Anorectal Disorders Flashcards
(25 cards)
What does the normal anatomy of the anorectal canal include?
- Structures
- Muscles
- Mucosa
- Blood vessels
- Nerves
What is important to understand about the physiology of the anorectal canal?
- Function
- Transit times
- Frequency
- Capacity
- Sensory control
- Motor control
How can anorectal abnormalities be characterised?
- Congenital/acquired
- Local/systemic
- Benign/malignant
- Early/late
What are the common presentations of anorectal disorders?
- Pain
- Haemorrhage
- Dysfunction
What are the 4 classifications of anorectal disorders?
- Inflammation
- Infection
- Malignancy
- Trauma
Give 3 examples of congenital anorectal abnormalities.
- Imperforate anus
- Uro-genital fistulae
- Hirschsprung’s myenteric plexus deficiency
Give examples of acquired anorectal abnormalities.
- Haemorrhoids
- Fissure
- Abscess
- Fistula-in-ano
- Ulceration
- Cancer
- Control of continence
What is stapled anoplexy a treatment for?
Procedure for prolapse and haemorrhoids
What is involved in ultrasound guided ligation of haemorrhoids?
- Trans anal haemorrhoid dearterialiastion
- Protoscopy USS guided
- Suture transfixion of haemorrhoid arteries
- No tissue resection
- Above denate line, no pain
What can medically be used to relax the anal sphincter?
- Topical nitric oxide
- 0.2% glyceryl trinitrate paste
- 2% diltiazem calcium blocker
How can the internal anal sphincter be relaxed surgically?
Internal lateral sphincterotomy
How is a perianal abscess treated?
- Incision and drainage
- Try to avoid complications
How is a fistula in ano superficial treated?
Lay open by fistulotomy
How is a fistula in ano trans-sphincteric treated?
- Seton suture
- Fistula plug/permacol paste
- Aim to close primary (internal) opening
What are the CRC sites in order from most common to least?
- Left colon
- Right colon
- Rectum
- Transverse colon
- Other
- Anus
What imaging is used for CRC?
- Videoscape view
- +/- X-ray screening
What is CT colonography?
- X-ray procedure
- Virtual video of colonic lumen
How does MRI guided colonoscopy work?
- EM transmission coils every 10cm and the colonoscope generates pulsed low voltage magnetic field
- External receiver coils locate and orientate the transmission coils on a 3D screen-Virtual 3D image on PC screen while direct viewing the videoscope image
How are anal squamous cancers treated?
Radiotherapy
How are rectal adenocarcinomas treated?
- Neo adjuvant chemoRad
- Laparoscopic resection
What is the CRC infiltration on the Duke’s staging?
- A: submucosa
- B1: muscle
- B2: wall
- C1: nodes not apical
- C2: nodes apical
- D: distant mets
What can result in anal ulceration?
- Crohn’s disease
- Malignancy
- Syphilis (Chancre)
- Nicorandil
How can incontinence be treated?
Sacral nerve root stimulator implant
What nerves are involved in the sacral nerve root stimulator implant?
S2
S3
S4
