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Anal inc/ CME meeting From: jay kulkin (jkulkin@mindspring.com) Wed Jun 4 20:17:08 1997 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Kelly Shanahan: "Re: Study - Hypnosis and Breech Conversion" Previous message: Allen Gardner: "Re: Turner's mosaic/thrombocytopenia" Gary, Lots of articles in the literature discribing anal incontinence as being much more common than we think after NSVD. I wish I could give you the references off the cuff but maybe some others on the list will. I know I've read these in our mainstream journals in the past 12 months. I've had 2 or 3 of these myself, most after delivering large babies. As for the meeting I discussed a few weeks ago, it looks like it will be Nov 1-2 in Atlanta. The first day will be on Effective Management of OB-GYN Problems Under Capitation. The second day will be Business 101 for OB-GYN's. Hope to see you all there. Brochures should go out in a few weeks. Jay At 10:42 AM 6/4/97 -0500, you wrote: >Please give opinions about the following patients: > >36 YO P 1102 with no gyn history presents, referred from a GI doc (she >is an existing patient that I delivered twice) for a 2 to 4 month >history of anal incontinece of normal stool. > >Her two deliveries were spontaneous, with 2nd degree tears, >repaired--easy deliveries. Her youngest is 4.5 years old. > >On exam, she has a normal vaginal exam, no cystocele, a small rectocele >(not out of line with a para 2), a slightly short perineal body. >Neurologically, she has good vaginal tone when I ask her to squeeze, and >I feel the levators on a two finger vag exam. Upon digital rectal exam, >I can palpate what I believe is an intact sphincter, and when she >squeezes, she has little tighterning around my finger. > >She has normal perineal pinprick, but I could not elicit an anal wink. > >Her BE and sigmoidoscopy were normal; she did have a nasty fall from a >horse at age 17. > >She is going to see the colorectal surgeon. > >I'm thinking this is neurologic, not anatomic. I'm also wondering about >multiple sclerosis. > >Any thoughts would be appreciated. > >Garry > >-- >Garry E. Siegel, M.D., FACOG >Private Practice >Roswell, Ga. > -- Jay M. Kulkin, MD, MBA, FACOG Medical Resource Group 1117 Perimeter Center West Suite 510 East Atlanta, Georgia Phone:770-392-3475 e-mail: medresourcegroup@mindspring.com Next message: Kelly Shanahan: "Re: Study - Hypnosis and Breech Conversion" Previous message: Allen Gardner: "Re: Turner's mosaic/thrombocytopenia"

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