Anal and Rectal Diseases: A Concise Manual PDF
Preview Anal and Rectal Diseases: A Concise Manual
Anal and Rectal Diseases Eli D. Ehrenpreis Shmuel Avital Marc Singer ● ● Editors Anal and Rectal Diseases A Concise Manual Editors Eli D. Ehrenpreis, MD Marc Singer, MD Chief of Gastroenterology and Endoscopy NorthShore University Health System Highland Park Hospital Department of Surgery Medical Director, Center for the Study of Division of Colon and Rectal Surgery Complex Diseases Evanston, IL, USA NorthShore University Health System Clinical Associate Professor of Medicine University of Chicago Medical Center Highland Park, IL, USA Shmuel Avital, MD Chief of Surgery Department of Surgery B Meir Medical Center Kfar-Saba, Israel ISBN 978-1-4614-1101-7 e-ISBN 978-1-4614-1102-4 DOI 10.1007/978-1-4614-1102-4 Springer New York Dordrecht Heidelberg London Library of Congress Control Number: 2011939744 © Springer Science+Business Media, LLC 2012 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identifi ed as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) I would like to express my gratitude to my wife Ana for her encouragement, to my children Benjamin, Jamie, and Joseph for their understanding, and to my parents, Bella and Seymour for bringing academics and scholarship to my world. Eli D. Ehrenpreis, MD I would like thank my wife, Michal, for her ongoing support since I was a medical student and her understanding of the time commitments involved in academia beyond the obvious time needed for clinical practice. Shmuel Avital, MD Preface Anorectal pathology is common in the general population. Understanding the pathophysiology, diagnosis, and treatment of diseases of the anus and rectum is often quite a challenge for physicians and other healthcare providers. There are many barriers to achievement of high quality care for these conditions. Patients may be embarrassed to admit to anorectal symptoms. Specifi c education about diseases of the anus and rectum may be limited among primary treating physicians depending on the institution where training takes place. Of most importance from the author’s standpoint, a short book that connects together anorectal anatomy and pathophysi- ology with medical and surgical treatment of anorectal disease is needed by many in the medical fi eld. In creating A nal and Rectal Diseases: A Concise Manual , my surgical coeditors and I have worked diligently to fulfi ll the aforementioned unmet need. The style of the book was developed to communicate the most important information on each topic in brief, therefore making the book useful for reference and review. Studying a specifi c chapter will give the reader an accurate overall picture of each subject. We have also included many fi gures to aid the reader in their understanding of the presented material. By adding detailed information about surgeries performed for these conditions, it is our hope that practitioners who are not surgeons will develop a deeper understanding of these procedures, their indications, their benefi ts to the patient as well as their potential complications. Throughout the book, we have included “clinical pearls,” generally summarizing important aspects of the preceding short chapter. These small pieces of insight are selected by choice of the individual section authors. They may represent the author’s opinion based on experience rather than pure evidence from technical literature about the topic. We believe that despite tremendous advances in the scientifi c appli- cation of medical knowledge, clinical experience, refl ected in the practitioner’s art, remains a vital dynamic in the complete care of a patient. Highland Park, IL Eli D. Ehrenpreis, MD Kfar-Saba, Israel Shmuel Avital, MD Evanston, IL Marc Singer, MD vii Introduction Anorectal disorders are among the most common problems encountered in primary care practice. These maladies include a wide array of benign and malignant conditions effecting patients of all ages spanning the pediatric to the geriatric groups. Patients frequently present to their primary care provider with such diverse disor- ders such as fi stula and abscess, fi ssure and stenosis, anal and rectal carcinoma, condylomata acuminata and sexually transmitted diseases, and hemorrhoids. In addition, symptoms ranging from pruritis ani to painless rectal bleeding are cause for analysis by the primary care provider. Due to the prevalence of these problems the primary care provider and trainee require access to a comprehensive, clear, and concise volume to help them with the evaluation and management of these issues. There are a plethora of volumes available to assist the practitioner with the manage- ment of anorectal disorders. However, very few of these books are written from the point of view of a gastroenterologist. As surgeons we occasionally, or perhaps routinely, become myopically focused upon a myriad of surgical terminology, descriptions of methodology, and illustrations of techniques. Therefore, it was very refreshing for me to read some of the chapters in Dr. Ehrenpreis and his coeditors’ new book which offer an alternative gastroentero- logic perspective on anorectal disorders. The descriptive methods as well as the diagnostic and therapeutic modalities described will be very clinically relevant for the practicing internist, family practitioner, and gastroenterologist as well as the trainees in those areas. I am absolutely confi dent that this book will be a welcome additional to the clinical library of many primary care practitioners and trainees and as such I highly commend it to gastroenterologists, family practitioners, internists, and interns, residents, and fellows in those specialties who evaluate and manage patients with diseases of the anus and rectum. Given the frequency of such disor- ders, I can safely recommend this book to all of these practitioners and their respec- tive trainees. I congratulate Dr. Ehrenpreis, Dr. Singer, and Dr. Avital for having gathered this information and arranged and presented it in such an easy to follow manner. I am also honored that they have asked me to write this introduction. Weston, FL Steven D. Wexner , MD ix
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