disorders of perianal area Flashcards
CF of haemorrhoids
painless bleeding
fresh red blood not mixed with stool, on paper often
severe anaemia
no change in bowel habit or weight loss
haemorrhoids - common positions
3, 7 and 11 o clock in the lithotomy position
causes of haemorrhoids
constipation with prolonged straining
investigations for haemorrhoids
PR
rigid sigmoidoscopy
proctoscopy
haemorrhoids - use of flexible sigmoidoscopy
patient >50
treatment of haemorrhoids
sclerosaiton therapy
rubber band legation
open or stapled haemorrhoiectomy
HALO/THD procedure
what is good about HALO
pain free
partial rectal prolapse involves
mucosa layers
complete rectal prolapse involves
all layers
aetiology of rectal prolapse
lax sphincter
prolonged straining
treatment of rectal prolapse
bulking agent and education of manual reduction
delormes procedure
perineal or abdominal rectopexy
treatment of incomplete rectal prolapse in children
dietary advice and treat constipatin
treatment of incomplete rectal prolapse in adults
similar to haemorrhoids
what may multiple anal fissures be due to
crohns
anal fissure CF
acute severe anal pain following episode of constipation
bright rectal bleeding
how long does pain in anal fissure last after defecation
half-hour
treatment of anal fissure
dietary advice
stool softeners
pharmacological or lateral sphyncterotomy
botox injetion
what does pharmacological sphyncterotomy involve
GTN or diltiazem ointment PR for 6 weeks
fistula in ano complications
pain bleeding inconstance of flatus or stool recurrence further surgery
fistula in ano investigations
endoanal US scan of anorectum
rigid or flexible sigmoidoscopy
Proctoscopy
MRI
fistula in ano treatment
high fistula - seton suture
low fistula - laid open to heal by secondary intention
