Author: Janet Skinner / Editor: Adrian Boyle / Reviewer: Emma Everitt, Mohamed Elwakil / Codes: / Published: 26/09/2022
This session covers the diagnosis, management and treatment of anorectal conditions that commonly present to the emergency department.
After completing this session you will be able to:
- Describe the causes of anorectal pain and bleeding that commonly present to the emergency department
- Perform an assessment of a patient who presents with an anorectal condition
- Institute appropriate emergency department management for patients with anorectal conditions
- Make appropriate admit/discharge decisions and arrange appropriate follow-up in patients with anorectal conditions
- Describe the medical and surgical management of common anorectal conditions
References:
- Coates WC. Anorectum. In: Wall R, Hockberger R, et al. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 10th edn. Elsevier. 2022.
- Burgess BE, Bouzoukis JK. Anorectal disorders. In: Tintinalli JE, Kelen GD, Stapczynski JS et al, eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 6th edn. New York: McGraw-Hill, 2003.
- Acheson A G, Scholefield J H. Management of haemorrhoids BMJ 2008; 336 :380.
- Dunlop M. Anorectal conditions. In: Garden OJ, Bradbury AW, Forsythe JLR et al, eds. Principles and Practice of Surgery. 5th edn. Edinburgh: Churchill Livingstone, 2007:332-340.
- Nelson RL. Treatment of anal fissure. BMJ. 2003 Aug 16;327(7411):354-5.
- Greenhalgh R, Cohen C R, Burling D, Taylor S A. Investigating perianal pain of uncertain cause. BMJ 2008; 336 :387
- National Institute for Health and Care Excellence. Haemorrhoids. NICE CKS. Revised: 2021.
- Alonso-Coello P, Guyatt G, et al. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev. 2005 Oct 19;2005(4):CD004649.
- Nelson RL, Thomas K, Morgan J, Jones A. Non surgical therapy for anal fissure. Cochrane Database Syst Rev. 2012 Feb 15;2012(2):CD003431.
- Lumb KJ, Colquhoun PH, et al. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev. 2006 Oct 18;2006(4):CD005393.
- Nelson RL, Chattopadhyay A, Brooks W, Platt I, Paavana T, Earl S. Operative procedures for fissure in ano. Cochrane Database Syst Rev. 2011 Nov 9;2011(11):CD002199.
- McCallum I, King PM, Bruce J. Healing by primary versus secondary intention after surgical treatment for pilonidal sinus. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD006213.