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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
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Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...
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Related Experiment Video

Updated: Apr 21, 2026

Anogenital Distance and Perineal Measurements of the Pelvic Organ Prolapse POP Quantification System
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Perianal Paget's Disease.

Chang Woo Kim1, Yon Hee Kim2, Min Soo Cho1

  • 1Division of Colon and Rectal Surgery, Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Annals of Coloproctology
|November 1, 2014
PubMed
Summary

Extramammary Paget's disease (EMPD) is rare. This case study details the successful surgical treatment of a challenging EMPD case using wide local excision and perforator flap reconstruction, achieving disease-free margins.

Keywords:
Extramammary Paget's diseasePerianal Paget's disease

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Area of Science:

  • Dermatology
  • Surgical Oncology
  • Plastic Surgery

Background:

  • Extramammary Paget's disease (EMPD) is a rare intraepithelial adenocarcinoma.
  • EMPD often presents with non-specific symptoms, leading to delayed diagnosis.
  • Perianal location of EMPD poses unique surgical challenges.

Purpose of the Study:

  • To report a case of extramammary Paget's disease (EMPD) in an 84-year-old Korean male.
  • To describe the surgical management of a large perianal EMPD.
  • To highlight the reconstructive approach for resulting defects.

Main Methods:

  • Diagnosis confirmed via perianal skin biopsy.
  • Wide local excision with a 1-cm margin.
  • Reconstruction using bilateral inferior gluteal artery perforator flap transpositions.

Main Results:

  • The EMPD lesion measured 14 cm × 9 cm.
  • Surgical excision achieved disease-free lateral and basal margins.
  • Perforator flap reconstruction successfully addressed the soft tissue defect.

Conclusions:

  • Wide local excision combined with perforator flap reconstruction is an effective treatment for large perianal EMPD.
  • Achieving clear margins is crucial for successful EMPD management.
  • This case demonstrates a viable surgical strategy for a rare malignancy.