PPT-Approach to Patient with Anal Pain or Bleeding Per Rectum

Contents of seminar Bleeding per rectum Introduction Causes Approach Anal pain Introduction Causes Approach Investigations related to bleeding per rectum and anal pain The case A 52yearold man consulted in extreme perianal discomfort that he had experienced for 48 hours He had no past history of similar problems and was otherwise asymptomatic There was no abnormality on abdominal examination while on examination of the perianal area there was a tense dark blue grapesized swelling that was acutely tender to touch Rectal examination was difficult to perform adequately because of pain but no other masses were palpable What is the diagnosis differential diagnosis and management . Four different types of epithelium :. 1.perianal skin. anal verge. 2.(pale-colored zone). pectinate line. 3.mucosal folds of the anal valves, . 4. transitional epithelium. Anatomy. The major lymphatic pathways flow to three lymph node systems. . Bernard M. Jaffe, MD. Professor of Surgery, . Emeritus. Tulane University School of Medicine. ANAL CANAL. Borders- Coccyx. . . Ischiorectal. Fascia Bilaterally. . Female- Perineal Body; Male- Urethra. What is the pathogenesis of haemorrhoids?. How can haemorrhoids be classified?. How can haemorrhoids be managed?. What is the pathogenesis of fissures?. What are the options for managing fissures?. PERINEAL BODY . is essential for the integrity of the pelvic floor, particularly in females. Levator ani- 3 striated muscles:. Puborectalis. Pubococcygeous . Iliococcygeous .  . Puborectalis . is innermost and merges with the external anal sphincter. . Kimberly Perez, MD. Gastrointestinal Medical Oncology. November 6, 2015. Disclosures. I . have no relationships to . disclose.. I . will . discuss the use vaccines in a manner not approved by the U.S. Food and Drug Administration.. 3 May 2017. Ardis Ann Moe, M.D.. UCLA Center for AIDS Research and Education/NEVHC Van Nuys Adult HIV Clinic. amoe@mednet.ucla.edu. Case#1 . 60 year old male, MSM/MSW presents to clinic in August 2013. . -. . GPwSI. Gastroenterology. . - C&H Gastro CCG lead. Miss . Tamzin. . Cuming. . - Consultant Colorectal Surgeon, . Homerton. Rectal Bleeding. U. p . to 38% of people will experience rectal bleeding at some point in their lives. An Anal Fistula ( Bhagandar / Fistula in ano ) is a small channel that develops between the end of the bowel and the skin around the anus. It often is the result of a previous or current anal abscess. Fistula has an area with two openings - Internal opening into the rectum or anal canal and External opening through the skin of the rumps. An Anal Fistula ( Bhagandar / Fistula in ano ) is a small channel that develops between the end of the bowel and the skin around the anus. It often is the result of a previous or current anal abscess. Fistula has an area with two openings - Internal opening into the rectum or anal canal and External opening through the skin of the rumps. 8. Anal Canal. Is about . 4 cm . in length. .. Passes downwards and backwards from the rectal ampulla (at the level of the prostate, in the males) to the anus. . Except during defecation, its lateral walls are maintained in position by levatores ani muscles and anal sphincters. . Assistant professor. Department of Surgery. CIMS&H, Lucknow. Definition. :. It is a common disease of anus and a painful condition which makes the patient often anxious and embarrassed.. The word ‘Fissure’ means crack. It is longitudinal crack in the long axis of the lower anal canal. In other words we can just say that it is true ulcer of the anoderm below the dentate line of the anal canal.. Anatomy. Hemorrhoids are not varicose veins. . everyone has anal cushions. The anal cushions are composed of blood vessels, smooth muscle (. Treitz’s. muscle), and elastic connective tissue in the submucosa. a.al-nuaimi@sheffield.ac.uk. . abdulameerh@yahoo.com. . Prof. . Abdulameer. Al-. Nuaimi. E-mail: . Large Intestine. www.google.co.uk/search?. www.google.co.uk/search?. Rectum and Anal Canal. Anal valves. Fahad. Al-. Sabhan. Supervised by: Dr. . Khayal. Al-. Khayal. Overview:. Anatomy of the anal canal. Hemorrhoids. Anal fissures. Anal abscesses. Anal fistulas. Anatomy of the anal canal:. The anal canal is 4 cm long.