Ano-rectal Conditions

Question 1

what are common presentations of ano-rectal disorders?

Answer 1

> pain
haemorrhage
dysfunction

Question 2

name some congenital ano-rectal abnormalities

Answer 2

> imperforated anus
uro-genital fistulae
hirschprung’s myenteric plexus deficiency

Question 3

name some acquired ano-rectal abnormalities

Answer 3

> haemorrhoids
> fissures
> abscess
> fistula-in-ano
> ulceration
> cancer
> control of continence

Question 4

why do you band haemorrhoids above the dentate line?

Answer 4

there is no somatic innervation, they will therefore necrose and fall off with no pain

Question 5

what is the procedure for prolapse and haemorrhoids?

Answer 5

stapled anopexy

Question 6

how can you relax the internal anal sphincter?

Answer 6

> medicaly with topical nitric oxide, glyceryl trinitrate paste or diltiazem calcium blocker
surgically with and internal lateral sphincterectomy

Question 7

what is the management for a perianal abscess?

Answer 7

incision and drainage

Question 8

what is the management for a superficial fistula in ano?

Answer 8

lay open by fistulotomy

Question 9

what is the management for a trans-sphincteric fistula in ano?

Answer 9

seton suture and fistula plug. aim is to close the primary opening

Question 10

what imaging is used in a colorectal imaging?

Answer 10

colonoscopy: videoscope view, xray screening

MRI guided colonoscopy

Question 11

describe mri guided colonoscopy

Answer 11

> EM transmission coils are every 10 cm and they generate pulsed low voltage magnetic fields
an external receiver coil locates and orientates the transmission coils on a 3d screen
virtual 3d image is displayed on a pc screen

Question 12

what treatment is there for anal squamous carcinoma?

Answer 12

radiotherapy

Question 13

what treatment is there for rectal adenocarcinoma?

Answer 13

> neoadjuvant chemo rad

> laparoscopic resection

Question 14

what can cause anal ulceration?

Answer 14

> crohns disease
malignancy
syphilis
nicrorandil