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Flashcards in Anorectal Disease Deck (121)
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31

Diagnosis of Rectal Prolapse

Anal EMG
Anal manometry
Anal ultrasound
Colonoscopy
Proctosigmoidoscopy

32

Treatment of Rectal Prolapse

Stool softeners
Pushing rectum back up into the anus
Abdominal repair
Rectal repair

33

Recovery of Surgery in Rectal Prolapse

Hospitalization 3-5 days
Complete recovery in 3 months

34

Define Pilonidal Cyst

Cyst near the natal cleft of the buttocks that often contain hair or skin debris

35

Risk Factors of Pilonidal Cyst

Hair punctures skin & becomes embedded
Hairy young men
Prolonged sitting
Obesity
Local trauma/irritation

36

Clinical Presentation of Pilonidal Cyst

Pain
Erythema & swelling of the skin
Drainage of foul smelling pus or blood from the opening skin

37

Treatment & Prevention of Pilonidal Cyst

I&D
Surgical cyst removal
Antibiotics in the case of cellulitis

38

Antibiotic options in Pilonidal Cyst

1st generation cephalosporin (cefazolin) + metronidazole (Flagyl)

39

Define Hemorrhoids

Dilated veins of the hemorrhoidal plexus in the lower rectum

40

Define External Hemorrhoids

Below edentate line consisting of squamous cells

41

Define Internal Hemorrhoids

Internal edentate line consisting of anal mucosal

42

Classification of Hemorrhoids

Grade 1: hemorrhoids that do not prolapse
Grade 2: Hemorrhoids prolapse on defecation & reduce spontaneously
Grade 3: hemorrhoids prolapse on defecation & reduce manually
Grade 4: hemorrhoids are prolapse & cannot be reduce manually

43

Causes of Hemorrhoids

Pregnancy
Frequency heavy lifting
Repeated straining during defecation
Constipation
Prolonged sitting
Obesity

44

Clinical Presentation of External Hemorrhoids

Painful/purplish swelling
Rarely ulcerate & cause minor bleeding
Resolves in 2-3 days
Swelling lasts a few weeks
Itchiness around anus

45

Clinical Presentation of Internal Hemorrhoids

Bleeding after defecation
Mucous & fecal incontinence
Itchiness

46

Clinical Presentation of Strangulated Hemorrhoids

Very painful
Ulceration
Necrosis

47

Diagnosis of Hemorrhoids

Anoscopy
Sigmoidoscopy or colonoscopy

48

Treatment of Hemorrhoids

Stool softeners/fiber
Sitz baths after BM
Anesthetic ointments
Banding
Surgical

49

Key Points of Hemorrhoids

External may thrombus & become painful
Internal often bleed and not painful
Stool softeners, topical treatments, & analgesics usually adequate for external
Bleeding internal may require injection or rubber band ligation
Surgery last resort

50

Define Hernias

Protrusion, bulge, or projection of an organ or part of an organ through the body wall that normally contains it

51

When does a hernia become a medical & surgical emergency?

When the blood supply is cut off at the hernia opening in the abdominal wall

52

Types of Hernias

Inguinal
Umbilical
incisional/Ventral
Epigastric
Femoral
Spigelian

53

Where is an epigastric hernia?

Upper abdomen at midline

54

Where is an incisional hernia?

At site of previous surgical incision

55

Where is an umbilical hernia?

At the naval

56

Where is a direct inguinal hernia?

Near the opening of the inguinal canal

57

Where is an indirect inguinal hernia?

At the opening of the inguinal canal

58

Where is a femoral hernia?

In the femoral canal

59

What is the most common type of hernia?

Inguinal hernia

60

Why are inguinal hernias so prominent?

Weak area occurs in the inguinal canal where the spermatic cord or round ligament exits the abdomen