Anal fistula physical examination: Difference between revisions
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===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 | *Low [[Blood pressure|blood pressur]]<nowiki/>e with normal [[pulse pressure]] | ||
==Rectal Exam== | ==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> | *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 perianal skin is inflamed and excoriated. | *On inspection perianal skin is inflamed and excoriated. | ||
*On palpation, there is tenderness and fluctuation due to abscess. | *On palpation, there is tenderness and fluctuation due to abscess. | ||
Revision as of 18:29, 1 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
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 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 inflamed 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.
- Internal opening is seen clearly with an anoscope.
- Sigmoidoscopy is used to visualize opening in the rectum.
- Fistula track is explored by fistula probe.
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.