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Colorectal surgery > Anal disorders > Flashcards

Anal disorders Flashcards

1
Q

What are symptoms involving anal disorders?

A

fresh bleeding, pain on defecation, pain + inflammation, prolapsing tissue, ulcerated lesions

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2
Q

Name four anal disorders

A 
anal fissure
haemorrhoids
anal carcinoma
anal sphincter damage 
peri-anal sepsis
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3
Q

What are the investigations for anal disorders?

A 
clinical exam withe DRE
biopsy
Might require anaesthetic to examine
ultrasound
sigmoidoscopy/protoscopy
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4
Q

What is the treatment of anal fissures?

A

laxatives, drugs to relax anal sphincter- GTN, diltiazem

surgery

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5
Q

What are the key features of peri-anal sepsis?

A

painful, systemic upset, abscess formation

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6
Q

What is the treamtent for peri-anal sepsis?

A

incision and drainage of abscess (sepsis six?)

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7
Q

What is the treatment for haemorrhoids?

A

banding/injection sclerotherapy at out-patient clinic or surgical excision

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8
Q

Which is the most common anal carcinoma?

A

squamous carcinoma

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9
Q

Where is the most common site of spread of anal carcinoma?

A

inguinal lymph nodes

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10
Q

What is commonly associated with anal sphincter damage?

A

labour

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11
Q

Name two atypical causes of anal fissures?

A

crohn’s, HIV, cancer

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12
Q

Two associations of peri-anal sepsis?

A

crohn’s
DM
malignancy

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13
Q

What is the cause of peri-anal sepsis?

A

anal gland blockage- infection

Skin infection from sebaceous gland or hair follicle

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14
Q

What is the definition of haemorrhoids?

A

disrupted and dilated anal cushions= spongy vascular tissue

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15
Q

Two causes of haemorrhoids?

A

constipation + prolonged straining

Venous congestion- pregnancy, abdo tumour, portal HTN

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16
Q

Two symptoms of haemorrhoids?

A 
•  Fresh painless PR bleeding 
Bright red 
On paper, on stool, may drip into pan 
•  Pruritis ani 
•  Lump in perianal area 
•  Severe pain = thrombosis
17
Q

Two differentials for haemorrhoids

A

Perianal haematoma
fissure
abscess
tumour

18
Q

Management of haemorrhoids?

A

Conservative- fluids and stop straining
Medical- topical analgesics, hydrocortisone, laxatives
Surgery- excision

19
Q

What is the treatment for anal fissures as seen in crohn’s disease?

A

oral metronidazole and surgery

Colorectal surgery (11 decks)

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