Anorectal Disorders Flashcards
Types of anorectal disorders
Congenital
Acquired
Presentations of anorectal disorders
Pain
Haemorrhage
Dysfunction
Types of anorectal disorders
Inflammation
Infection
Malignancy
Trauma
What are some congenital anorectal abnormalities?
Imperforate anus
Uro-genital fistula
Hirschprung’s myenteric plexus deficiency
What are some acquired ano rectal abnormalities?
Haemorrhoids Fissure Abscess Fistula-in-ano Ulceration Cancer Control of continence
Another name for haemorrhoids
Piles
Definition of haemorrhoids
Swellings containing enlarged blood vessels that are found inside or around the rectum and anus
Treatment of haemorrhoids
Increased fibre and fluids to soften stools
Haemorrhoidal creams
Ice packs to reduce swelling
Sitting in plain warm water
Complications of haemorrhoids
Ruptured haemorrhoid
GI bleeding (can lead to anaemia if severe)
Thrombosis
What is a stapled anopexy?
Removal of haemorrhoidal tissue and repositioning of tissue
When can stapled anopexy be done?
Haemorrhoids
Prolapse
Definition of anal fissure
Tear or open sore (ulcer) that develops on the lining of the anal canal
Treatment of anal fissures
Relax internal anal sphincter
- topical nitric oxide
- 0.2% glyceryl trinitate paste
- 2% Diltiazem calcium blocker
- Surgery - internal lateral sphincterotomy
Complications of anal fissures
Failure to heal
Recurrence
Tear extends to surrounding tissues
Treatment of peri anal abscess
Incision and drainage
Antibiotics
Pain relief
Definition of fistula-in-ano
Infected tunnel that develops between the skin and the muscular opening at the end of the anus
Treatment of fistula-In-ano
Superficial - lay open by fistulotomy Trans-sphinctertic - seton suture - "COOK SIS" fistula plug
Complications of fistula-in-ano
Rarely heel if left untreated
Types of ano-rectal cancer
Anal squamous cancer
Rectal adenocarcinoma
Treatment of anal squamous cancer
Radiotherapy
Treatment of rectal adenocarcinoma
Neoadjuvant chemoradiotherapy
Laparoscopic resection
Staging of ano-rectal cancer
Duke’s staging
Sites of colorectal cancer
Right colon 27% Transverse 10% Left colon 36% Rectum 16% Anus 3% Others 8%
What is the most common site for colorectal cancer?
Left colon
