What is PILES (Haemorrhoides)?
- Dilatation,Elongatin & Tortuosity of Haemorrhoidal veins is called PILES (HAEMORRHOIDES)
- Varicosities of the veins of the anal canal are known as HAEMORRHOIDES (PILES).
Types Of Piles
Internal piles: Above the Hilton's line are internal piles. 1st, 2nd, 3rd & 4th Degree piles.Its called painless and bleeding piles.
Covered by mucous membrane.
External piles: Below Hilton's line are External piles.No degree. Covered by skin .
Painful &No bleeding but very rarely bleeding seen.
What is FISSURE ?
Fissure means longitudinal ulcer in the anal canal.Posteriorly situated in majority cases.
Types Of Fissure
Acute Fissure:
Deep tear in anal canal with surrounding oedema & inflamamatory induration.
Severe painful defaecation.
Anal Sphincteric spasm.
Bright streak of blood with the passage of stool.
Chronic Fissure:
When acute fissure fails to heal it will gradually develop into a deep undermined ulcer with continuing infection & oedema.
The ulcer stops above at the pectinate line.Below , there is hypertrophied papilla and skin tag known as 'Sentinel tag or pile'.
Acute on Chronic Fissure:
When chronic fissure comes in acute painful condition then its acute on chronic fissure.
What is FISTULA?
- A Fistula is an abnormal epithelialized track connecting two cavities, or one cavity with the exterior.
- The Fistula is said to be complete when it opens both internally into the lumen of the gut and erternally at the surface.
- Fistula in ano is caused by spontaneous rupture of an abscess around the anus or may follow surgical drainage of the abscess.
Most of these sbscesses are formed by the small vestigeal glands opening into the anal sinuses.Such ananorectal abscess tends to track
in various directions and mau open medially into the anal sinus,laterally into the ischiorectal fossa,inferiorly at the surface and
superiorly into the rectum.
- A fistula can also be caused by an ischiorectal or a pelvirectal abscess.
Types Of FISTULA in ANO
LOW LEVEL FISTULA:These fistulae open into the anal canal below the Ano rectal ring. Subtype are as below
- Subcutaneous type
- Submucous type
- Intersphincteric type
- Transphincteric type
- Suprasphincteric type
HIGH LEVEL FISTULA:These fistulae opens into the anal canal at or above the ano rectal ring. Subtype are as below
- Extrasphincteric or supralevator type
- Transphincteric type
- Pelvi-rectal fistula
What is SINUS?
Sinus having only one opening & not two openings like fistula.
Track does not open into the anal canal or rectum,then it is sinus.
What is PILONIDAL SINUS?
- The word 'Pilonidal' means nest of hairs.
- It is a sinus which contains a free tuft of hairs.
- These sinuses are commonly found in the skin covering the sacrum and coccyx; between the fingers ( in hair dressers)
and the soften skin either by sweat or some form of dermatitis.
- Pilonidal sinuses are always in the mid-line of the natal cleft over the lowest part of the sacrum and coccyx.
- The Common symptoms are Pain and discharge.
About RECTAL PROLAPSE...
- This condition is seen at the extremes of life in children between 1 to 3 yrs and in the elderly after 40 years of age.
- Women are more commonly affected than men.
- The main complaint is that something is coming out per rectum during defaecation.
- It may come out spontaneously even on standing ,walking or coughing.
- If the length of the prolapse is less than 3.75 cm it is a partial prolapse and
If it is more than that this it is acomplete prolapse.
About CARCINOMA OF RECTUM...
- Unlike other carcinomas this condition may be seen even in young patients.
- So age is not criteriaon for diagnosis.
- Bleeding is the most constant symptom.
- Weight loss.
- Anaemia.
- Spurious diarrhoea.
- ABOUT 90% OF RECTAL CANCERS CAN BE FELT BY FINGER FOR RECTAL EXAMINATION.