Anal fistula physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Anal fistula}} | {{Anal fistula}} | ||
{{CMG}} {{AE}} {{MKK}} | {{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=== | ===Appearance of the Patient=== | ||
*Patients with anal fistula usually appear in distress due to throbbing rectal pain. | *Patients with anal fistula usually appear in [[distress]] due to throbbing [[rectal pain]]. | ||
===Vital Signs=== | ===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 | 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 | *High-grade [[fever]] | ||
*[[Tachycardia]] with regular pulse | *[[Tachycardia]] with regular [[pulse]] | ||
*Tachypnea | *[[Tachypnea]] | ||
*Low blood pressure with normal pulse pressure | *Low [[Blood pressure|blood pressure]]<nowiki/>e with normal [[pulse pressure]] | ||
==Rectal Exam== | ==Rectal Exam== | ||
*Patient with anal fistula usually have throbbing rectal pain. | *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 inspection perianal skin is | *On [[palpation]], there is [[tenderness]] and fluctuation due to [[abscess]]. | ||
*On palpation external opening can be palpated if it is just beneath the skin. | **The external opening can be palpated if it is just beneath the [[skin]]. | ||
**The external opening is | **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]]. | ||
==Lymph Node Examnination== | ==Lymph Node Examnination== | ||
Inguinal lymph nodes are usually enlarged. | On palpation, [[Inguinal lymph node|inguinal lymph nodes]] are usually enlarged. | ||
==References== | ==References== | ||
Latest revision as of 20:29, 13 February 2018
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Anal fistula Microchapters |
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Diagnosis |
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Treatment |
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Anal fistula physical examination On the Web |
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American Roentgen Ray Society Images of Anal fistula physical examination |
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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
- 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 pressuree with normal pulse pressure
Rectal Exam
- Patient with anal fistula usually have throbbing rectal pain. The examination is usually done under sedation.[1][2]
- On inspection perianal skin is red and excoriated.
- On palpation, there is tenderness and fluctuation due to abscess.
- Bidigital rectal examination is usually done under the local anesthesia due to severe pain.
Lymph Node Examnination
On palpation, inguinal lymph nodes are usually enlarged.
References
- ↑ "www.fascrs.org" (PDF).
- ↑ 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.