Anorectal Disease Flashcards
Rectal Prolapse Treatment
Treat first at home with stool softeners and pushing the fallen tissue back up into the anus by hand
Surgery:
Abdominal repair
Rectal (perineal) repair
Pilonidal Cyst
Cyst near the anal cleft of the buttocks that often contains hair or skin debris
Usually happens when hair punctures the skin and becomes embedded
Occurs in hairy young men
Sitting for long periods of time can be a risk
Tx. I&D and avoid prolonged sitting
Hemorrhoids Grading Classification
Grade I
Hemorrhoids that do not prolapse
Grade II
Hemorrhoids prolapse on defecation and reduce spontaneously
Grade III
Hemorrhoids prolapse on defecation and must be reduced manualy
Grade IV
Hemorrhoids are prolapsed and cannot be reduced manually
Inguinal hernia: Indirect
Most common type
Hernia protrudes through the internal inguinal ring
Hernia sac is located lateral to the inferior epigastric artery
Sometimes the hernia will protrude into the scrotum
Can occur at any age, but becomes more common as people age
Inguinal hernia: Direct
Protrude medial to the inferior epigastric vessels within the Hesselbach’s triangle
Result of a weakness in the floor of the inguinal canal
Rarely protrude into the scrotum
Almost always occur in older individuals as their abdominal walls weaken with age and stretching
Spigelian hernia
Hernia through the spigelian fascia Often no notable swelling Risk of strangulation is high due to small size Most occur on right side Rare Diagnosed with CT scan Surgery is the treatment of choice
Appendicitis
Anorexia and vague periumbilical discomfort that develops into RLQ pain
N/V generally not first symptoms
Pelvic appendix can present with urinary symptoms and diarrhea
Most common extrauterine cause for abdominal surgery in pregnant women
Acute Abdomen Red flags
Severe pain
Signs of shock
Signs of peritonitis
Abdominal distention
Study of choice in evaluation of undifferentiated abdominal pain
CT Scan
