tailieunhanh - Anal and rectal diseases explained - part 2

Đo áp lực hậu môn trực tràng được sử dụng rộng rãi để chẩn đoán các bất thường chức năng hậu môn trực tràng. Xét nghiệm này sử dụng một ống thông nhạy cảm với áp lực kết nối với đầu dò. Thiết bị ống thông được đưa vào hậu môn và hậu môn áp lực được đo trong suốt chiều dài của ống hậu môn | Chapter Anorectal manometry Description of procedure Anorectal manometry is widely used to diagnose abnormalities of anorectal function. This test employs a pressure-sensitive catheter connected to a transducer. The catheter device is inserted into the anus and anal pressure is measured throughout the length of the anal canal. The transducer translates the mechanical pressures into an electrical signal which is converted to a computerized readout and used to interpret the data obtained. Indications Chronic constipation fecal incontinence documentation of the presence or absence of rectoanal inhibitory reflex RAIR for the diagnosis of Hirschsprung s disease see Figure 1 and preoperative use prior to ileoanal pouch or colorectal anastomosis. Anorectal manometr y can also be used as an adjunctive tool for performance of anorectal biofeedback. Complementary procedures Dynamic proctography anorectal electromyography EMG and pudendal nerve terminal motor latency study PNTML flexible sigmoidoscopy full-thickness biopsy of the rectum for diagnosis of Hirschsprung s disease and anorectal ultrasound. Normal Rectum External Sphincter Internal Sphincter Figure 1 absent in Hirschsprung s Disease and 15 Chapter 2 Contraindications Anal obstruction. Relative contraindications Severe anal pain and anal stricture. Preparation of patient The patient should receive one or two sodium phosphate enemas several hours prior to examination. You should also talk with them prior to the procedure to answer any concerns they may have so that they are relaxed and cooperative when the procedure begins. How the procedure is performed The patient is placed in a left lateral position with flexion of the knees and hips and proper draping for adequate modesty. Pressure-sensitive catheters balloon system water perfusion system or solid-state microtransducer system are gently placed in the anal canal following calibration of the manometer. The pressure is measured through eight .