Trastornos anorectales

Antecedentes

Anatomy of the anus and rectum.

Anatomy of the anus.

The interior of the anal cami and lower part of the rectum, showing the anal columns and the anal valves between their lower ends (columns in image numerous than typical).

Coronal section of rectum and the anal canal.

Clinical Features

Visual Diagnosis

• 

  Anal tags

• 

  Enterobius (pinworms)

• 

  External hemorrhoid

• 

  Anal fissure

• 

  Anal warts

• 

  Perianal abscess

• 

  Internal hemorrhoid with prolapse

• 

  Pilonidal cyst

• 

  Rectal prolapse

Differential Diagnosis

Trastornos Anorrectales

• Fisura anal
• Fístula anal
• Malignidad anal
• Etiquetas anales
• Absceso anorrectal
• Coccidinia
• Malignidad colorrectal
• Condiloma acuminado
• Estreñimiento
• Enfermedad de Crohn
• Criptitis
• GC/Clamidia
• Impactación fecal
• Hemorroides
  • Hemorroide interno
  • Hemorroide externo
• Síndrome del elevador del ano
• Pólipo pediculado
• Quiste pilonidal
• Proctalgia fugaz
• Proctitis
• Prurito anal
  • Enterobius (oxiuros)
• Cuerpo extraño rectal
• Prolapso rectal
• Fisura sifilítica

Similares No GI

• Prostatitis

Evaluation

Algorithmic Diagnostic Approach

• Pain
  • Bleeding
    • External hemorrhoid
    • Prolapsed internal hemorrhoid
    • Anal Fissure
      • Off midline = cancer, HIV, TB, Crohn's
  • No bleeding
    • Swelling
      • Anorectal abscess
        • Perirectal
        • Ischiorectal
        • Intersphincteric
        • Supralevator
      • Pilonidal cyst
      • Anal fistula
      • Hidradenitis suppurativa
    • No swelling
      • Proctalgia fugax
• No pain
  • Bleeding
    • Cancer
    • Internal hemorrhoid
  • Swelling
    • Itch: Condyloma acuminata
    • No itch: Rectal prolapse
  • Itching
    • Discharge: Proctitis
    • No discharge: Pruritus Ani

Management

Disposition

See Also

• Diagnoses by Body Part (Main)

External Links

References

References