Haemorroids

Question 1

43 YEAR OLD BUILDER PRESENTS WITH PAINLESS BRIGHT RED BLEEDING AFTER BOWEL MOVEMENTS

1. DIAGNOSIS?
   2 NAME A-C
2. CLOCKFACE LOCATIONS OF THE
   ANAL CUSHIONS? (3)
   4 CLASSIFICATION? (4)
3. PROCEDURE TO VISUALISE INTERNALLY?
4. NON-SURGICAL OPTIONS? (4)

Answer 1

1. DIAGNOSIS? - HAEMORRHOIDS

2 A - + PECTINATE/DENTATE LINE
B - > EXTERNAL ANAL SPHINCTER
C - > INTERNAL ANAL SPHINCTER

3. CLOCKFACE LOCATIONS OF THE ANAL CUSHIONS?
   > 3, 7 AND II O’CLOCK
4. CLASSIFICATION?-
   -> |ST DEGREE - > NO PROLAPSE
   > 2ND DEGREE > PROLAPSE RETURNS ON RELAXING
   3RD DEGREE - > PROLAPSE CAN BE PUSHED IN
   4TH DEGREE - > PROLAPSE PERMANENTLY
5. TO VISUALISE INTERNALLY? - + PROCTOSCOPY
6. NON-SURGICAL?
   > RUBBER BAND LIGATION
   > INJECTION SCLEROTHERAPY
   -> INFRA-RED COAGULATION
   > BIPOLAR DIATHERMY