelvic floor dysfunction in 86 rectal prolapse in 38, 84 self-digitation in 88 spastic pelvic floor syndrome in 89 symptomatology in 84 treatment 90 biofeedback training in 91 spastic pelvic floor syndrome 88, 97 biofeedback training for 98 defaecography in 97 electromyography in 67 manometry in 13 solitary rectal ulcer syndrome and 89 sphincter lesion neuropathy in 193 reconstruction sphincter reconstruction 188 colostomy and 188 complications in 192 following surgery for Crohn's disease 213 post-operative management 192 pre-operative preparation 189 results 192 technique 190 wound infection in 188 sphincter saving operation anal resting pressure after 201 intestinal function after 203 patient selection 203, 204 radicality in rectal carcinoma resection 203 recto-anal distension reflex after 202 sphincter function after 204

8 234 squeeze pressure after 202 spina bifida, incontinence, biofeedback training in 160 spinal cord dysfunction 74 lesion incontinence in 113 incontinence treatment of 150 sacral lesion, incontinence treatment in 151 stimulation of 22 spinal lesion, impaired sensation in 139 syringe pump 9 tabes dorsalis 114 ulcerative colitis faecal incontinence in 145 ileo-anal anastomosis in 220 urgency to defaecate following colo-anal anastomosis 198 following colo-rectal anastomosis 198 urinary incontinence 18 urinary tract, infections in faecal soiling 73 vaginal delivery external anal sphincter lesion in 18 pudendal nerve damage in 27 Waldeyer's fascia 177