ABSTRACT
Rectal stenoses, often accompanied by a simple, non-specific symptomatology, have multiple and varied causes. The clinical picture is far from specific and can go from absolute latency to the full picture of a distinct colic occlusion. The clinical examination mainly relies on the data from the proctologic examination and, in particular, the rectal touch that enables detection of the lesion. This proctologic examination is completed with a uro-genital clinical check-up. The complementary endoscopic, X-ray and biological examinations are dominated by rectoscopy, barium enema and, if necessary, scanner, ultrasonography and anatomopathology. The etiological forms comprise stenoses by extrinsic compression; inflammatory or non-inflammatory pseudo-tumoral stenoses; inflammatory cryptogenetic (RCH, Crohn) or specific (infectious, parasitic and venereal) stenoses; ischaemic stenoses; traumatic stenoses by internal or external traumatism and medical iatrogenic, post-physiotherapeutic or post-surgical stenoses. The therapeutic problems depend on the type, age and size of the evolution as well as the cause (etiology) of the lesions. Depending on the case, we have to "make do with it", circumvent the problem, force or remove the obstacle.
Subject(s)
Rectal Diseases/diagnosis , Constriction, Pathologic/diagnosis , Constriction, Pathologic/etiology , Constriction, Pathologic/therapy , Humans , Iatrogenic Disease , Ischemia/complications , Ischemia/diagnosis , Proctitis/complications , Proctitis/diagnosis , Proctoscopy , Radiography , Rectal Diseases/etiology , Rectal Diseases/therapy , Rectum/blood supply , Rectum/diagnostic imaging , Rectum/injuries , Sexually Transmitted Diseases/complications , Sexually Transmitted Diseases/diagnosis , UltrasonographyABSTRACT
With regards to an observation of a solid tumor of the small "epiploon", the authors recall the exceptionnal character of the primitive small tumors of the "mesenterium". Such cases pose a histological problem because, when dealing with the "mesenterium", the various criteria for benignity or malignity are difficult to appraise due to the peculiar tissue structure. A pre-operative-selective "arteriogram" cannot be dispensed with this type of tumor. Outside of the diagnostic possibilities offered, this "arteriogram" will be the basis for the treatment given since the possibilities of removal are limited by the connection between the tumor and the vessels. Furthermore due to the histological difficulties posed by these tumors it is desirable to treat them as potentially malignant material and include the removal, even if limited, of the corresponding digestive segment.
