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Incontinence anale: bilan, indications thérapeutiques Laurent Abramowitz Unité de proctologie médico-chirurgicale Hôpital Bichat Claude Bernard Incontinence anale • Anatomie • Epidémiologie • Physiopathologie • Bilans • Traitements • Cas particulier (femmes enceintes…) Epidémiologie !Denis et al (GCB 1992) : "Population française représentative > 45 ans : 11 % (2 % de pertes fécale quotidiennes ou hebdomadaires) "Personnes âgées en institution : 33 % (23 % fécales quotidiennes) !idem Angleterre : Barrett et al (Gut 1989) !Damon et al (GCB 2006) " Pop générale (>18 ans) = 5,1% La continence dépend de : • Sphincters : externe (profond et superficiel), internes, sangle pubo- rectale • Nerf honteux interne (pudendale) • Compliance rectale • Sensibilité sus pectinéale • Consistance selles " Multifactorielle Causes d’inc A. • Accouchements (Sphincters et nerf) • Chir anale et colo-rectale • Diarrhées (MICI, fonctionnelle…) • Modif anatomiques périnée (prolapsus, rectocèle, périnée descendant) • Neuropathie (diabète, mal neurologiques, médicaments…) • … Bilans • Clinique • Manométrie anorectale • Echographie endo-anale • Electrophysiologie • Colpocystodéfécographie + Grêle • IRM dynamique Examen clinique • Interrogatoire • MA • TR • Anuscopie Interrogatoire • Depuis quand ? • Soit IA : motif de consultation • Soit: – Découverte par interrogatoire ciblé (IU, prolapsus, constipation…) –Symptômes masqués (vient pour diarrhée)

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Incontinence anale: bilan, indications thérapeutiques. Laurent Abramowitz. Unité de proctologie médico-chirurgicale. Hôpital Bichat Claude Bernard

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46 Pages·2007·1.94 MB·French

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Incontinence anale: bilan, indications thérapeutiques. Laurent Abramowitz. Unité de proctologie médico-chirurgicale. Hôpital Bichat Claude Bernard

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Author:	Unknown
Publication Year:	2007
Pages:	46
Language:	French
File Size:	1.94
Format:	PDF
Price:	FREE

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