Anorectal emergencies
Open Access
- 1 January 2016
- journal article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 22 (26), 5867-78
- https://doi.org/10.3748/wjg.v22.i26.5867
Abstract
Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrhoid, thrombosed or strangulated internal hemorrhoid, bleeding hemorrhoid, bleeding anorectal varices, anal fissure, irreducible or strangulated rectal prolapse, anorectal abscess, perineal necrotizing fasciitis (Fournier gangrene), retained anorectal foreign bodies and obstructing rectal cancer. Sexually transmitted diseases as anorectal non-surgical emergencies and some anorectal emergencies in neonates are also discussed. The last part of this review dedicates to the management of early complications following common anorectal procedures that may present as an emergency including acute urinary retention, bleeding, fecal impaction and anorectal sepsis. Although many of anorectal disorders presenting in an emergency setting are not life-threatening and may be successfully treated in an outpatient clinic, an accurate diagnosis and proper management remains a challenging problem for clinicians. A detailed history taking and a careful physical examination, including digital rectal examination and anoscopy, is essential for correct diagnosis and plan of treatment. In some cases, some imaging examinations, such as endoanal ultrasonography and computerized tomography scan of whole abdomen, are required. If in doubt, the attending physicians should not hesitate to consult an expert e.g., colorectal surgeon about the diagnosis, proper management and appropriate follow-up.Keywords
This publication has 43 references indexed in Scilit:
- Approach to the diagnosis and management of retained rectal foreign bodies: clinical updateTechniques in Coloproctology, 2012
- Fecal Impaction: A Cause for Concern?Clinics in Colon and Rectal Surgery, 2012
- Hemorrhoids: From basic pathophysiology to clinical managementWorld Journal of Gastroenterology, 2012
- The management of patients with primary chronic anal fissure: a position paperTechniques in Coloproctology, 2011
- Comparison of the sensitivity for detecting foreign bodies among conventional plain radiography, computed tomography and ultrasonographyDento maxillo facial radiology, 2010
- Presentation and management of perirectal sepsisThe Annals of The Royal College of Surgeons of England, 2008
- Delayed Presentation of Life-Threatening Perineal Sepsis Following Stapled Haemorrhoidectomy: A Case ReportThe Annals of The Royal College of Surgeons of England, 2007
- Sexually transmitted proctitisPublished by Oxford University Press (OUP) ,2006
- Fournier's gangrene and its emergency managementPublished by Oxford University Press (OUP) ,2006
- Relationship of portal pressure, anorectal varices and hemorrhoids in cirrhotic patientsJournal of Hepatology, 1992