Chennammal, M (2013) Painful Conditions of the Anal and Peri-Anal Region. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
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Abstract
INTRODUCTION: Painful conditions of the anal and peri-anal region are not only the frequently encountered problems in surgical practice but also forms the most distressing symptoms to the suffering patient such as bleeding, mass, discharge and pruritis and incapacitates the day today life of the sufferer. The importance of light into this subject lies in reviewing the history of the great warrior Napolean Bonaparte. It is believed that the course of battle of Waterloo would have been different if that great warrior’s painful pile masses would have been treated successfully. It is also true that proper clinical assessment and appropriate management of these conditions definitely alleviates the pain, anxiety and distress of the patient. This study is to highlight the causes, frequency, age and sex incidence and presence and absence of associated symptoms in the patients presenting with pain in the anal and peri-anal region. AIMS OF THE STUDY: The aim of the study is to evaluate the various painful conditions in the anal and peri-anal region which draws the emergency attention of the surgeon as well as the patient. • To review the Surgical Anatomy and Physiology of the Anal triangle. • To study the various diseases presenting with pain in the anal and peri-anal region. • To highlight the magnitude of the problem. • To study the frequencies of diseases presenting with pain. • To study the age incidence of patients presenting with pain in the anal and peri-anal region in associated with individual diseases. • To study the sex ratio of patients presenting predominantly with anal and peri-anal pain. • To study other associated clinical presentations. • To study the diagnosis of the painful conditions. • To study the surgical management of the acute conditions. MATERIALS AND METHODS: This study of the painful conditions of the anal and peri-anal region was conducted by collecting and analysing data from the patients with complaints of pain in the anal and peri-anal region with or without associated symptoms who attended outpatients and inpatients of Government Mohan Kumaramangalam Medical College hospital, Salem between June 2010 to October 2012. A detailed history, physical examination including digital rectal examination, proctoscopy (when needed under anaesthesia) and relevant investigations like colonoscopy, sigmoidoscopy, Fistulogram were performed. 100 cases were studied during above period of study. Cases of Fissure-in-ano were admitted and if acute treated conservatively initially and if chronic operated and discharged 5 days after surgery and regularly followed up. Cases of prolapsed and thrombosed strangulated haemorrhoids were treated conservatively initially and then admitted, operated and discharged after 3-4 days and followed up regularly. Cases of anorectal abscess were incised and drained under general anaesthesia and discharged after 2 days with antibiotics according to culture and sensitivity and followed up regularly. Cases of fistula-in-ano admitted and surgery was done and discharged after one week. Cases of Anal injury were admitted in AE ward initially and operated and discharged. Cases of Carcinoma Anal canal, Complete Rectal Prolapse and Hypertrophied Anal papilla were admitted and operated and discharged and followed up regularly. CONCLUSION: Pain in anal and perianal region is one of the most common problems encountered in surgical practice. The basic aim of this study is to highlight the magnitude of the problem. In this prospective study of 100 cases in Government Mohan Kumaramangalam Medical college hospital, Salem during the study period of June 2010 to October 2012 ,the following conclusion has been arrived. • The most common condition causing pain anus is Fissure-in-ano and next ranks strangulated thrombosed internal haemorrhoids. • The most commonly affected age group is 31-60 years. • Men are most commonly affected by the conditions causing pain in anal and peri anal region except hypertrophied anal papilla which is common in female sex. • In chronic Fissure-in-ano cases, most of our cases got relieved of pain through lateral internal sphincterotomy. • Most of these above conditions can be cured and patient can be relieved of pain, if sensible measures are taken.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Painful Conditions, Anal and Peri-Anal Region. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Devi S |
| Date Deposited: | 27 Mar 2020 02:41 |
| Last Modified: | 27 Mar 2020 02:41 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12476 |
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