Anal Fissure Diagnosis and Treatment

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What is typically seen at the outer end of a chronic anal fissure?

A lateral sphincter

A blocked anal canal gland

A sentinel tag (correct)

A perianal abscess

What is the primary cause of pain in an anal fissure?

Infection in a blocked anal canal gland

The fissure itself

Constipation

The spasm of the anal sphincter (correct)

What is the purpose of a lateral sphincterotomy?

To abolish the spasm of the anal sphincter (correct)

To treat a perianal abscess

To relieve constipation

To perform a manual dilatation of the anus

What is the Classification of an abscess located in the region of the anal canal?

Perianal Signup and view all the answers

What is the recommended treatment for a chronic anal fissure?

All of the above Signup and view all the answers

Where are the glands located that can cause an abscess in the region of the anal canal?

In the intersphincteric plane Signup and view all the answers

What is typical of the history of an anorectal fistula?

A pattern of discharge followed by healing and then further discharge Signup and view all the answers

During examination, what is typically found adjacent to the anus?

A pit or granulating hole in the skin Signup and view all the answers

What is the preferred type of anaesthetic for anorectal fistula examination?

One that preserves the tone of the anal muscles Signup and view all the answers

What is the purpose of Goodsall's rule during the examination?

To locate the internal opening of the fistula Signup and view all the answers

What is the typical location of the anorectal fistula in relation to the anorectal ring?

Below the anorectal ring Signup and view all the answers

What is a possible cause of an anorectal fistula that communicates between the rectum and the skin through the levator ani?

Pelvic sepsis Signup and view all the answers

What is the main objective of treating an anal fistula?

To core out the fistula track from below through the levator ani Signup and view all the answers

What is a rare cause of fistula-in-ano?

Tuberculosis Signup and view all the answers

What is the purpose of performing a histological examination on tissue removed in recurrent or problematical fistulae?

To identify the underlying cause of the fistula Signup and view all the answers

What is a common feature of rectal prolapse?

It is usually reducible Signup and view all the answers

How can a prolapse be produced during examination?

By asking the patient to strain Signup and view all the answers

What is a treatment option for minor degrees of mucosal prolapse?

Injections of haemorrhoids Signup and view all the answers

What is usually performed if the lesion is more than 5 cm from the anus and not very large?

Anterior resection with anastomosis on the descending colon to the lower rectum Signup and view all the answers

Why is the use of a mechanical stapling device helpful in an anterior resection?

It makes the very low anastomosis more feasible, especially in males Signup and view all the answers

What is the resulting consequence of an abdominoperineal excision of the rectum?

Permanent colostomy Signup and view all the answers

When is a Hartmann's procedure usually performed?

When the tumour is not resectable Signup and view all the answers

What is the purpose of staging in adenocarcinomas of the gastro-intestinal tract?

To classify the tumour Signup and view all the answers

What is the characteristic of Stage A in the Duke's classification?

The tumour is confined to the bowel wall Signup and view all the answers

What is the recommended follow-up for vinous adenomas?

Regular sigmoidoscopies Signup and view all the answers

What is the commonest site for carcinoma of the large bowel?

Rectosigmoid junction Signup and view all the answers

What is thought to increase the exposure of the mucosa to carcinogenic influences?

A contemporary, Western, low-residue, constipating diet Signup and view all the answers

What type of carcinoma may occur in the anal canal?

Squamous cell carcinoma Signup and view all the answers

What is the characteristic of polyps with a diameter of greater than 2 cm?

They have a high chance of being malignant Signup and view all the answers

What is the initial pattern of spread of rectal carcinoma?

Local through the wall into neighbouring tissues Signup and view all the answers