Anorectal Disorders Flashcards
(23 cards)
What is proctitis associated with?
C.diff
IBD
What is anorectl abscess caused by?
E.Coli
Staphylococcus aureus
What causess anal fistula?
Previous and-recal abscess, determined by goodsall rule
What is associated with rectal intussceception?
Rectal wall in a gates in itself due to rectal prolapse
What causes pruritus ani?
Itching of the skin a round ans
-> children it is worms
-> adults it ishaemorrhoids
What is a solitary rectal ulcer caused by?
Syndrome of painful and difficult defecation, a sense of incomplete evacuation, and lower gastrointestinal bleeding associated with constipation.
What will histology show for solitary rectal ulcer?
Histology shows mucosal thickening, lamina propria replaced with collagen and smooth muscle (fibromuscular obliteration) and ulcers
Where are anal fissures located?
painful rectal bleeding
Location: midline 6 (posterior midline 90%) & 12 o’clock position. Distal to the dentate line
Where are haemorrhoids located?
3, 7, 11 o’clock position
What is the triad for chronic anal fissure?
Ulcer, sentinel pile, (skin tag at anal Canal enrance) enlarged anal papillae
What does revere and severe pain on examination indicate?
Intersphincteric abscess
-> managed with anaesthesia and drainage
What causes foul smelling discharge from the anus and epithelial defect in 5’o;cock position?
Fistula, a tract that occurs in and, occurring from previous and-rectal sepsis
How to differentiate between fistula
When are topical nitrates used?
For chronic anal fissures by relaxing the internal anal sphincter muscle, thereby improving blood flow to the area and promoting the healing of fissures
What is given for chronic anal fissure?
Topical GTN
What s given initially for anal fissure that is acute?
Lidocaine
What occurs at the 6 or 12 o clock position?
anal fissure and anal abscess
How to distinguish anal fissure from abscess?
Anal fissures have intense pain following defaecation
Perianal abscess will have a continuous discomfort
How do anal ulcers present?
Bright tried blood and sharp or burning sensations with bowel movements
What is the imaging for fistula with bladder involvement?
Cystoscopy to visualise the bladder mucosa and identify
What does a lateral anal fissure indicate?s
3 o clock position Secondary cause and may require cancer referral
Where are anal fissures typically found?
Anterior fissures are in the 6 or 12 o clock position
What is the first line imaging for suspected diverticulitis?
CT abdominal and pelvis
-> it will show pericolic fat stranding and Diverticular inflammation
