Rectum & Anus Flashcards
Conditions
What are haemorrhoids?
Engorgement of veins in the soft connective tissue cushions around the anorectal junction
How will haemorrhoids present?
Bright red blood in stools
Pian on defaecation
How are haemorrhoids investigated?
Digital rectal exam
Could perform colonoscopy
How are haemorrhoids classified?
First degree - remain inside
Second degree - reversibly prolapse
Third degree - permanently prolapsed
How are haemorrhoids treated?
Creams, ointments and suppositories to relieve swelling and discomfort
Usually clear by themselves
Surgical banding
What procedure can be performed to treat prolapse or severe haemorrhoids?
Stapled anopexy, removes ring shaped section of anal canal
What treatment can be used in an anal fissure?
topical nitric oxide
glyceryl trinitrate paste
diltiazem calcium blocker
Surgery: internal lateral sphincterotomy
What are some congenital anal disorders?
Imperforate anus
Urogenital fistula
Hirschsprung’s myenteric plexus deficiency
What is fistula-in-ano?
A tunnel from the bowel to the skin near the anus
What usually causes a fistula-in-ano?
Infection near the anus that caused an abscess in the nearby tissue
What treatment is required for a fistula-in-ano?
Rarely heal on their own, needs surgery
Fistulotomy cuts along the length to promote scarring
Aim to close primary opening with Cook SIS plug
What symptoms present in fistula-in-ano?
Skin irritation around the anus Throbbing pain, worse on sitting Smelly discharge around the anus Passing blood or pus on bowel movements Bowel incontinence
What type of cell change leads to colorectal cancer?
Epithelial cell dysplasia
What type of cancer is found in the rectum and what type is in the anus?
Anal - squamous
Rectal - adenocarcinoma
What are the risk factors for colorectal cancer?
Smoking
Diet high in fat and red meat
Genetic predisposition
Chronic colitis
