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Flashcards in Perianal Deck (12)
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1

Haemorrhoids

Engorged vasc cushions
Ano rectal junc
Netw of CT and BV, keep anus closed and sense solid vs air
Graded by amnt prolapse

2

chronic haemorrhoids

Bleeding
Constipated stool
Itching
Prolapse

3

acute haemorrhoids

Thrombosed prolapse, pain-
Try to reduce early. If late px then ice, resolves few wks.
Perianal haematoma-
Drain if under 24hr, analgesia if late,

4

Haemorrhoid ix

Proctoscopy
Sigmoidoscopy if symps sugg more than haemorrhoids AND for all rectal bleed over 50.

5

Haemorrhoid mx

Diet- fibre and water
Creams
Stool softener
Fibre supplems
Banding
Injection, rare
HALO artery ligation, rare
Haemorrhoidectomy for large, prolapsed, lot pain

6

Fissure in ano px

Sev pain
Hx of constipation

7

fissure mx

Diet
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

8

Perianal abcess mx

Drain

9

Necrotising fasciitis RFs

Imm comprom
Eld
Steroid
DM
Obese

10

Perianal sepsis

Can lead to fistula- connec btw 2 epith surfs
Anal gl block, then abcess, then pus tract forms fistula

11

Fistula mx

Lay open- can reduce tone and contin, deps on amnt musc inv.
seton drain
Lift procedure

12

Pilonidal sinus

Nest of hairs
Abces acute
Disch gran tiss, inflamed
Mx- remove affected tiss and close with flap