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At least 19 recordsLinked to original sources

Haemorrhoids--objective measurement of proctoscopic appearances.

The proctoscopic diagnosis of haemorrhoids may be influenced by the surgeon's knowledge of the presence or absence of associated symptoms. In this study, an observer with no knowledge of the history, was used to check the surgeon's proctoscopic findings in 12 asymptomatic controls, and 24 symptomatic patients on 2 occasions, the latter group undergoing McGivney rubber band ligation. There was very good correlation between the findings of the surgeon and the observer, indicating a lack of 'historical bias'. The documentation method designed to allow this comparison proved sufficiently accurate and reproducible to enable a correlation between haemorrhoidal mass and symptoms. Relief of symptoms after treatment correlated well with an objective reduction in haemorrhoidal mass.

Adult

Diagnosis of rectal gonorrhoea by blind anorectal swabs compared with direct vision swabs taken via a proctoscope.

Eight hundred and twenty-three examinations were carried out on 662 homosexual patients. At each examination a blind anorectal swab and a rectal swab taken via a proctoscope were inoculated on to a culture plate. From a total of 100 gonococcal infections of the rectum 96 gave positive results from blind anorectal swabs and 99 from swabs taken via a proctoscope. Blind anorectal swabs proved to be a reliable method in the diagnosis of rectal gonorrhoea.

Gonorrhea

Human rectal mucosa: proctoscopic and morphological changes caused by laxatives.

To determine whether laxatives alter the proctoscopic and morphological appearances of the human rectum, 10 normal subjects were studied prospectively, and the following manipulations were assessed in a randomized, blinded manner: no treatment; oral mannitol to induce diarrhea; isotonic saline enema; Fleet's Phospho-Soda enema; and bisacodyl (Dulcolax), 10 mg, by enema or suppository. The rectal mucosa after mannitol-induced diarrhea, or after saline enema could not be distinguished from untreated rectum by proctoscopy, light microscopy, or scanning electron microscopy. Fleet's enema, and bisacodyl invariably changed proctoscopic appearances, and frequently altered light and scanning microscopic aspects. Both Fleet's enema and bisacodyl caused sloughing of surface epithelium. In addition, bisacodyl decreased the uptake of hematoxylin and eosin by crypt epithelial cells so that the affected cells had a partially erased appearance (16 of 25 biopsies examined by light microscopy). The lamina propria of 3 of these 25 biopsies contained polymorphonuclear cells. Transmission electron microscopy revealed that the abnormal crypt epithelial cells contained fewer cytoplasmic organelles and less nuclear chromatin. All lesions resolved within 7 days. Fleet's enema and bisacodyl by rectum may mislead the proctologist and the pathologist by altering normal rectal mucosa.

Bisacodyl

Depth of colorectal biopsies with proctoscopic forceps.

It has been suggested that a barium enema may safely follow a colorectal biopsy superficial to the muscularis propria within 24 hours, but that the colon radiograph should be postponed 3 to 7 days following a biopsy including this layer. The authors prospectively studied 67 colorectal biopsies obtained with the Wolf 3-mm (grasping) and 5-mm (cutting) proctoscopic forceps from 49 patients to determine the depth of the biopsies. The 5-mm biopsies were not significantly deeper than the 3-mm biopsies (p greater than 0.5). In 18 patients biopsied with each instrument, the 3-mm biopsy was deeper in two cases (11%), the 5-mm biopsy was deeper in three cases (17%), and the biopsies were of equal depth in 13 cases (72%). None of the biopsies with either forceps reached the muscularis propria. The authors concluded that it may be unnecessary to wait longer than 24 hours before performing a barium enema after colorectal biopsy with these forceps.

Barium Sulfate

[Proctoscopic Doppler sonography in hemorrhoidal hemorrhage--vascular diagnosis and therapy follow-up].

Painless bright red peranal bleeding is a leading symptom of first and second degree hemorrhoid. After having excluded the possibility of bleeding in an upper region diagnosis is made proctoscopically, which is generally followed by injection therapy. Arterial blood supply can be reliably imaged with the aid of 20 MHz microvascular Doppler sonography and the success of therapy can be verified as well as documented after injecting a sclerosing substance.

Adult

[Proctoscopic versus histologic diagnosis of rectal polyps].

On the basis of the endoscopic appearance, 71 rectal polyps were assessed as adenomata or non-neoplastic polyps, after which the endoscopic diagnosis was compared with the results of histological examination. The diagnosis based on macroscopic examination of the polyps proved correct in only 62% of the cases. It is concluded that the diagnosis of adenoma cannot be established solely on the proctoscopic appearance of a polyp and, as adenomata are premalignant, removal of all polyps found at proctoscopy is recommended.

Adenoma