Affections of rectum: prolapse, rectal tear, anal adenitis.

Congenital anomalies of colon, rectum, anus.

RECTAL PROLPSE
Commonly seen in young, heavily parasitic infested
animals although any breed, sex or age can be affected.
Etiology: inadequate tone of the sphincter and or a high
pressure gradient can result in eversion of mucosa.
Further irritation of mucosa may occur due to exposure
with environment and leads to complete prolapse of
rectum.

Predisposing factor:
Diarrhoea, tenesmus or increased intra abdominal
pressure due to bloat, rectal examination, act of
parturition, excessive coughing, colitis and cystitis.
Straining caused by rectal polyps, neoplasia foreign
bodies, constipation, perineal hernia, congenital
defects and prostatic disease
Clinical signs:
1. a mucosal mass is protruding beyond the anus
with a
variable amount of oedema,
inflammation and necrosis.
2. In earley stages of prolapse, the mass is bright
red and
non-nucleated but in chronic stages, it
is either red or
blackish in color with ulcerated
or necrotic.

Diagnosis:
1. Clinical signs
2. Inability to pass a blunt probe or fingure
between the
rectal wall and prolapsed
tissue.
Treatment:
1. elimination of predisposing causes
2. soothing of thee irritated mucosa
3. elimination of straining
4. resolving the prolapse
Epidural anesthesia will temporarily eliminate
straining, facilitate repositioning and allow
surgical intervention

1. Reducible prolapse can be treated with a purse-string

suture around the anus tied loosely enough to allow
passage of soft stools
2. Recurrent prolapse can be treated with submucosal
resection, amputation and colopexy
3. Necrotic, friable, severely edematous prolapses should be
treated by amputation and rectal anastamosis.
4. Extensive prolapse needs abdominal ventropexy
(colopexy)

RECTAL TEAR
Occur primarily due to trauma secondary to
penetrating foreign bodies and pelvic fractures
There may be tearing of all the layers of rectum
(mucosa, submucosa, muscularis) and sometimes
extend into the peritoneal cavity.

Diagnosis: Presence fresh blood in the rectum

Abdominal radiograph: presence of free gas in
abdomen or
gas within perirectal soft tissue.
Prognosis:
Grave when diagnosis and treatment are delayed or
when septicemia is present

TREATMENT:
1. Immediate exploratory laperotomy surgery and closure of the
tearing rectum via an abdominal, perineal and anal approach.
2. Before surgery, epidural anesthesia is indicated which relaxes
rectum and anal sphincter and facilitates careful examination

ANAL ADENITIS
Anal sacs (modified sebaceous gland) are located at approximately
4 and 8 oclock positions around the anus.
The secretion of this gland is accumulated due to the closure of
their orifices and lead to inflammation

Clinical signs:
Rubbing of the anus on the floor , tail biting, tenesmus,
diarrhoea, and feeling of pain.
The gland may sometime swollen, bluish, fluctuating and
contain pus which may burst if not treated in time and produce anal
fistula.

TREATMENT:
Evacuate the contents of the gland and subsequent injection of an
irritant solution or infusion of antibiotic
Anal sacculectomy:
1. Closed technique: removal of anal sac can be facilitated by
packing with string, latex melted wax or acrylic
2. Open technique: an incision is made on the caudal wall of
the anal sac and duct and overlying tissue by inserting a
scissor blade into the duct.
The sac and the duct are removed with blunt dissection
the wound is either sutured or left open ot heal by
second
intension

and

CONGENITAL ANOMALIES OF COLON

(Congenital Atresia, Agenesis, Duplication, and Ectasia)

Colonic atresia seen in cats and dogs,

Congenital atresia occurs when areas of the intestine fail to
vascularize or vessels degenerate early in development.
Diagnosis:
Abdominal distention and absence of defecation.
Gross distention of abdomen and intestinal loops is seen
radiographically.
Feces is impacted in small intestine.
Confirmed: Barium enema or at exploratory laparotomy.
Treatment: Euthanized.

 Agenesis of the cecum and the ascending and transverse

colon in cats

Short colon," representing agenesis of the ascending and

transverse colon, seen in cats and dog.

The large intestine was patent in all of these animals,

and clinical signs improved in all cases with symptomatic
treatment
Duplication of the colon and rectum is seen in dogs.

VASCULAR ECTASIA OF THE SMALL INTESTINE,

DESCENDING COLON, RECTUM, AND ANUS

Associated with severe rectal bleeding. This is probably congenital

based on the age. Vascular ectasia is seen in older patients.

Clinical signs: Intermittent hemorrhage from the anus varying

from a coating on the feces to profuse bleeding & markedly anemia.
Diagnosis: Clinical signs, and proctoscopy, biopsy, and radionuclide
scanning with Technetium-labeled red blood cells.
Therapy for in humans includes conservative treatment with blood
transfusions, endoscopic ablation techniques, and surgical
resection.

CONGENITAL MEGACOLON
Results from a congenital absence of the inhibitory neurons in
Meissner's submucosal plexus and Auerbach's myenteric plexus
in the distal colon or rectum.
The aganglionic intestinal segment is spastically contracted, and
the colon proximal to this functional obstruction becomes dilated
and hypertrophied.
The diagnosis: confirmed by manometry(evaluation of
pressure, eg. Esophageal motility study , Anorectal
manometry , Rhinomanometry etc) and biopsy of the
affected intestinal segment.

 Aganglionosis in colonic tissues from cats

with megacolon, and myenteric ganglia
were absent from the distal end of colon
resected from cat.

Treatement: Removal of aganglionic

segment in a one- or two-stage pull-through
procedure.

ATRESIA ANI
Congenital abnormality, common in calves, lambs and kids
Characterized by absence of anus, fistula formation between rectum
and reproductive tract and abnormalities of urinary tract.
Clinical signs: unable to pass feces except in females with
rectovaginal fistula that passes feces through the fistula
Abdominal distension, straining, abdominal pain, depression and
weakness.

 If only the rectum involved, the rectum bulges subcutaneously

in the normal region of anus during straining and when
manually compressed.
If no bulge is observed atresia of the posterior rectum is
suspected.
Diagnosis: physical examination, radiography, and
ultrasonography

Surgical correction:
1. A circular incision of 1-2cm diameter is made through
the skin and subcutaneous tissue at the site where the
anus would normally be located.
2. Blunt dissection
3. Rectal pouch is gently pulled

4. The rectum is sutured to subcutaneous tissue

5. Rectal pouch is incised and mucosa is sutured to the skin
6. Rectovaoginal fistula is repaired if present before suturing
the rectum to the perineal skin
Fecal incontinence is frequent complication

Atresia ani-et-recti et-coli

Atresia ani-et-recti: incomplete development of anus and rectum
where there is incomplete absence of a portion of colon (mid
spiral loop of the ascending part) in conjunction with the atresia
ani-et-recti, the condition is termed as atresia ani-et-recti et-coli
Symptoms: Cessation of the milk intake, no feces, colic, increased
intra abdominal distention, bulges in the right flank, and slow
deterioration of the general condition.

Treatment
1. Rehydration, acid base balance & antibiotics
2. Remove gas and ingesta proximal to blind end of
colon
3. Continuity is established to the descending colon
by end to side anastomosis

RECTO VAGINAL FISTULA

Seen in calves with atresia of anus and in adult cows secondary to
dystocia
During parturition, the forefoot of a calf typically perforates the
dorsal aspect of the vestibule and enters the rectum
Treatment:
Smaller defect is reduced markedly s a result of wound
contraction and heal completely with the passage of time
Large and deep fistulae requires surgical repair (forsells
opertion)

TECHNIQUE

In adult cows : reconstruction of the defect

Make an incision between the anus and vagina
Explore the fistula
Repair the tear in the rectum and dorsal wall of vagina
Congenital with atresia ani:
Make plus type of incision at the site of natural opening
of the anus
With a blind dissection identify the rectum
Pull the rectum to the level of skin and suture to the skin

Complication: Fecal incontinence due to lack of anal

sphincter