Colorectal Surgery. Living Pathology in the Operating Room

About this atlas

From the Foreword

"The experienced surgeon will appreciate this book by recognizing the details and exquisitely rendered images that call to mind similar cases encountered. For the surgeon or trainee relatively new to the practice of colorectal surgery, the graphic presentation of the surgical pathology, with the accompanying succinct and informative text, will make the acquisition of this book a worthwhile one." - Victor Fazio, M.D. and Stanley Goldberg, M.D.

As Lord Moynihan frequently mentioned in his legendary lectures, surgeons have the unique opportunity to study pathology in vivo, or in a living state. The pathology is seen in relation to normal anatomy, leading to important surgical judgments that ensure only diseased tissue will be removed, and with minimal damage or sacrifice to normal structures. In addition to influencing surgical design making, observation of living pathology offers a glimpse into the disease process and provides a valuable assessment of the morphological features of the specimen before it is preserved with formalin.

Colorectal Surgery: Living Pathology in the Operating Room is a unique collection of beautifully illustrated cases focusing on the pathology as much as the operative technique used to remove the diseased tissue. One hundred case reports describe unusual findings, or unusual manifestations of more common conditions, encountered by the author during his 40-plus years in practice as a colorectal surgeon. All of the drawings in the book were sketched immediately after the procedures in order to capture the details and significance of the specimen. As finished drawings, Dr. Killingback’s beautiful images increase the reader’s conceptual knowledge of surgical pathology and how it presents. Accompanying text, photos, and diagnostic studies provide the details of patient management and shed further light on the intrinsic art and science of interpreting living pathology, making this a must-have resource for colorectal surgeons and residents as well as general surgeons and surgical pathologists.

Written for: Colorectal surgeons, pathologists, proctologists, and general surgeons

Keywords:

• colorectal pathology
• colorectal surgery
• surgical atlas
• surgical case studies

Table of contents

SMALL BOWEL: Lipoma: Terminal Ileum.- The Intruding Carcinoid.- Carcinoidosis of the Ileum.- GIST of the Ileum.- Adenocarcinoma of the Jejunum.- Blind Pouch Syndrome.- Blind Pouch Syndrome after Ileorectal Anastomosis.- APPENDIX: Appendicitis: Diagnosis at Colonoscopy.- Mucocele of the Appendix.- Cystadenoma: Appendix.- Carcinoma of the Appendix.-

POLYPS-POLYPOSIS: A Mega Polyp Associated with a Micro Cancer.- Extensive "Benign" Polyp of the Rectum and Sigmoid Colon.- A Bad Result from a Successful Operation for a Polyp in the Sigmoid Colon.- One Operation for Double Pathology.- Juvenile Polyposis and Rectal Prolapse.- Juvenile Polyposis in an Adult.- Chronic Intussusception of the Colon due to Peutz-Jeghers Syndrome.- Carcinoma of the Rectum:FAP and Rectovaginal Fistula.- Ileorectal Anastomosis for FAP: Rectal Cancer.- Large Bowel Lipomatosis.- A Polypoid Lesion in the Sigmoid Colon.-

CANCER OF THE COLON AND RECTUM: Synchronous Colon Carcinoma and Malignant Carcinoid.- Coexistent Cancer and Diverticulitis.- Sigmoid Carcinoma and Serosal Cysts.- Cavitating Cancer of the Transverse Colon.- The Wagging Tongue of a Sigmoid Cancer.- Protracted Recurrence of Mucoid Cancer.- Anaplastic Colon Cancer.- Linitis Plastica of the Colon and Rectum.- Curative Resection of Rectal Cancer Despite Liver Metastases.- Small Sigmoid Cancer: "Mega" Lymph Node Metastasis.- Rectal Cancer Infiltrating the Buttock via An Anal Fistula.- Lucky Local Recurrence.- Thoraco-abdominal Approach to Carcinoma of the Splenic Flexure.-

DIVERTICULAR DISEASE: Was It Diverticulitis.- Large Pseudopolyp of the Sigmoid Colon.- Which Operation for Acute Diverticulitis with Peritonitis.- Waiting to Die.- Distal Abscesses and Diverticular Disease.- Colo Perineal Fistula.- Diverticulitis: Extensive Abscess in the Mesorectum.- Diverticulitis: Colovesical Fistula.- Dissecting Diverticulitis.- Annular Extramural Dissecting Diverticulitis.- Giant Diverticulum.- Diverticulitis: Large Bowel Obstruction.-

INFLAMMATORY BOWEL DISEASE: Ulceration in Crohn’s Disease of the Small Bowel.- Recurrent Crohn’s Disease.- Crohn’s Disease: Strictures of Ascending Colon and Duodenum.- The Appendix, Fistulae and Pseudopolyps in Crohn’s Disease.- A "Shamrock" Deformity due to Crohn’s Disease.- A Short "Hose Pipe" Colon: Crohn’s Disease.- Recurrent Crohn’s Disease: Pseudopolyposis.- Presentation of Crohn’s Ileitis as an Abdominal Malignancy.- Crohn’s Disease 19 Years After Initial Resection.- Large Bowel Obstruction: Crohn’s Disease.- Subacute Toxic Megacolon due to Ulcerative Colitis.- Colitis and Pseudopolyposis.- Ileo-Rectal Anastomosis for Chronic Ulcerative Colitis: Early Diagnosis of Carcinoma: Late Diagnosis of Large Polyp.- Childhood Ulcerative Colitis: Rectal Cancer.- Obstructive Colitis.- Pseudomembranous Colitis and Toxic Megacolon.- Ileocaecal Tuberculosis Mimicking Crohn’s Disease or Vice Versa.-

LYMPHOMA: Burkitt’s Lymphoma (Ileum) with Intussusception.- Ileo-Caecal Lymphoma.- Multiple Lymphoma and Ulcerative Colitis.- Lymphoma of the Rectum.-

ANO RECTAL DISEASE: An Intrasphincteric Anal Tumour.- Aggressive Angiomyxoma of the Pelvis.- Implantation Metastasis into an Anal Fistula.- Local Excision of a Rectal Carcinoma can be an Easy Operation.- Proctitis Cystica Profunda.- Rectopexy for a Rectal Stricture.- Intersphincteric Anal Fistula with Proximal Perirectal Extension.- Necrotising Infection after Removal of "Benign" Rectal Polyp.-

VARIOUS PATHOLOGY: Intra-Abdominal Desmoid Unassociated with FAP.- Pneumatosis Coli.- Stercoral Ulceration: Sigmoid Perforation.- Non Gangrenous Ischaemic Colitis.- Infarction of the Omentum.- Metastatic Linitis Plastica of the Colon.- Lipoma Transverse Colon.- Intestinal Endometriosis.- Hirschsprung’s Disease.- Gallstone Obstruction: Sigmoid Colon.- Intussusception.-

COMPLICATIONS OF INVESTIGATION AND TREATMENT: Barium Perforation of the Rectum.- Colonoscopy Injury to the Colon.- Mesenteric Thrombosis after Colon Resection.- Postoperative Abdominal Apoplexy.- Local Excision of Rectal Cancer and Radiotherapy.- Residual Diverticulitis after Resection Causing an Elongated Abscess with a Prolongated Solution.- Perforated Diverticulitis and its Consequences.- Anastomotic Dehiscence after Anterior Resection.- Post Operative Necrosis of the Left Colon.- Ileostomy Closure: an Impasse due to Adhesions.- Perforation of the Sigmoid colon due to Radiation Injury.- Radiation Rectovaginal Fistula.