Anorectal Disorders Flashcards
What locations are haemorrhoids at? (Using a clock face)
3,7, 11 o’clock
What is the treatment for haemorrhoids?
Rubber band ligation
Haemorrhoidectomy
What location in the anus are anal fissures?
Midline - 6 (posterior midline) and 12’o clock.
90% are posterior midline
Are anal fissures distal or proximal to the dentate line?
Distal
Anal fissures are chronic if they have been going on for longer than how long?
6 weeks
What is the classic fissure triad?
Deep Ulcer
Sentinel pile
Enlarged anal papillae
What are the causes of proctitis?
Crohn’s
Ulcerative colitis
Clostridium difficile
What are the causees of Ano Rectal Abscesses?
E.Coli
Staph Aureus
Itchy & red anus that can be due to systemic or local causes.
Pruritus Ani
Associated with chilbirth and rectal intussceception.
May be internal or external
Rectal prolapse
What is the most common type of anal neoplasm and how does this differ from the commonest form of rectal neoplasm?
Squamous cell carcinoma - Anus
Adenocarcinoma - Rectal
(Just think of it as the other way round) :-)
Associated with chronic straining and constipation. Histology shows mucosal thickening, lamina propria replaced with collagen and smooth muscle (fibromuscular obliteration)
Sikutary rectal ulcer
A severe, episodic, rectal and sacrococcygeal pain. It can be caused by cramp of the levator ani muscle, particularly in the pubococcygeus.
Proctalgia fugax
A 60-year-old male presents with a change in bowel habit and, on sigmoidoscopy, a 2 cm ulcer is found in the rectum at 10 cm.
- Anal fissure
- Anal haematoma
- Crohn’s disease
- Diverticulitis
- Haemorrhoids
- Ischaemic colitis
- Proctalgia fugax
- Ulcerative proctocolitis
Ulcerative proctocolitis
Differential diagnoses of solitary painful ulcer in the rectum at 60 years of age are:
- Cancer
- Solitary rectal ulcer syndrome (otherwise known as ulcerative proctocolitis), and
- Rarely infections, such as amoebiasis or bilharziosis.
