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World Journal of Pediatric Surgery 2024年第1期7卷 66-69页

作者： Md Samiul Hasan Md Nazmul Islam Refoyez Mahmud Umama Huq Ashrarur Rahman Pediatric Surgery Bangladesh Shishu Hospital and InstituteDhakaBangladesh

Anorectal malformation(ARM)is a frequently occurring surgical condition in neonates,with a prevalence of 1 in 4000 live births.'In boys with this anomaly,the rectum and urinary tract share a common wall for some distance,often ending up in fistulous communication.The goals of definite reconstruction are to separate the rectum from the urinary tract without injuring the urethra and mobilizing the rectum to the perineum within the muscle complex.Separating the rectum and the urinary tract is the most critical part of this operation and is associated with a significant risk of urinary tract injury.2-5 The original procedure described by Pena and Devries involves multiple stay sutures on the rectal mucosa just above the fistula,lifting the mucosa and continuing a submucosal dissection up to the prostate,where the entire thickness of the intestine can be separated from the urinary tract.

关键词： urinary rectum intestine

Hematochezia due to rectal invasion by an internal iliac artery aneurysm: A case report

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World Journal of Clinical Cases 2024年第11期12卷 1980-1989页

作者： Fang Li Bin Zhao Yong-Qiang Liu Guo-Qing Chen Rong-Feng Qu Chao Xu Zhui Long Jin-Song Wu Mao Xiong Wei-Hang Liu Li Zhu Xiao-Ling Feng Lei Zhang Department of General Surgery Chongqing General HospitalChongqing 401147China

BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula,expanding the differential diagnosis for gastrointestinal bleeding.It emphasizes the importance of considering vascular origins in cases of atypical hematochezia,particularly in the absence of common gastrointestinal causes,and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual presentations.CASE SUMMARY A 75-year-old man with a history of hypertension presented with 12 d of hematochezia,experiencing bloody stools 7-8 times per day.Initial computed tomography(CT)scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma development.Hemoglobin levels progressively decreased to 7 g/dL.Emergency arterial angiography and iliac arterycovered stent placement were performed,followed by balloon angioplasty.Despite initial stabilization,minor rectal bleeding and abdominal pain persisted,leading to further diagnostic colonoscopy.This identified a neoplasm and potential perforation at the proximal rectum.An exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall,necessitating partial rectal resection,intestinal anastomosis,and ileostomy.Postoperative recovery was successful,with no further bleeding incidents and normal follow-up CT and colonoscopy results after six months.CONCLUSION In cases of unusual gastrointestinal bleeding,it is necessary to consider vascular causes for effective diagnosis and intervention.

关键词： Iliac artery aneurysm Hematoma rectum Hematochezia Case report

Technical feasibility of salvage endoscopic full-thickness resection for a giant gastrointestinal stromal tumor located in low rectum after imatinib:a case report

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Gastroenterology Report 2023年第1期11卷 527-529页

作者： Jingyi Liu Bing Li Pinghong Zhou Mingyan Cai Yunshi Zhong Endoscopy Center Zhongshan Hospital of Fudan UniversityShanghaiP.R.China Endoscopy Research Institute of Fudan University ShanghaiP.R.China Shanghai Collaborative Innovation Center of Endoscopy ShanghaiP.R.China Endoscopy Center Xuhui HospitalZhongshan Hospital of Fudan UniversityShanghaiP.R.China

Introduction Gastrointestinal stromal tumors(GISTs)in adults are nearly 10%–30%with a potential malignant tendency[1].Colorectal GISTs account for 5%of all cases and have a higher progression risk with a poor prognosis[2,3].Rectal GISTs usually need radical operations such as laparoscopy to obtain tumor-free margins.Sometimes,it is difficult for surgery to preserve the anal function because of the tumor size and location.Here,we report a case of a 70-year-old female with a giant GIST located in the lower rectum,which was removed by function-preserving endoscopic minimally invasive resection after routine imatinib therapy.

关键词： rectum resection routine

Treatment of Prostatorectal Fistula by Transanorectal Route: About an Observation

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Open Journal of Urology 2024年第4期14卷 262-266页

作者： Mohamed Mahmoud Beya Ahmed Salem Terouzi Y. Tfeil Diagana Mouhamadou Urology Department Cheikh Zayed Hospital Nouakchott Mauritania

This is a 54-year-old patient admitted for the management of urinary leakage through the anus that had been occurring for a month, in whom the diagnosis of a prostatorectal fistula was made. The fistula was successful... 详细信息

关键词： Fistula Prostate rectum York Masson

Cortical and spinal evoked potential response to electrical stimulation in human rectum

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World Journal of Gastroenterology 2010年第43期16卷 5440-5446页

作者： Brian Garvin Lisa Lovely Alex Tsodikov Danielle Minecan Shaungson Hong John W Wiley Department of Internal Medicine University of Michigan Michigan Clinical Research Unit Level 1 Room 1702 Cardiovascular Center 1500E Medical Center Drive Ann Arbor MI 48109 United States Department of Neurology University of Michigan Ann Arbor MI 48109 United States Department of Biostatistics University of Michigan Ann Arbor MI 48109 United States

AIM: To study a novel technique to record spinal and cortical evoked potentials (EPs) simultaneously in response to electrical stimulation in the human rectum. METHODS: Eight male and nine female healthy volunteers participated. Stimulating electrodes were attached to the rectal mucosa at 15 cm and 12 cm above the dentate line. Recording skin electrodes were positioned over vertebrae L4 through S2. The electrical stimulus was a square wave of 0.2 ms duration and the intensity of the stimulus varied between 0 and 100 mA. EP responses were recorded using a Nicolet Viking IV programmable signal conditioner.RESULTS: Simultaneous recording of cortical and spinal EPs was obtained in > 80% of the trials. The EP responses increased with the intensity of the electrical stimulation, were reproducible overtime, and were blocked by application of Lidocaine jelly at the site of stimulation. The morphology (N1/P1), mean ± SD for latency (spinal N1, 4.6 ± 0.4 ms; P1, 6.8 ± 0.5 ms; cortical N1, 136.1 ± 4.2 ms; P1, 233.6 ± 12.8 ms) and amplitude (N1/P1, spinal, 38 ± 7 μV; cortical 19 ± 3 μV) data for the EP responses were consistent with those in the published literature. Reliable and reproducible EP recordings were obtained with the attachment of the electrodes to the rectal mucosa at predetermined locations between 16 and 8 cm above the anal verge, and the distance between the attachment sites of the electrodes (the optimal distance being approximately 3.0 cm between the two electrodes). CONCLUSION: This technique can be used to assess potential abnormalities in primary afferent neural pathways innervating the rectum in several neurodegenerative and functional pain disorders.

关键词： Spinal evoked potentials Cortical evoked potentials rectum Electrical stimulation Primary afferent neurons Visceral sensation

Anatomy of the lateral ligaments of the rectum: A controversial point of view

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World Journal of Gastroenterology 2010年第43期16卷 5411-5415页

作者： Guo-Jun Wang, Chun-Fang Gao, Dong Wei, Cun Wang, Wen-Jian Meng, Institute of Digestive Surgery and Department of General Surgery, 150 Hospital of PLA, Gaoxin District, Luoyang 471031, Henan Province, China Institute of Digestive Surgery and Department of General Surgery 150 Hospital of PLA Gaoxin District Luoyang 471031 Henan Province China.

The existence and composition of the lateral ligaments of the rectum (LLR) are still the subjects of anatomical confusion and surgical misconception up to now. Since Miles proposed abdominoperineal excision as radical surgery for rectal cancer, the identification by "hooking them on the finger" has been accepted by many surgeons with no doubt; clamping, dividing and ligating are considered to be essential procedures in mobilization of the rectum in many surgical textbooks. But in cadaveric studies, many anatomists could not find LLR described by the textbooks, and more and more surgeons also failed to find LLR during the proctectomy according to the principle of total mesorectal excision. The anatomy of LLR has diverse descriptions in literatures. According to our clinical observations, the traditional anatomical structures of LLR do exist; LLR are constant dense connective bundles which are located in either lateral side of the lower part of the rectum, run between rectal visceral fascia and pelvic parietal fascia above the levator ani, and covered by superior fascia of pelvic diaphragm. They are pathways of blood vessels and nerve fibers toward the rectum and lymphatic vessels from the lower rectum toward the iliac lymph nodes.

关键词： The lateral ligaments of the rectum Anatomy Total mesorectal excision Abdominoperineal excision Fascia

Prostatic tissue ectopia in the rectum

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Chinese Medical Journal 2010年第22期123卷 3372-3374页

作者： WU Xin-lin SHI Lin ZHAO Li-zhen WANG Jing-yuan DONG Pei-de XIA Yang-zhi Department of General Surgery the First Affiliated Hospital of Inner Mongolia Medical College Huhhot Inner Mongolia 010059 China Department of Pathology the First Affiliated Hospital of Inner Mongolia Medical College Huhhot Inner Mongolia 010059 China

Areview of the literature on ectopic prostatic tissue reveals about 200 reports dating back to as early as 1894. The presence of prostate tissue outside the genitourinary system is extremely rare. It is usually incidentally found in surgical pathology and autopsy. Including the present case, there are only 16 cases of ectopic prostatic tissue outside the genitourinary system reported.

关键词： prostate ectopia rectum immunohistochemistry

Large heterotopic gastric mucosa and a concomitant diverticulum in the rectum:Clinical experience and endoscopic management

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World Journal of Gastroenterology 2018年第30期24卷 3462-3468页

作者： Wen-Guo Chen Hua-Tuo Zhu Ming Yang Guo-Qiang Xu Li-Hua Chen Hong-Tan Chen Department of Gastroenterology The First Affiliated HospitalCollege of MedicineZhejiang University

Heterotopic gastric mucosa(HGM) in the rectum is an extremely rare clinical entity which may be missed or misdiagnosed due to a lack of knowledge.In the present study,a 14-year-old girl visited our hospital due to a 5-year history of repeated hematochezia.Colonoscopy showed a solitary superficial depressed lesion approximately 5 cm in size and a concomitant 1.5 cm deep diverticulum in the rectum.Histological examination of the endoscopic biopsy showed typical ectopic gastric mucosa in the depressed lesion and inside the diverticulum.Narrow band imaging further confirmed the histological results.Endoscopic ultrasound indicated that the lesion originated from the mucosal layer,and partially involved the submucosal layer.Endoscopic submucosal dissection was performed in this patient due to the large size and shape of the lesion.No bleeding,perforation or other adverse events were observed.The presence of HGM in the diverticular cavity greatly increased the surgical difficulty.A literature review was also carried out in our study.

关键词： Endoscopic submucosal dissection rectum Helicobacter pylori Endoscopy Heterotopic gastric mucosa

Collision carcinoma of the rectum involving neuroendocrine carcinoma and adenocarcinoma:A case report

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World Journal of Clinical Cases 2021年第18期9卷 4789-4796页

作者： Xing Zhao Gang Zhang Chun-Hui Li Department of Pathology The Affiliated Hospital of Chengde Medical UniversityChengde 067000Hebei ProvinceChina Department of General Surgery IV Baoding First Central HospitalBaoding 071000Hebei ProvinceChina

BACKGROUND Collision carcinoma is a rare histological pattern,and includes two or more different types of tumors coexisting in the same organ as one neoplasm.Different to the combined type,the two adjacent tumors of collision carcinoma are histologically distinct.Collision carcinoma may occur from any origin or organ,including the cecum,liver,cervix,thyroid,stomach,kidney,and esophagus.In the rectum,adenocarcinoma is the most common pathological type,the combined type is rare,and collision tumors are even rarer.To date,only a limited number of collision carcinoma cases originating from the rectum have been reported.Due to the scarcity of rectal collision carcinoma,more cases need to be reported to fully understand the clinico-pathological features and biological behavior of the tumor.CASE SUMMARY Here we report a 40-year-old female who presented with the chief complaints of persistent changes in bowel habits and hematochezia for 10 d.She underwent Miles'operation which revealed a collision carcinoma of the rectum,showing a“side by side”pattern,composed of a high grade neuroendocrine carcinoma,(small cell carcinoma)and moderately differentiated adenocarcinoma,based on its clinico-pathological features and biological behavior.The patient remained disease-free at 12 mo follow-up.We also focused on the related literature and expert opinion.CONCLUSION Collision carcinoma is a rare tumor with ambiguous biological behavior.Greater attention should be paid to its clinico-pathologic diagnosis.Regular and adequate follow-up is essential to help rule out metastasis and assess the prognosis.

关键词： Collision carcinoma rectum Neuroendocrine carcinoma Adenocarcinoma Case report

Small-cell neuroendocrine carcinoma of the rectum—a rare tumor type with poor prognosis:A case report and review of literature

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World Journal of Clinical Cases 2020年第23期8卷 6095-6102页

作者： Zhen-Zhou Chen Wang Huang Zheng-Qiang Wei Department of Gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China

BACKGROUND Small-cell neuroendocrine carcinoma(SNEC)of the rectum is a rare tumor associated with poor prognosis.CASE SUMMARY We report a case of a 77-year-old male who came into our hospital because of blood with his stool.An endoscopy revealed a cauliflower-like neoplasm in his rectum.Imaging examination showed that the lesion in the upper rectum was likely rectal cancer,and there was no evidence of metastasis.The patient was treated with surgery.Pathological examination confirmed SNEC of the rectum and an R0 resection was achieved.However,1 mo after the operation,the patient developed intestinal and ureteral obstructions due to peritoneal metastases.Finally,the patient died from renal failure.CONCLUSION SNEC of the rectum is a high-grade carcinoma with an aggressive phenotype,and surgery should be cautiously considered.

关键词： Case report Small-cell neuroendocrine carcinoma rectum Treatment Prognosis Rare tumor