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Surgery > Anorectal > Flashcards

Anorectal Flashcards

1
Q

What s anal fissure

A

Longitudinal split in the anoderm of the distal anal canal

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2
Q

Extension of anal fissure

A

anal verge to the dentate line. Not beyond that.

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3
Q

Anal fis common at wht age

A

Common in young adults

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4
Q

Common sites of AF

A
  • Anterior- common in women (10:1)

- Posterior- frequently affected

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5
Q

Wht are ectopic siites of anal ffis

A 
Crohn’s disease
– Anal intercourse
– TB
– Sexually transmitted disease – HIV
– Squamous cell carcinoma
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6
Q

Causes for anal fissures

A

Strained evacuation of a hard stool
• Repeated passage of diarrhea
• Vaginal delivery-anterior anal fissure

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7
Q

What are types of anal fissures

A

Acute

Chronic

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8
Q

Three features of chronic af

A

Hypertropic anal papilla
Fissure with heaped up scarred edges
Sentinalskin tag

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9
Q

Two mx tyes of anal fissure

A

Conservative

Surgical

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10
Q

Outcome of conservative mx af

A

healing of almost all acute and the majority of chronic fissures

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11
Q

What are used in conservative mx of AF

A 
Analgesics oral and local
Stool bulking agents
Stool softners
Adequate water i take
Chemical agrnts -GTN 0.2%bd tds
-CCB =dilitiazem 2%
Botox injections
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12
Q

What are Surgical Management options AF

A

Lateral internal sphincterotomy

Anal advancement flap

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13
Q

What are complications of internal sphincterectomy in AF

A 
Haemorrhage
Haematoma
Bruising
Perianal abscess and fistula
Faecal incontinence- particularly in women
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14
Q

What’s haemorroids

A

Dilalated anal cushions increased venous pressure within them
Common in elderly
Situated in 3, 7,11 O’clock positions

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15
Q

How haemorrhoids get Development

A

Man’s upright posture
Lack of valves in the portal venous system
Raised abdominal pressure

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16
Q

What are types of haemorroids

A

Primary

Secondary

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17
Q

Reasons for primary haemorroids

A

Constipation
• ProfuseDiarrhea
• Pregnancy
• Obesity

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18
Q

Reasons for secondary haemorroids

A
  • Portalhypertension
  • Rectalcancer
  • Pelvictumours
19
Q

What are clinical featurs of haemorroids

A 
Bleeding per rectum
Lump at anus on
defecation
Mucous discharge
Anaemia- not rare
Pain- in complicated haemorrhoids
DRE-Cannotbepalpable
20
Q

What are 4 degrees of hemorroids

A

1st D- Bleeding only
2nd D- Prolapse, reduce spontaneously
3rd D- Prolapsed, Manually reduced
4th D- Permanently prolapsed

21
Q

What are Complications of haemorrhoids

A

Strangulation and thrombosis

Ulceration

Gangrene

Portal pyaemia

Fibrosis

22
Q

How to Assessment of haemorrhoids

A

Proctoscopy

Flexible sigmoidoscopy- to exclude underlying malignancies in elderly

23
Q

What are types of Management in haemorroids

A

Conservative
Minimal invasive
Operative

24
Q

What are Conservative Management types

A
  • Advice about defecatory habits
  • Stool softeners
  • Stool bulking agents
25
Q

What are minimal invasive management for hemorrhoids

A

Injection sclerotherapy

Banding

26
Q

What will be done in the injection sclerotherapy

A

5% phenol in Archies or Almond oil

27
Q

For what degree of hemorrhoids operative management used

A

Third and fourth- degree hemorrhoid second-degree not cured by nonoperative tx

28
Q

What are the types of operation management in hemorrhoids

A

Hemorrhoidectomy

Hemorrhoidal artery ligation

29
Q

What are the complications of the hemorroids

A 
Bleeding 
acute urinary retention 
anal fissure and submucous abscess
Fecal incontinence
Anal stenosis and stricture
30
Q

What are . adynamic intestinal obstructions A

A

Paralytic ileus. Pseudo obstruction- colonic & intestinal

31
Q

What’s paralytic ileus.

A

Faliure of transmission of peristaltic wave

secondary to neuromuscular faliure

32
Q

In whom gallstones are common

A

Fat fertile frothy fair female 5F

33
Q

Gallstones more common in whom

A

24% female abd 12% male

34
Q

Is old age gallstones common

A

Yes

35
Q

Types of gallstones

A

Cholesterol 15% mixedstones 80% pigment stones 5%

36
Q

How cholesterol stones appear

A

Solitary, more than 2.5cm , round shape

37
Q

How mixed stones appear

A

Multiple a faceted, cholesterol, calcium phosphate, calcium carbonates s proteins

38
Q

What’s least % of stones

A

5% pigmented stones , black or brown, small size.

39
Q

What’s %.gallstones that radio opaque

A

10%

40
Q

What are condition which precipitate gallstones

A

Billiary infections , billiary stasiss , altered gb function.

41
Q

What happen to gb when gallstones present

A

30% get affected by infections, gram -.bacteria.

42
Q

Clinical features of gallstones inside gallbladder.

A

Acute cholecytitis, emphyma-sepsis, mucocele, billiary colic , mucocele, billiary colic, carcinoma.

43
Q

What are clinical features when gallstones in neck of gb

A

Mirrizi syndrome

Surgery (7 decks)

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