GI EOR Flashcards
Anal fissures are most commonly found at:
Posterior midline
Treatment for anal fissure
Sitz bath
Topical diltiazem
Topical glyceryl trinitrate ointment
Botox
What is the 90% rule
For anal fissures:
90% posterior
90% heal with medical treatment
90% of patients that undergo LIS heal successfully
What is a sentinel pile
Thickened mucosa/skin at distal end of anal fissure
Often confused with small hemorrhoid
Treatment for rectal abscess
Surgical drainage and antibiotics
50% of patients with rectal abscess develop ______ within 6 months of surgery
Fistula in ano
Where are rectal fistulas located
Within 3 cm of anal margin
How do you diagnose a rectal fistula in the OR
Inject H2O2 (or methylene blue) into the external opening and look for bubbles coming out of the internal opening
What is Goodsall’s rule
Rectal fistulas:
Anterior: course straight
Posterior: curved tract
Treatment for rectal fissure
Surgical fistulotomy
Causes of anorexia
Appendicitis Gastric ulcer Duodenal ulcer Gastric cancer Lower GI bleed Carcinoma of the gallbladder Pancreatic carcinoma
With appendicitis, which comes first, the pain or the N/V
Periumbilical pain —> N/V —> anorexia —> RLQ pain
Describe the abdominal exam in acute appendicitis
Soft
Non-distended
TTP at mcburneys point
Rovsing sign:
RLQ pain with LLQ palpation
Obturator sign
RLQ pain with internal and external hip rotation with flexed knee
