Anal fistula physical examination: Difference between revisions

Jump to navigation Jump to search
m (Categories)
No edit summary
 
(25 intermediate revisions by one other user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Anal fistula}}
{{Anal fistula}}
{{CMG}} {{AE}}
{{CMG}}, {{AE}}{{MKK}}
 
==Overview==
==Overview==
Patients with anal fistula usually appear in [[distress]] due to throbbing [[rectal pain]]. Patient presents with anal fistula is having normal vital signs but if [[anal fistula]] gets [[infected]], it will lead to the formation of an [[abscess]]. Patient with an [[abscess]] presents with unstable vitals like high-grade [[fever]], [[Tachycardia]], [[Tachypnea]], low [[Blood pressure|blood pressure]]. On rectal examination, there is redness, tenderness and discharge is seen.
===Appearance of the Patient===
*Patients with anal fistula usually appear in [[distress]] due to throbbing [[rectal pain]].
===Vital Signs===
Patient presents with anal fistula is having normal vital signs but if [[anal fistula]] gets [[infected]], it will lead to the formation of an [[abscess]]. Patient with an [[abscess]] presents with unstable vitals:
*High-grade [[fever]]
*[[Tachycardia]] with regular [[pulse]]
*[[Tachypnea]]
*Low [[Blood pressure|blood pressure]]<nowiki/>e with normal [[pulse pressure]]
==Rectal Exam==
*Patient with [[anal fistula]] usually have throbbing [[rectal pain]]. The examination is usually done under [[sedation]].<ref name="urlwww.fascrs.org">{{cite web |url=https://www.fascrs.org/sites/default/files/downloads/publication/clinical_practice_guideline_for_the_management_of_anorectal_abscess_fistula-in-ano_and_rectovaginal_fistula.pdf |title=www.fascrs.org |format= |work= |accessdate=}}</ref><ref name="pmid27824697">{{cite journal |vauthors=Vogel JD, Johnson EK, Morris AM, Paquette IM, Saclarides TJ, Feingold DL, Steele SR |title=Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula |journal=Dis. Colon Rectum |volume=59 |issue=12 |pages=1117–1133 |year=2016 |pmid=27824697 |doi=10.1097/DCR.0000000000000733 |url=}}</ref>
*On [[Inspection (medicine)|inspection]] perianal skin is [[red]] and excoriated.
*On [[palpation]], there is [[tenderness]] and fluctuation due to [[abscess]].
**The external opening can be palpated if it is just beneath the [[skin]].
**The external opening is felt like a [[cord]] and [[discharge]] is seen.
*Bidigital [[rectal]] examination  is usually done under the local [[anesthesia]] due to severe [[pain]].


==Physical examination==
==Lymph Node Examnination==
''Diagnosis'' is by examination, either in an [[outpatient]] setting or under [[anaesthesia]] (referred to as EUA - Examination Under Anaesthesia). The examination can be an [[anoscopy]].
On palpation, [[Inguinal lymph node|inguinal lymph nodes]] are usually enlarged.
 
Possible findings:
*The opening of the fistula onto the skin may be seen
*The area may be painful on examination
*There may be redness
*An area of [[induration]] may be felt - thickening due to chronic infection
*A discharge may be seen
*It may be possible to explore the fistula using a fistula probe (a narrow instrument) and in this way it may be possible to find both openings of the fistula


==References==
==References==

Latest revision as of 20:29, 13 February 2018

Anal fistula Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Anal fistula from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Diagnostic study of choice

Laboratory Findings

X Ray

Electrocardiogram

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Anal fistula physical examination On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Anal fistula physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Anal fistula physical examination

CDC on Anal fistula physical examination

Anal fistula physical examination in the news

Blogs on Anal fistula physical examination

Directions to Hospitals Treating Anal fistula

Risk calculators and risk factors for Anal fistula physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Patients with anal fistula usually appear in distress due to throbbing rectal pain. Patient presents with anal fistula is having normal vital signs but if anal fistula gets infected, it will lead to the formation of an abscess. Patient with an abscess presents with unstable vitals like high-grade fever, Tachycardia, Tachypnea, low blood pressure. On rectal examination, there is redness, tenderness and discharge is seen.

Appearance of the Patient

Vital Signs

Patient presents with anal fistula is having normal vital signs but if anal fistula gets infected, it will lead to the formation of an abscess. Patient with an abscess presents with unstable vitals:

Rectal Exam

Lymph Node Examnination

On palpation, inguinal lymph nodes are usually enlarged.

References

  1. "www.fascrs.org" (PDF).
  2. Vogel JD, Johnson EK, Morris AM, Paquette IM, Saclarides TJ, Feingold DL, Steele SR (2016). "Clinical Practice Guideline for the Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula". Dis. Colon Rectum. 59 (12): 1117–1133. doi:10.1097/DCR.0000000000000733. PMID 27824697.

Template:WH Template:WS