Mgt

Question 1

Appendicular lump

Answer 1

Conservative mgt-

Surgery c/i

Question 2

Low perianal fistula

Answer 2

Fistulectomy
Fistulotomy
LIFT- ligation of fistulous tract
VAFT- video assisted fistula therapy

Question 3

High perianal fistula

Answer 3

Seton t/t
1. Cutting Seton: prolene suture or kshar suture
2. Draining Seton: chrons dis

Question 4

Partial rectal prolapse
1. First episode
2. Recurrent episode

Answer 4

1. Digital reposition
2. Thiersch wiring or sclerotherapy

Question 5

Full thickness rectal prolapse

Answer 5

Perineal procedure elderly
1. Thiersch wiring
2. Delorme repair
3. Altemier repair

Abd approach: young fit pt low recurrence
Rectopexy

Question 6

Solitary rectal ulcer syndrome

Answer 6

STARR procedure ( stapled trans anal rectal resection of intussusception)

Question 7

Anorectal malformation
1. Low
2. High

Answer 7

1. Definative surgery
2. Two stage procedure
   Diverting colostomy
   Definative surgery

Posterior sagittal anorectoplasty

Question 8

IOC
1. Haemorrhoids
2. Anal fissure
3. Diverticulitis
4. Diverticulitis
5. Peri anal fistula
6. Anorectal malformation
7. Rectal prolapse

Answer 8

1. Proctoscopy
2. External examination
3. Colonoscopy
4. CECT
5. MRI
6. MRI> Invertogram
7. MR defecography

Question 9

Haemorrhoids
Grade1
Grade 2
Grade 3
Grade 4

Answer 9

1. Conservative - lifestyle changes, Sitz bath,laxatives,Infrared coagulation
2. Grade 1+ Rubber band ligation or sclerotherapy,Infrared coagulation
3. Like grade 4 no response surgery
4. Surgery
   Open ( Milligan Morgan surgery) or closed (Ferguson surgery)
   Haemorrhoidectomy
   Stappler haemorrhoidopexy
   Doppler guided haemorrhoidal artery ligation ( DGHAL)