J-pouch
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J-pouch
In medicine, the ileal pouch–anal anastomosis (IPAA), also known as restorative proctocolectomy (RPC), ileal-anal reservoir (IAR), an ileo-anal pouch, ileal-anal pullthrough, or sometimes referred to as a J-pouch, S-pouch, W-pouch, or a pelvic pouch, is an anastomosis of a reservoir pouch made from ileum (small intestine) to the anus, bypassing the former site of the colon in cases where the colon and rectum have been removed. The pouch retains and restores functionality of the anus, with stools passed under voluntary control of the person, preventing fecal incontinence and serving as an alternative to a total proctocolectomy with ileostomy. During a total proctocolectomy, a surgeon removes a person's diseased colon, rectum, and anus. For the ileostomy, the end of the small intestine is brought to the surface of the body through an opening in the abdominal wall for waste to be removed. People with ileostomies wear an external bag, also known as an ostomy system or stoma appl ...
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Ileostomy
Ileostomy is a stoma (surgical opening) constructed by bringing the end or loop of small intestine (the ileum) out onto the surface of the skin, or the surgical procedure which creates this opening. Intestinal waste passes out of the ileostomy and is collected in an external ostomy system which is placed next to the opening. Ileostomies are usually sited above the groin on the right hand side of the abdomen. Uses Ileostomies are necessary where injury or a surgical response to disease has meant the large intestine cannot safely process waste, typically because the colon and rectum have been partially or wholly removed. Diseases of the large intestine which may require surgical removal include Crohn's disease, ulcerative colitis, familial adenomatous polyposis, and total colonic Hirschsprung's disease.''Ileostomy Guide''< ...
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Professor John Nicholls
Ralph John Nicholls, FRCS (Eng), EBSQ is a retired British colorectal surgeon, Emeritus Consultant Surgeon at St Mark’s Hospital London and Professor of Colorectal Surgery, Imperial College London. R. John Nicholls is best known for his work in the development of ileal pouch surgery. With the advancement of ileal-anal pouch surgery, selected patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP) were successfully relieved of the disease through removing the colon and rectum, but in contrast to the conventional operation of a total proctocolectomy used at the time, ileal pouch-anal anastomosis (IPAA) surgery also called Reconstructive Procotocolectomy (RPC) added the optional choice for the person to avoid the need for a stoma and external appliance bag by internally holding stool in a pouch made from ileum (small bowel) that connects to the anus and restores traditional anal evacuation. The drive behind creating and developing ileo-anal pouch surgery ...
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Alan Parks
Sir Alan Guyatt Parks (19 December 1920 – 3 November 1982) was a British colorectal surgeon, who served as president of the Royal College of Surgeons. Early life and education Parks attended Sutton High School and later Epsom College (1935–1940) on a scholarship. He became president of the Oxford University Athletic Club while playing rugby during his bachelors studies. He graduated from Brasenose College, Oxford in 1943 after four years of study. Parks then became one of few people chosen as a Rockefeller student at Johns Hopkins University for medical training. He graduated with his medical doctorate (MD) from Johns Hopkins in 1947 and returned to Guy's Hospital in London the same year. Career At Guy's Hospital, Parks was a house physician and research assistant for two years. He then spent two years with the Royal Army Medical Corps (RAMC) as a surgeon with deployments in Asia including Japan and Korea. Upon returning to London, Parks became a resident surgical ...
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Nils Kock
Nils G. Kock (January 29, 1924 – August 24, 2011) was a professor of surgery who taught and practiced at the University of Gothenburg, Gothenburg, Sweden. Kock was noted for his research, experimentation, and colorectal surgical techniques. These led to his breakthrough development of the Kock pouch, used for people who require excretory stomas. Personal life and education Kock was born in Jakobstad, Finland in 1924. Following military service in the Finnish Army during World War II, he attended the University of Helsinki Medical School, and graduated in 1951.''Nils G. Kock''
Classic Article; foreword by Corman, Marvin L., M.D.; March 1994; Springer (web); Volume 37, Issue 3; excerpt from "Diseases of the Colon & Rectum"; Chapter: Intra-abdominal 'Reservoir' in Patients With Permanent Ileostomy; Pp. 278–279.
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Medicine
Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Contemporary medicine applies biomedical sciences, biomedical research, genetics, and medical technology to diagnose, treat, and prevent injury and disease, typically through pharmaceuticals or surgery, but also through therapies as diverse as psychotherapy, external splints and traction, medical devices, biologics, and ionizing radiation, amongst others. Medicine has been practiced since prehistoric times, and for most of this time it was an art (an area of skill and knowledge), frequently having connections to the religious and philosophical beliefs of local culture. For example, a medicine man would apply herbs and say prayers for healing, o ...
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Reconstructive Surgery
Reconstructive surgery is surgery performed to restore normal appearance and function to body parts malformed by a disease or medical condition. Description Reconstructive surgery is a term with training, clinical, and reimbursement implications. It has historically been referred to as synonymous with plastic surgery. In regard to training, Plastic Surgery is a recognized medical specialty and a surgeon can be a "board-certified" plastic surgeon by the American Board of Plastic Surgery. However, reconstructive surgery is not a specialty and there are no board-certified reconstructive surgeons. More accurately, reconstructive surgery should be contrasted with cosmetic surgery. Reconstructive surgery is performed to # Improve/restore to normal function. # Restore to a normal appearance of "abnormal" or "malformed" body parts caused by the disease or condition and/or # Improve the patient's quality of life. Separately, the patient must be healthy enough so that the benefits ...
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Curative Care
Curative care or curative medicine is the health care given for medical conditions where a cure is considered achievable, or even possibly so, and directed to this end. Curative care differs from preventive care, which aims at preventing the appearance of diseases through pharmaceuticals and such techniques as immunization, exercise, proper eating habits and other life style issues, and from palliative care, which concentrates on reducing the severity of symptoms, such as pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, .... References Clinical medicine {{treatment-stub ...
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Elective Surgery
Elective surgery or elective procedure (from the la, eligere, meaning to choose) is surgery that is scheduled in advance because it does not involve a medical emergency. Semi-elective surgery is a surgery that must be done to preserve the patient's life, but does not need to be performed immediately. By contrast, an urgent surgery is one that can wait until the patient is medically stable, but should generally be done within 2 days, and an emergency surgery is one that must be performed without delay; the patient has no choice other than immediate surgery if permanent disability or death is to be avoided. Types Most surgeries necessary for medical reasons are elective, that is, scheduled at a time to suit the surgeon, hospital, and patient. These include inguinal hernia surgery, cataract surgery, mastectomy for breast cancer, and the donation of a kidney by a living donor. Elective surgeries include all optional surgeries performed for non-medical reasons. This includes cosmet ...
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Ulcerative Colitis
Ulcerative colitis (UC) is a long-term condition that results in inflammation and ulcers of the colon and rectum. The primary symptoms of active disease are abdominal pain and diarrhea mixed with blood (hematochezia). Weight loss, fever, and anemia may also occur. Often, symptoms come on slowly and can range from mild to severe. Symptoms typically occur intermittently with periods of no symptoms between flares. Complications may include abnormal dilation of the colon (megacolon), inflammation of the eye, joints, or liver, and colon cancer. The cause of UC is unknown. Theories involve immune system dysfunction, genetics, changes in the normal gut bacteria, and environmental factors. Rates tend to be higher in the developed world with some proposing this to be the result of less exposure to intestinal infections, or to a Western diet and lifestyle. The removal of the appendix at an early age may be protective. Diagnosis is typically by colonoscopy with tissue biopsies. It is ...
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Familial Adenomatous Polyposis
Familial adenomatous polyposis (FAP) is an autosomal dominant inherited condition in which numerous Adenomatous polyps, adenomatous Colorectal polyp, polyps form mainly in the epithelium of the colon (anatomy), large intestine. While these polyps start out benign, malignant transformation into colorectal cancer, colon cancer occurs when they are left untreated. Three variants are known to exist, FAP and attenuated FAP (originally called hereditary flat adenoma syndrome) are caused by APC gene defects on chromosome 5 while autosomal recessive FAP (or MUTYH-associated polyposis) is caused by defects in the ''MUTYH'' gene on chromosome 1. Of the three, FAP itself is the most severe and most common; although for all three, the resulting colonic polyps and cancers are initially confined to the colon wall. Detection and removal before metastasis outside the colon can greatly reduce and in many cases eliminate the spread of cancer. The root cause of FAP is understood to be a genetic mutati ...
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Toxic Megacolon
Toxic megacolon is an acute form of colonic distension. It is characterized by a very dilated colon (megacolon), accompanied by abdominal distension (bloating), and sometimes fever, abdominal pain, or shock. Toxic megacolon is usually a complication of inflammatory bowel disease, such as ulcerative colitis and, more rarely, Crohn's disease, and of some infections of the colon, including '' Clostridium difficile'' infections, which have led to pseudomembranous colitis. Other forms of megacolon exist and can be congenital (present since birth, such as Hirschsprung's disease). It can also be caused by ''Entamoeba histolytica'' and ''Shigella''. It may also be caused by the use of loperamide. Signs and symptoms * Abdominal pain * Abdominal bloating * Abdominal tenderness * Fever * Tachycardia (rapid heart rate) * Dehydration There may be signs of septic shock. A physical examination reveals abdominal tenderness and possible loss of bowel sounds. An abdominal radiography shows coloni ...
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Immune-mediated Inflammatory Diseases
An immune-mediated inflammatory disease (IMID) is any of a group of conditions or diseases that lack a definitive etiology, but which are characterized by common inflammatory pathways leading to inflammation, and which may result from, or be triggered by, a dysregulation of the normal immune response. All IMIDs can cause end organ damage, and are associated with increased morbidity and/or mortality. Inflammation is an important and growing area of biomedical research and health care because inflammation mediates and is the primary driver of many medical disorders and autoimmune diseases, including ankylosing spondylitis, psoriasis, psoriatic arthritis, Behçet's disease, arthritis, inflammatory bowel disease (IBD), and allergy, as well as many cardiovascular, neuromuscular, and infectious diseases. Some current research even suggests that aging is a consequence, in part, of inflammatory processes. Characterization IMID is characterized by immune disregulation, and one underlyi ...
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