RECTUM / ANUS Flashcards Preview

A ORAL BOARDS 2016 > RECTUM / ANUS > Flashcards

Flashcards in RECTUM / ANUS Deck (3)
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1

Treatment of fistula if found at the time of abscess drainage

Clinical scenarios that says:

Do not remove fistula at the time of acute inflammation just place a seton.

Incising center and also when there is inflammation present causes increased gapping of the incision and risks incontinence

2

TRANSANAL EXCISION OF RECTAL LESION



CONSENT:
- radical therapy or adjuvant therapy may be needed later
- . bleeding
- . need preop bowel prep

POSITION:
- Lithotomy or prone

keep lesion in the lower half of operative field

beanbag and taping of pt. to secure position

PROCEDURE:

circumferential anal block ( local + epi )

insert operating proctoscope

mark a 1 cm margin circumferentially with cautery

maintain wide proximal margin

incise rectal wall FULL THICKNESS down to perirectal fat

dissect through this fat layer to undercut specimen

hemostasis assured

defect closed with full thickness running absorbable suture

3

treatment of anal fissure

If this is a typical position lateral fisher think Crohn's, or immuno

stool softener
Nitropaste
calcium channel blocker
Biofeedback

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Sphincterotomy:
Incision in the intersphincteric groove:
Between internal and external pillar

11 blade towards the anal Canal
Incision internal sphincter