DISORDERS OF THE ANAL CANAL

-

 DISORDERS OF THE ANAL CANAL


Disorders of the rectum and anal canal along with their symptoms, management, and investigations:

  1. Haemorrhoids

    • Painful protrusion of the anal mucosa due to constipation and hard stools.
    • Predisposing factors: Low-fiber diet, dehydration, pregnancy, colon cancer, HIV/AIDS, other painful anal conditions.
    • Types:
      • First degree: Internal, no protrusion.
      • Second degree: Protrude during defecation but retract.
      • Third degree: Remain protruded, may thrombose.
    • Complications: Bleeding, thrombosis, ulceration.
    • Management: High-fiber diet, stool softeners; haemorrhoidectomy for third degree.

  2. Anal Fissure

    • Painful anal tear caused by hard stool and poor hygiene.
    • Management: Manual dilatation, fissure scraping with nitroglycerin injection, sitz baths.

  3. Anal Fistula

    • Fibrous tunnel from rectum/anal canal to skin, causing drainage and pain.
    • Causes: Poorly managed abscess, HIV/AIDS, diabetes.
    • Classification: Low-level (below internal sphincter), high-level (involves internal sphincter).
    • Management: Sitz baths, antibiotics, fistulotomy or fistulectomy.
    • Surgical complications: Infection, fecal incontinence.

  4. Ischiorectal Abscess

    • Abscess in the fatty tissue between the ischium and rectum, hard to treat due to poor blood supply.
    • Management: Cruciate incision for proper drainage.

  5. Cancer of the Rectum

    • Second most common GI cancer, usually adenocarcinoma.
    • Risk factors: High-fat diet, age >50, family history.
    • Staging: A (confined) to D (metastasis).
    • Symptoms: Bleeding, lower abdominal pain, bowel changes, weight loss.
    • Management: Examination, biopsy, resection (stages A/B), palliative care (stages C/D).

  6. Hirschsprung Disease

    • Congenital condition with intestinal dilation due to lack of ganglions, causing severe constipation.
    • Diagnosis: Abdominal X-ray, rectal biopsy.
    • Management: Surgical resection of affected segment, followed by anastomosis.

  7. Special Investigations

    • Proctoscopy: Direct visual examination of the rectum using a proctoscope.
    • Colonoscopy: Examination of the colon via a colonoscope to detect ulcers, polyps, and tumors.
    • Barium enema: X-ray examination after contrast media is introduced via the anus to visualize obstructions.

  8. Special Procedures

    • Rectal Lavage: Clearing the rectum for proctoscopy.
    • Enema Administration: Contrast media introduction through the anus for diagnostic imaging.

These disorders involve common complications such as infection, incontinence, and recurrence, requiring careful diagnosis and treatment based on the specific pathology.

Comments

Post a Comment

Popular posts from this blog

DEPRESSION- ENDOGENOUS & EXOGENOUS

-
Image
DEPRESSION- ENDOGENOUS & EXOGENOUS   1. Mr. chembe aged 30 years is brought to Chainama Hospital Ward X with history of profound sadness and suicidal ideations  for 2 weeks. On admission, the Doctor conducted a Mental State Examination and a diagnosis of Depresion is made  a)  Define Depression                                                                                          5 marks                                                                             b) Explain five (5) causes/predisposing factors of Depression                             25 marks c) outline  the differences between reactive and endogenous depression  20 marks d) Discuss how you are going to nurse Mr. chembe during his stay in hospital                                                                                                                           50 marks     Patient Case: Mr. Chembe at Chainama Hospital Ward X a) Define Depression (5 marks): Depression is a mood disorder characterize
Read more

SUBSATNCE ABUSE PRESENTATION 2.

-
  QUESTION  :  SUBSATNCE ABUSE Namwela Zanga aged 21 years has been brought to your mental health unit with history of  alcoholism for the past 3 years. He is reported to be regular consumer of a local beer brew. This has led to self-neglect and he can no longer eat his food. a)     Outline any five (5) theories of alcohol/substance abuse           20% b)     Outline five (5) Social effects of alcohol abuse                                 20% c)      Discuss the seven (7) phases of alcohol intoxication                    35% d)     Discuss five (5) ways of how alcohol abuse can be prevented  25% INTRODUCTION Worldwide substance use and abuse are significant problems for adolescents. They carry serious consequences such as assault and rape. Substance abuse involve use of psychological active substances which are potentially harmful to the individual. It i s generally agreed by most scientists that stress, conflicts and frustration are major factors in substance abuse. T
Read more

MANIA

-
Image
  Christabel Kabindama aged 23 yeras is brought to the psychiatric hospital amidst talking and shouting on top of her voice non-stop. She is accompanied by Mwaka Ng'ambi who said she is also unable to sleep and claims she owns Livingstone College of Nursing and have supper powers. After examinations a diagnosis of mania is made. DEFINE MANIA Mania is a mental condition with distinct period during which mood is abnormally and persistently elevated, expansive, or irritable. STATE THE PREDISPOSING FACTORS TO MANIA There is no specific known cause for mania. However, the predisposing factors are biopsychosocial in nature and includes the following: Biological factors Genetics. Mania is hereditary in nature. First degree relatives with these disorders are more likely to develop the mood disorder than people in the general population. Biochemistry. Research have shown that those with mania have too much of serotonin and epinephrine. Social factors Stressful life events, lack of social
Read more