Anorectal and surgery Flashcards
Define haemorrhoids?
- enlarged vascular cushions in the lower rectum and anal canal
What is the presentation of haemorrhoids?
- painless bleeding
- fresh bright red blood, not mixed in stool
- perianal itchiness
What investigations into haemorrhoids should be done?
- PR exam
- Rigid sigmoidoscopy
- proctoscopy
Over which age should a flexible sigmoidoscopy be used over a rigid?
- over the age of 50
What is the management of haemorrhoids?
- solarisation therapy
- rubber band ligation
- open haemorrhoidectomy
Explain a HALO/THD procedure for haemorrhoids?
- haemorrhoidal artery ligation
- haemorrhoid shrinks over time
What are the two types of rectal prolapse?
- partial (anterior mucosal)
- complete (full thickness)
Rectal prolapse presentation
- protruding mass from anus especially during defecation
- bleeding and passing mucus common
Treatment for rectal prolapse?
- too frail??
- bulking agent
- Delorme’s procedure
- perianal rectopexy
Describe an anal fissure?
- Tear in the anal margin due to passage of constipated stool
- Usually in the midline posteriorly but may be occasionally anterior
Multiple anal fissure?
- investigate for Crohn’s
Presentation of an anal fissure?
o Acute onset of severe anal pain usually following episode of constipation
o “glass passing”
o pain lasts 1/2hr after defecation
o bright rectal bleeding
Describe fistula in ano
- Abnormal communication between two epithelial surfaces
Investigations of fistula in ano?
- EUA of anorectum
- MRI
Cardio complications of surgery?
- haemorrhage
- MI
- DVT
