Anorectal Disorders Flashcards
Ano-rectal abnormalities can be;
congenital/acquired
local/systemic
benign/malignant
early/late
What are the most common presentations of ano-rectal conditions?
Pain
Haemorrhage
Dysfunction
Ano-rectal conditions can be caused by;
Inflammation
Infection
Malignancy
Trauma
Give an example of a congenital ano-rectal condition
Imperforate anus
Uro-genital fistulae
Hirschprung’s Myenteric Plexus Deficiency
Give 5 examples of acquired ano-rectal conditions
Haemorrhoids Fissure Abscess Fistula-in-ano Ulceration Cancer Incontinence
How do haemorrhoids usually present?
Itching/irritation/pain around the anus
Painful bowel movements
Bleeding from anus after defaecation
How can haemorrhoids be treated?
Stapled anopexy
Ultrasound guided ligation
How are anal fissures staged?
As acute or chronic
At what point is an anal fissure chronic?
After it has been present for more than 6 weeks
How are anal fissures treated?
By relaxing the internal anal sphincter;
medically - topical nitric oxide, glyceryl trinitrate paste or diltiazem calcium blocker
surgically - internal lateral sphincterotomy
What is the treatment for peri-anal abscess?
Incision and drainage
At what locations can a peri-anal abscess occur?
Submucosal
Intersphincteric
Ischiorectal
Perianal
What is the typical presentation of fistula-in-ano?
Pain and swelling around the anus
Pain during bowel movements
What are the treatment options for fistula-in-ano?
Fistulotomy - if superficial
Seton suture, fistula plug or permacol paste if trans-sphincteric
What are the possible causes of anal ulceration?
Crohn’s disease
Malignancy
Syphilis chancre
Nicorandil
