37 Anal and Rectal

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What is the arterial supply to the anus?

External hemorrhoid artery

Middle rectal artery

Superior rectal artery

Inferior rectal artery (correct)

Which plexus is responsible for the venous drainage above the dentate line?

Superior hemorrhoid plexus

Internal hemorrhoid plexus (correct)

Middle hemorrhoid plexus

External hemorrhoid plexus

What can cause pain in external hemorrhoids?

Bleeding

Straining (correct)

Itching

Prolapse

What type of innervation do internal hemorrhoids have?

Autonomic innervation Signup and view all the answers

What is the recommended treatment for thrombosed external hemorrhoids if the condition has persisted for more than 72 hours?

Lance open Signup and view all the answers

What is the surgical indication for resecting external hemorrhoids?

Large external component Signup and view all the answers

What is the most common symptom of anal melanoma?

Rectal bleeding Signup and view all the answers

Which anal cancer requires standard postoperative chemo/XRT similar to rectal cancer?

Adenocarcinoma Signup and view all the answers

What is the recommended treatment for pilonidal cysts?

Drainage and packing followed by surgical resection Signup and view all the answers

What is the most common cancer in patients with AIDS?

Kaposi's sarcoma Signup and view all the answers

Which type of anal incontinence has no good treatment?

Neurogenic incontinence Signup and view all the answers

What is the precursor for anal squamous cell carcinoma (SCCA)?

Anal intra-epithelial neoplasm (AIN) III Signup and view all the answers

Which type of cancer is associated with HPV, HIV, XRT, and immunosuppression?

Squamous cell carcinoma below the dentate line Signup and view all the answers

What is the most common site for melanoma?

Rectum Signup and view all the answers

What is the primary treatment for anal margin squamous cell carcinoma if it involves the sphincter or if there are positive nodes?

Chemotherapy only Signup and view all the answers

What is the primary drainage and packing followed by surgical resection recommended for?

Pilonidal cysts Signup and view all the answers

What should be considered for biopsy to rule out cancer and diagnose anal problems?

Inguinal nodes Signup and view all the answers

What is the surgical treatment for rectal prolapse in older and frail patients?

Transabdominal posterior suture rectopexy Signup and view all the answers

What is the primary medical treatment for anal fissure?

Bulk (psyllium) Signup and view all the answers

Which condition can be a contraindication to sphincterotomy for anal fissure?

Incontinence after botulinum injection Signup and view all the answers

What is the recommended surgical treatment for lateral or recurrent anal fissures?

Lateral subcutaneous internal sphincterotomy Signup and view all the answers

Which type of anorectal abscess may form a horseshoe abscess?

Intersphincteric abscess Signup and view all the answers

What percentage of patients with fistula-in-ano eventually develop a fistula-in-ano?

30% Signup and view all the answers

What is Goodsall's rule used for in the context of fistula-in-ano?

Identifying the type of fistula based on location Signup and view all the answers

What is the recommended treatment if less than 1/4 of the external anal sphincter is involved in a fistula-in-ano?

Fistulotomy Signup and view all the answers