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GI AM > Anorectal conditions > Flashcards

Anorectal conditions Flashcards

1
Q

What are the common presentations of anorectal conditions?

A

Pain
Haemorrhage
Dysfunction

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2
Q

What are the classifications of anorectal conditions?

A

Inflammation
Infection
Malignancy
Trauma

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3
Q

What are the congenital anorectal conditions?

A

Inperforate anus
Uro-genital fistulae
Hirschprung’s myenteric plexus deficiency

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4
Q

What are the causes of an imperforate anus?

A

Rectum may end in a pouch which does not connect with colon
Rectu may have openings to other structures
Stenosis of anus or no anus

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5
Q

What is the treatment of imperforate anus?

A

Surgery

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6
Q

What is Hirschsprung’s myenteric plexus deficiency?

A

Stool becomes stuck in anus as nerves supplying the end of the colon are missing/not working

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7
Q

What are the signs of Hirschsprung’s?

A

Failure to defaecate in first 48 hours of life

Vomiting

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8
Q

What is the treatment of Hirschsprung’s?

A

Surgery to remove uninnervated section and attach rectum to a section with innervation

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9
Q

What is done pre op in Hirschsprung’s?

A

IV nutrition
Bowel washouts
Possible antibiotics

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10
Q

What are the acquired anorectal abnormalities?

A 
Haemorrhoids
Fissure
Abscess 
Fistula
Ulceration
Cancer
Incontinence
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11
Q

What are haemorrhoids?

A

Painful, swollen veins that may bleed

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12
Q

What are the signs and symptoms of haemorrhoids?

A

Irritation, pain and extreme itching around anus
Itchy or painful lump or swelling around anus
Faecal leakage
Painful bpwel movements
Melaena

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13
Q

What is the treatment of haemorrhoids?

A

Pain relief
Fibre supplements
Rubber band ligation
Stapled anopexy

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14
Q

What are the complications of haemorrhoids?

A

Anaemia

Bleeding

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15
Q

What are the signs of an anal tissue?

A

Sharp pain when passing stool followed by a burning pain for several hours
Melaena

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16
Q

What are the causes of an anal tissue?

A

Constipation- straining can cause a tear in the lining
Persistant diarrhoea
IBD
Pregnancy and childbirth

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17
Q

What is the treatment of an anal fissure?

A 
Should resolve itself
Fibre
Hydration
Pain relief
Possible laxatives
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18
Q

What is an anal abscess?

A

Collection of pus near anus, usually as a result of infection of small anal glands

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19
Q

What is the most common type of anal abscess?

A

Perianal abscess

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20
Q

What is a perianal abscess?

A

Painful, boil lie swelling ear the anus

Red in colour, warm to touch

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21
Q

What are the causes of anal abscesses?

A

Infected fissure
STI
Blocked anal glands

22
Q

What are the symptoms of an anal fissure?

A

Constant throbbing pain, worse when seated
Skin irritation around anus
Discharhe of pus
Constipation or pain associated with bowel movements

23
Q

What is the treatment of anal abscesses?

A

Surgical incision and drainage

Post drainage pain relief and possible antibiotics

24
Q

What are the complications of an anal abscess?

A

Fistula formation

25
Q

What is an anal fistula?

A

Narrow channel with internal opening in anal canal and external opening in skin near the anus

26
Q

What are the causes of anal fistulae?

A

Abscess which, when draining away, leaves behind a tunnel
IBD
Diverticulitis

27
Q

What are the symptoms of an anal fistula?

A 
Skin irritation around anus
Constant throbbing pain which is worse when seated, moving, having a bowel movement or coughing
Smelly discharge from anus
Melaena
Pus in stool
Swelling and redness around anus
Bowel incontinence
28
Q

What is the treatment of anal fistulae?

A

Fistulotomy
Seton suture
Fill fistula with glue, block with plug, or cover with a flap of tissue

29
Q

What is a fistolotomy?

A

Cutting open length of fistula so it heals as a flat scar

30
Q

What are the causes of anal ulceration?

A

Crohn’s
Malignancy
Syphilis
Nicorandil- angina drug

31
Q

What are the symptoms of anal cancer?

A 
Rectal bleeding
Itching and pain around anus
Small lumps around anus
Discharge of mucus from anus
Bowel incontinence
32
Q

How is anal cancer diagnosed?

A

Examination
Colonoscopy
CT colonography
MRI guided colonoscopy

33
Q

What is the classification system of anal cancer?

A

Dukes

34
Q

What is Dukes A anal cancer and the 5 year survival?

A

Submucosal cancer

90%

35
Q

What is Dukes B anal cancer and the 5 year survival?

A

B1- muscle invasion 80-85%

B2- wall invasion 70-75%

36
Q

What is Dukes C anal cancer and the 5 year survival?

A

C1- lymph nodes not apical 50-65%

C2- lymph nodes apical 25-45%

37
Q

What is Dukes D cancer and the 5 year survival?

A

Distant mets

<5%

38
Q

What are the 2 types of anal cancer?

A

Squamous cell carcinoma

Rectal anenocarcinoma

39
Q

How is anal squamous cell carcinoma treated?

A

Radiotherapy

40
Q

How is rectal adenocarcinoma treated?

A

Neoadjuvant chemoradiation

Laprascopic resection

41
Q

What are the types of incontinence?

A

Urge bowel incontinence

Passive incontinence

42
Q

What is urge bowel incontinece?

A

Sudden urge to go to the toilet and are unable to make it in time

43
Q

What is passive incontinence?

A

Experience no sensation before soiling themselves

44
Q

What are the 3 causes of bowel incontinence?

A

Problems with rectum
Problems with sphincter muscles
Nerve damage

45
Q

What are the rectal reasons for incontinence?

A

Constipation
Diarrhoea
Scarring of rectum
Severe haemorrhoids

46
Q

How can constipation cause incontinence?

A

Bowel impaction can cause rectal wall muscles to weaken, allowing watery stools to leak around the impacted stools and out of the anus

47
Q

What can cause the sphincter muscles to weaken or be damaged?

A

Childbirth
Injury
Rectal/bowel surgery

48
Q

What nerves supply in the internal anal sphincter?

A

Sympathetic fibres of the inferior hypogastric plexus

49
Q

What nerves supply the external anal sphincter?

A

Inferior rectal nerve and perineal branch of S4

50
Q

What nerve ssupply the anal canal?

A

Upper 1/2- hypogastric plexus

Lower 1/2- inferior rectal nerves

51
Q

What can cause damage to the nerves supplying the anal canal?

A

Diabetes
MS
Stroke
Spina bifida

GI AM (34 decks)

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