Anoreactal Conditions Flashcards
what are the 3 categories of haemorrhoids?
primary - internal
second degree - prolapsing
third degree - prolapsed
what can patients with haemorrhoids present with?
painless rectal bleeding
pruritus ani
discomfort
red blood on toilet paper and/or around stool
what investigations are used to diagnose haemorrhoids?
inspection
rectal examination
proctoscopy
what are the different treatments for haemorrhoids?
suppositories with local anaesthetic and steroids Rubber band ligation Injection of sclerosant haemorrhoid artery ligation operation surgery - anorectal anoplexy
what is an anal fissure?
a tear in the sensitive skin-lines lower anal canal which causes pain on defecation
can be primary or associated with crohns or UC
what is the medical treatment for anal fissure?
initial treatment is anaesthetic gel and stool softeners
topical nitric oxide
0.4% glyceryl trinitrate paste
2% diltiazem ointments (CCB)
surgical - Internal lateral sphincterotomy
what is the treatment for a perianal abscess?
incision and drainage
what can occur as a consequence of an abscess and what conditions is this normally found in?
fistula
crohns disease and TB
what are the common causes of anal ulceration?
crohns disease
malignancy
syphillis
nicorandil
how do you investigate if ano-reactal cancer is suspected?
CT colonoscopy
MRI guided colonoscopy
CT chest abdo, pelvis and chest for staging
what is the treatment for anorectal cancer?
squamous carcinoma = radiotherapy
adenocarcinoma = neoadjuvant chemoradiotherapy & laparoscopic resection
what is the prognosis for dukes C ano-rectal cancer?
C1 = 50-65% C2= 25-45%
what is the prognosis for Dukes A anorectal cancer?
> 90%
what is the prognosis for Dukes B anorectal cancer?
B1 = 80-85% B2 = 70-75%
what is the prognosis for dukes D anorectal cancer?
D = <5%
