Perianal disease Flashcards
1
Q
Diseases associated with anorectal sepsis
A
Crohn's UC TB Ca anus 2ndry to pelvic sepsis Hydradenitis suppurativa Lyphogranuloma venereum Actinomycosis Foreign body
2
Q
Simple anal fistula
A
Single external opening
Easily identifiable primary tract
Lower third of internal sphincter
Internal opening just above dentate line
3
Q
Which patients require admittion for perianal abscess drainage
A
Very large abscess
Immunocomprimesed
DM or systemic disorders
4
Q
What is Goodsall’s rule
A
Anterior anal fistulas tend to be straight and radial.
Posterior are more likely complex but have a midline internal opening.
5
Q
Ways to identify internal opening of a fistula
A
Push external and look for bead of pus
Inject methyline blue into tract
Hydrogen peroxide produces internal bubbles
6
Q
Two options for fistula surgery
A
Lay open simple tracts
Insert setons into complex ones and refer
7
Q
Differential for anal pain
A
Abcess Fistula Thrombosed perianal varix Fissure Perianal haematoma Strangulated haemorrhoid Anal Ca Infected sebaceous cyst Hidradenitis suppurativa Cutaneous furuncle
