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Anal Disorders Notes

Medicine Notes > General and Vascular Surgery Notes

This is an extract of our Anal Disorders document, which we sell as part of our General and Vascular Surgery Notes collection written by the top tier of University Of Leicester students.

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Anal DisordersHaemarrhoids Fissures Perianal sepsis + fistulas Neoplasms

Haemorrhoids Swelling of endoanal cushions o Submucosa o Anorectal mucosa o Submucosal blood vessels Aetiology
- Constipation
- Chronic straining
- Obesity
- Pregnancy

- Confine to upper anal canal External
- Lower anal canal

Can ulcerate and become inflamed if recurrently prolapsing Clinical features
- Irritation (pruritis ani, mucosal discharge)
- Damaged mucosal lining (bleeding post defaecation)
- Prolapse (lump at margin usually after defeacation - reducable) Investigations
- Sigmoidoscopy/proctoscopy
- Haemorrhoids rarely start after 55 yrs age so be suspicious of rectal bleeding Treatment
- Medical o Avoid constipation and straining o Laxatives o Anal creams and suppositories
- Surgical o Sclerotherapy injection o Banding o Haemarrhoidectomy

Fissures Longitudinal tear in mucosa and skin of anal canal Aetiology
- Trauma when passing large constipated stool
- Crohn's disease
- STIs
- Delivery of baby Investigation
- Diagnosis by history and examination

Clinical features
- Pain on defaecation and sphincter spasm
- Red blood on toilet paper
- Fear of defaecation

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