Inferior Mesenteric Artery
10 results
1 - 10
Malignancy- A 64-year-old man with a midrectal cancer undergoes neoadjuvant therapy and subsequent total mesorectal excision with anastomosis. After surgery, he complains of urge urinary incontinence and retrograde ejaculation. Which of the following aspects of the operative procedure are responsible for his postoperative symptoms?
- An obese 55-year-old man underwent proctectomy with coloanal anastomosis for a distal locally advanced rectal tumor. He developed impotence and urinary retention after surgery. At which point in the dissection did this injury likely occur?
- A 65-year-old man undergoes low anterior resection for an anterior rectal cancer requiring excision of Denonvilliers fascia as a component of the surgical margin. He develops erectile dysfunction postoperatively. Which nerves were most likely to have been damaged during the course of dissection?
- A 55-year-old man undergoes low anterior resection with primary anastomosis for a T2N0 rectal cancer located 9 cm from the anal verge. The splenic flexure was mobilized, the inferior mesenteric artery was divided distal to the take-off of the left colic artery, followed by total mesorectal excision. His recovery is uneventful. He returns to the clinic 3 months after surgery describing normal erections, but he is unable to ejaculate. At which step of the operation is nerve damage most likely to have occurred?
- Anorectal Disease
- Benign Disease
- A 37-year-old man with a history of ulcerative colitis develops toxic megacolon. Which maneuver is recommended at the time of emergent total colectomy with ileostomy to increase the likelihood of success of a future ileoanal pouch creation?
- A 72-year-old woman is admitted to the medical intensive care unit with congestive heart failure and hypotension. You are consulted for sudden onset of crampy abdominal pain and bloody diarrhea. On examination, she has mild abdominal tenderness. What is the best initial step in management?
- You are asked to evaluate a 63-year-old woman with rectal bleeding 2 days after she underwent endovascular abdominal aortic aneurysm repair. What is your next best diagnostic step?
- Perioperative
- A 55-year-old woman undergoes a sigmoid colectomy with primary anastomosis. Which factor increases the risk for an anastomotic leak?
- While performing a low-anterior resection for rectal cancer, you identify a transection of the left ureter in the region of the lateral rectal ligament. What is the best method to repair this injury?