1 Surgery of the anorectum Surgery of the anorectum and the perianal region in and the perianal region in small animals small animals Surgery of the anorectum Surgery of the anorectum and the perianal region in and the perianal region in small animals small animals Dr. T. Németh, Dr. T. Németh, DVM, PhD, DipECVS DVM, PhD, DipECVS Associate Professor and Head of Surgery Associate Professor and Head of Surgery Dr. T. Németh, Dr. T. Németh, DVM, PhD, DipECVS DVM, PhD, DipECVS Associate Professor and Head of Surgery Associate Professor and Head of Surgery Surgical Surgical anatomy anatomy (Anorectum Anorectum) Surgical Surgical anatomy anatomy (Anorectum Anorectum) Zona cutanea Zona cutanea – Circumanal glands Circumanal glands – Anal sacs Anal sacs Zona intermedia Zona intermedia Zona columnaris Zona columnaris Linea anorectalis Linea anorectalis Surgical anatomy Surgical anatomy (Perineum) (Perineum) m. coccygeus m. coccygeus m. levator ani m. levator ani m. sphincter ani ext. m. sphincter ani ext. m. sphincter ani int. m. sphincter ani int. m. obturatorius int. m. obturatorius int. a., v. pudenda int. a., v. pudenda int. n. pudendus n. pudendus General diagnostic considerations of General diagnostic considerations of the anorectal and perianal diseases I. the anorectal and perianal diseases I. Anamnesis Anamnesis – generally chronic history generally chronic history – tenesmus in defecation tenesmus in defecation – fecal deviation fecal deviation – local signs local signs (pruritus, formal deviation…) (pruritus, formal deviation…) – General signs General signs (alimentary, septicus…) (alimentary, septicus…) General diagnostic considerations of General diagnostic considerations of the anorectal and perianal diseases II. the anorectal and perianal diseases II. Physical examination Physical examination – inspection inspection – palpation palpation superficial superficial rectal (RDP) rectal (RDP)
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Surgery of the anorectum Surgery of the anorectum and the perianal region in and the perianal region in
small animalssmall animals
Surgery of the anorectum Surgery of the anorectum and the perianal region in and the perianal region in
small animalssmall animals
Dr. T. Németh, Dr. T. Németh, DVM, PhD, DipECVSDVM, PhD, DipECVS
Associate Professor and Head of SurgeryAssociate Professor and Head of Surgery
Dr. T. Németh, Dr. T. Németh, DVM, PhD, DipECVSDVM, PhD, DipECVS
Associate Professor and Head of SurgeryAssociate Professor and Head of Surgery
m. coccygeusm. coccygeus m. levator anim. levator ani m. sphincter ani ext.m. sphincter ani ext. m. sphincter ani int.m. sphincter ani int. m. obturatorius int.m. obturatorius int. a., v. pudenda int.a., v. pudenda int. n. pudendusn. pudendus
General diagnostic considerations of General diagnostic considerations of the anorectal and perianal diseases I.the anorectal and perianal diseases I.
AnamnesisAnamnesis–– generally chronic historygenerally chronic history–– tenesmus in defecationtenesmus in defecation–– fecal deviationfecal deviation–– local signs local signs (pruritus, formal deviation…)(pruritus, formal deviation…)
–– General signs General signs (alimentary, septicus…)(alimentary, septicus…)
General diagnostic considerations of General diagnostic considerations of the anorectal and perianal diseases II.the anorectal and perianal diseases II.
Conservative therapyConservative therapy–– precise evacuation of the sac (rectally!!!)precise evacuation of the sac (rectally!!!)–– parenteral antibioticsparenteral antibiotics
–– uncertainuncertain aetiologyaetiology:: immuneimmune--mediatedmediated ((autoimmuneautoimmune)) DecreasedDecreased activityactivity of of mucosalmucosal and and circulatingcirculating IgAIgA hyperaktívhyperaktív local local immuniyimmuniy ((IgAIgA, , IgGIgG, , BB--andand TT--lymphocyteslymphocytes, ,
CD3+, CD3+, macrophagesmacrophages, , plasmaplasma cellscells, IL, IL--2, INF2, INF--))