Flashcards in Perianal Deck (12)
Engorged vasc cushions
Ano rectal junc
Netw of CT and BV, keep anus closed and sense solid vs air
Graded by amnt prolapse
Thrombosed prolapse, pain-
Try to reduce early. If late px then ice, resolves few wks.
Drain if under 24hr, analgesia if late,
Sigmoidoscopy if symps sugg more than haemorrhoids AND for all rectal bleed over 50.
Diet- fibre and water
HALO artery ligation, rare
Haemorrhoidectomy for large, prolapsed, lot pain
Fissure in ano px
Hx of constipation
GTN 0.2% cream, headache s/e
Diltiazem 1st line, 4-6wk, reduc int sphincter tone to impr BS
80% get better with creams
If not botox, not perm
Surg- lat sphincterectomy- s/e passive incontin so not for wom as short int sphinct and child birth
Perianal abcess mx
Necrotising fasciitis RFs
Can lead to fistula- connec btw 2 epith surfs
Anal gl block, then abcess, then pus tract forms fistula
Lay open- can reduce tone and contin, deps on amnt musc inv.