Prolapse of_rectum And chronic hemorrhoid.docx

1. Prolapse of rectum and chronic hemorrhoid 3_4 stage
Complaints :
_presence of prolapsus of rectum of it’s part outside
_stool changes ( diarrhea or constipation, presence of pathologic admixtures:
blood, mucus, pus or tumorous detritus)
-Fecal Leakage
-Pelvic pain
-Rectal Bleeding or with pus , mucus
-Tenesmus
-Fever
Anamnesis morbi :-
-Chronic beginning
- 2 Mounths
-Analgesics
Anamnesis Vitae :-
Child Birth
Physical examination :-
Visual inspiction
-of abdomen
- swollen
- symmetric or asymmetric
- extent of participation of anterior abdominal wall in breathing
-of the perianal area: presence of prolapsed part of mucose or others tunics of the rectum, it’s
oedema ( clock dail)
Physical Examination :-
-Pale Skin
-visible prolapsed

2. -Rectum
Palpation :-
Pain at rectal
Percussion:-
No change
Auscultaion :-
No change
Labaratory test :-
Decrase erythrosit
Decrease hemoglobin
Anemia
Instrumental Examination:-
-Digital Rectal Examination
-Speculum
-Proctoscope
Deffrential Diagnosis :-
-in case of the rectal prolapse with the malignant neoplasm of the rectum, intrarectal foreign
body, and chronic hemorrhoids of 3-4 stage;
-in case of chronic hemorrhoids of 3-4 stage with the anal fissure, malignant neoplasm of the
rectum, intrarectal foreign body and rectal prolapse;
Treatment :-
urgent or plane operation, (indications for operation, pre- and postoperative treatment) or
possibility of medicamental or out-patient treatment.