minor anal conditions Flashcards
Vascular condtions?
Piles
Thrombosed perianal varix
(‘perianal haematoma’)
Rarely
Anorectal varices
Odd things
types of piles?
internal hemorrhoid
prolapsed internal hemorrhoid
anal sphincter
thrombosed external hemorrhoid
symptoms?
Bleeding
Bright red
Into pan, may splatter
Lump
Itching
(Pain)
consequences?
Skin tags
Misdiagnosis of co-existing cancer…
Rarely
Acute prolapse/ strangulation/ infarction
Anaemia
classificiation?
1st degree – bleeding only
2nd degree – bleeding & prolapse (reduce spontaneously)
3rd degree – prolapse (manually reduced)
4th degree – permanently prolapsed
treatment?
Non-operative
Stool softeners/ fibre &c.
Outpatient therapies
Banding/ sclerotherapy
Operative
‘Traditional’ haemorhoidectomy
PPH (stapled) heamorrhoidectomy
anorectal abscesses and fistulas?
spread of infection from surrounding glands
symptoms of abscess?
Pain
Swelling
Discharge
Sepsis
treatment of abscesses?
Control of sepsis
Drainage
Usually operative
Antibiotics
Especially diabetics, immuno-compromised
areas affected?
fistula symptoms?
Itching/ discomfort
Discharge/ soiling
Bleeding
fistular treatment?
Principles
Define primary tract
Drain secondary sepsis…
Surgical treatment of track
Seton drainage
fistular surgical sieve?
Neoplastic types- glandular, squamous, (melanoma)
Traumatic
Autoimmune
Metabolic
Endocrine
Drugs- Nicorandil assoc. ulcers
Inflammatory- Inflammatory bowel disease
Cryptogenic
S
fissure symptoms?
Pain on defecation
Bleeding
Skin tag/ lump
fissure treatment?
Non-operative
- Stool softeners
- Analgesics, inc. topical Lidocaine
- Relaxants for sm spasm
- GTN
Diltiazem
Botox
