Benign Diseases of the Anal and Perianal Region Flashcards
1
Q
internal hemorrhoids
A
- originate above the dentate line, under mucosa
- parasympathetic innervation
- dull, crampy pain
2
Q
external hemorrhoids
A
- originate below the dentate line, under skin
- afferent of inferior rectal nerve
- sharp pain
3
Q
treatment of hemorrhoids
A
- lifestyle modification - stop reading on the toilet
- increase fiber intake
- stool softeners
- NEVER EX LAX
4
Q
treatment of internal hemorrhoids
A
- rubber band ligation
5
Q
rubber band ligaiton
A
- primarily for grade II
- results in necrosis of tissue and fixation of tissue to anal sidewall
- must be above dentate line
6
Q
infrared coagulation
A
- most beneficial on bleeding grade I and small grade II hemorrhoids
7
Q
hemorrhoidectomy
A
- done for severe disease (grade IV)
- painful
8
Q
anal fissure
A
- benign, superficial ulcer of anal canal
- involves anal lining below dentate line - painful
- hallmark is intense pain exacerbated by attempted defecation
- most common location is posterior midline
9
Q
treatment of anal fissure
A
- lifestyle modifications
- fiber
- local ointments
- botox injections
- internal anal sphincterotomy
- lateral division now is gold standard
10
Q
anorectal abscess
A
- classified by anatomic spaces of the perineum
- crypts extend into the anal sphincters
- patient has difficulty sitting down
- often fluctuant with head on abscess
11
Q
treatment of anorectal abscess
A
- surgical drainage - unroof the abscess
- antibiotics for IC or extensive disease
12
Q
anal fistula
A
- intermittent perianal/perirectal pain, swelling, drainage
