Anorectal Pathology Flashcards
What is the difference between grade 1, 2 ,3 and 4 Hemorrhoids
Grade 1: Bleed and prolapse into lumen of anal canal
Grade 2: can spontaneously reduce
Grade 3: requires manual reduction
Grade 4: can be gangrenous - can cause sepsis
What is the difference between external and internal hemorrhoids
EXTERNAL:
- origin below dentate line
- covered by by skin/anoderm
- Sensate
INTERNAL:
- Origin above dentate line
- covered by columnar mucosa
- insensate
What 3 things contained in what tissue are hemorrhoids?
hemorrhoids = cushions of submucosal tissue containing
venules
arterioles
smooth muscles fibers located in the anal canal
What are 3 Tx for Hemorrhoids?
- Dietary fiber, stool softeners, avoidance of dehydration/straining
- Topical treatment
- Surgery
What is procidentia? who is it more common in? what are Sx?
rectal prolapse (circumferential, full thickness) more common in Females 6:1
Sx: tenesmus, sensation of incomplete evacuation, incontinence, constipation, diarrhea
What do the majority of abscesses result from? what is main complaint?
infection of anal glands (cryptoglandular infection) found in intersphincteric plane
Sx: severe anal pain.
What is the Tx of abscesses?
Drainage, Abx
What can pts with abscesses eventually develop? what do they develop from?
Fistula - originate from infected crype
What is hidradenitis supurativa?
infection of cutaneous apocrine sweat glands
- glands rupture - forms subcutaneous tracts
- not involved at anal verge (no apocrine glands in anal canal)
What are anal fissures? how can they happen? what do they cause?
fissure = tear in the anoderm DISTAL to dentate line
-comes from trauma to the passage
causes spasm of internal anal sphincter = pain
Where do most anal fissures form?
posterior midline
What is Pilonidal disease? whats Tx?
cysts, infection, abscesses containing Hair-containing sinuses in gluteal cleft
Tx: always surgery
What malignancy is HPV associated with in anal region? what HPV types?
HPV 16, 18
Squamous cell carcinoma
