Difference between revisions of "Rectum"

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[[Image: Rectum - lateral view.jpg |thumb| right |[[Abdominoperineal_resection_grossing|Abdominoperineal resection specimen]] showing the rectum.]]
The '''rectum''' is part of the distal part of the gastrointestinal tract; it is between the sigmoid [[colon]] and anus.
The '''rectum''' is part of the distal part of the gastrointestinal tract; it is between the sigmoid [[colon]] and anus.


==Definition==
==Definition==
[[Image: Rectum - lateral view.jpg |thumb| right |[[Abdominoperineal_resection_grossing|Abdominoperineal resection specimen]] showing the rectum.]]
Pathologists generally agree that: the rectum starts/the sigmoid ends at the place where serosa ends on the posterior aspect of the bowel.  
 
Pathologist generally agree that: the rectum starts/sigmoid ends at the place where serosa ends on the posterior aspect of the bowel.  
In other words, the ''peritoneal reflection'' is the landmark that separates the sigmoid colon and rectum.
In other words, the ''peritoneal reflection'' is the landmark that separates the sigmoid colon and rectum.


===Notes on the definition===
===Notes on the definition===
*On a practical level, the definition is not easy to apply from the lumen, i.e. the definition is not practical in the endoscopic context.  
*On a practical level, the (anatomic/pathologic) definition is not easy to apply from the lumen, i.e. the definition is not practical in the endoscopic context.  
*Thus, there are several definitions for the rectum.<ref>{{cite journal |authors=Massalou D, Moszkowicz D, Mariage D, Baqué P, Camuzard O, Bronsard N |title=Is it possible to give a single definition of the rectosigmoid junction? |journal=Surg Radiol Anat |volume=40 |issue=4 |pages=431–438 |date=April 2018 |pmid=29218384 |doi=10.1007/s00276-017-1954-4 |url=}}</ref>
*There are several definitions for the rectum.<ref>{{cite journal |authors=Massalou D, Moszkowicz D, Mariage D, Baqué P, Camuzard O, Bronsard N |title=Is it possible to give a single definition of the rectosigmoid junction? |journal=Surg Radiol Anat |volume=40 |issue=4 |pages=431–438 |date=April 2018 |pmid=29218384 |doi=10.1007/s00276-017-1954-4 |url=}}</ref><ref name=pmid24130630>{{Cite journal  | last1 = Kenig | first1 = J. | last2 = Richter | first2 = P. | title = Definition of the rectum and level of the peritoneal reflection - still a matter of debate? | journal = Wideochir Inne Tech Maloinwazyjne | volume = 8 | issue = 3 | pages = 183-6 | month = Sep | year = 2013 | doi = 10.5114/wiitm.2011.34205 | PMID = 24130630 }}</ref>
**In a survey of surgeons:<ref name=pmid24130630>{{Cite journal  | last1 = Kenig | first1 = J. | last2 = Richter | first2 = P. | title = Definition of the rectum and level of the peritoneal reflection - still a matter of debate? | journal = Wideochir Inne Tech Maloinwazyjne | volume = 8 | issue = 3 | pages = 183-6 | month = Sep | year = 2013 | doi = 10.5114/wiitm.2011.34205 | PMID = 24130630 }}</ref>
**This is likely due to the above practical issue.
 
Note:
*In a survey of surgeons:<ref name=pmid24130630/>
**67% defined it by an anatomical landmark  
**67% defined it by an anatomical landmark  
***35% of all respondants considered the peritoneal reflection the proximal boundary of the rectum.
***35% of all respondents considered the peritoneal reflection the proximal boundary of the rectum.
**30% defined the proximal boundary as a distance from the anal verge.
**30% defined the proximal boundary as a distance from the anal verge.


==See also==
==See also==
*[[Colon]].
*[[Colon]].
*[[Lower anterior resection]].
*[[Abdominoperineal resection]].


==References==
==References==

Latest revision as of 15:00, 5 October 2023

The rectum is part of the distal part of the gastrointestinal tract; it is between the sigmoid colon and anus.

Definition

Pathologists generally agree that: the rectum starts/the sigmoid ends at the place where serosa ends on the posterior aspect of the bowel. In other words, the peritoneal reflection is the landmark that separates the sigmoid colon and rectum.

Notes on the definition

  • On a practical level, the (anatomic/pathologic) definition is not easy to apply from the lumen, i.e. the definition is not practical in the endoscopic context.
  • There are several definitions for the rectum.[1][2]
    • This is likely due to the above practical issue.

Note:

  • In a survey of surgeons:[2]
    • 67% defined it by an anatomical landmark
      • 35% of all respondents considered the peritoneal reflection the proximal boundary of the rectum.
    • 30% defined the proximal boundary as a distance from the anal verge.

See also

References

  1. Massalou D, Moszkowicz D, Mariage D, Baqué P, Camuzard O, Bronsard N (April 2018). "Is it possible to give a single definition of the rectosigmoid junction?". Surg Radiol Anat 40 (4): 431–438. doi:10.1007/s00276-017-1954-4. PMID 29218384.
  2. 2.0 2.1 Kenig, J.; Richter, P. (Sep 2013). "Definition of the rectum and level of the peritoneal reflection - still a matter of debate?". Wideochir Inne Tech Maloinwazyjne 8 (3): 183-6. doi:10.5114/wiitm.2011.34205. PMID 24130630.