Perianal disorders Flashcards
Fissure-in-ano
painful tear in the squamous lining of the lower anal canal
if chronic, often with a ‘sentinel pile’ or mucosal tag at the external aspect
Cause of fissure-in-ano
most are due to hard faeces
Rx fissure-in-ano
lidocaine ointment + GTN ointment
increase dietary fibre
fluids
stool softener + hygiene advice
lateral partial internal sphincterotomy
Anal fistula
a track communicates between the skin and anal canal/rectum
What does a blockage of deep intramuscular gland ducts do?
predisposes the formation of abscesses, which discharge to form a fistula
Goodsall’s rule
determines the path of the fistula track
Causes of fistulae
perianal sepsis, abscesses, chron’s disease, TB,
Tests for anal fistulae
MRI, endoanal US scan
Rx anal fistulae
fistulotomy + excision
What causes anorectal abscesses?
gut organisms
what types of anorectal abscesses can you get?
perianal
ischiorectal
intersphincteria
supralevator
Rx anorectal abscesses
incise & drain under GA
associations anorectal abscesses
DM, Chron’s, malignancy, fistulae
