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Flashcards in Anal Disorders Deck (15):

Symptoms of anal disorders 

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


Anal conditons 

  1. Anal fissure 
  2. peri-anal sepsis 
  3. haemorrhoids 
  4. anal carcinoma 
  5. anal sphincter damage 


Diagnosing anal disorders 

  1. clinical examination with DRE
  2. examination under anaethetic 
  3. proctoscopy 
  4. biopsy for pathology 
  5. manometry and ultrasound of anal spincters 


Anal fissure definition

A small tear in the mucosa 


Symptoms of anal fissure 

  • Painful on defecation 
  • fresh bleeding


Treatment of anal rectal fissures 

laxatives, drugs to relax the anal spincter - diliitazem, GTN 

surgery 0 lateral spincterotomy of internal sphincter


Peri-anal sepsis definition 

Also known as a perianal abscess represents an infection of the soft tissues surrounding the anal canal


Symptoms/signs of peri-anal sepsis 

  • painful 
  • inflammation 
  • systemic upset e.g pyrexia, abscess formation 
  • obvious externally but abscess may be higher and need rectal examination to detect 
  • fistula 



Treatment of peri-anal abscess 

Incision and drainage of abscess 

fistula may be layed open if below sphincter but if above may need seton suture to allow drainage or more complex surgery 


Haemorrhoid definition

A swollen vein or group of veins in the region of the anus 


symptoms/signs of haemorrhoids 

  1. fresh rectal bleeding after defecation 
  2. may be prolapsed 
  3. unconfortable 


Treatment of haemorrhoids 

  • treated with banding/ injection sclerotherapy at out=patient clinic 
  • prolasping haemorrhoids may need surgical excision - haemorrhoidectomy 


Anacarinoma features 

  • ulcerated lesion at anal margin 
  • may bleed, painful 
  • sqamous carcinoma 
  • spread to inguinal LN 


Treatment of anal carcinoma 

surgery- abdomino-perineal resection and/or radiotherapy 


Anal sphincter damage features 

  • previous vaginal deliverys with perineal tear
  • can be caused by surgery for other conditions e.g anal fissure surgery 
  • causes faecal incontinence 
  • investigated with manometry/endo-anal ultrasound of sphincters 
  • surgical repair of disrupted sphincter