General Surgery - Anal Disease

Question 1

common site of pilonodial sinus?

Answer 1

midline of the buttock

Question 2

risk factors for pilonodial sinus?

Answer 2

sitting
dark hair
hirsute
trauma

Question 3

what is a sinus?

Answer 3

abnormal cavity formed by destruction of tissue

Question 4

Tx for pilonodial sinus?

Answer 4

shaving and washing
Abx if infected
surgery

Question 5

describe the 3 types of wound healing?

Answer 5

primary intention - edges close
secondary - granulation tissue, healing from bottom up
third - combination of the two

Question 6

features of an anal fissure?

Answer 6

intense pain when passing stool

fresh blood on wiping

Question 7

causes of an anal fissure?

Answer 7

constipation
crohn’s
trauma
HIV

Question 8

Tx for anal fissure?

Answer 8

lidocaine/GTN/diltiazem ointment to relax
stool softener
increase fibre

Question 9

what two types of rectal prolapse are there?

Answer 9

partial - mucosa

complete - full thickness

Question 10

features of a rectal prolapse?

Answer 10

blood
itch
mass felt
incomplete emptying

Question 11

Tx for rectal prolapse?

Answer 11

avoid straining

surgery

Question 12

how do haemorrhoids occur?

Answer 12

anal cushions, made of spongy vascular tissue, protrude

Question 13

how do haemorrhoids become thrombosed?

Answer 13

protrude
gripped by anal sphincter
venous return is blocked

Question 14

risk factors for haemorrhoids?

Answer 14

pregnancy
constipation
tumours

Question 15

features of haemorrhoids?

Answer 15

bright red blood
painless
can be in pan after stool
itch

Question 16

classifications of haemorrhoids?

Answer 16

1st - in rectum
2nd - come out on defecation but spontaneously reduce
3rd - digital reduction
4th - remain prolapsed

Question 17

Tx for haemorrhoids?

Answer 17

increase fibre intake
stool softner
ice pack
topical steroid
surgery