SURGERY-ABDOMINAL CONDITIONS

1. CONDITIONS OF THE
RECTUM AND ANAL CANAL
PAULINE TEMBO-RN/BSC

2. ANATOMY OF THE RECTUM AND ANAL CANAL

3. ANAL FISSURE

4. ANAL FISSURE

5. ANAL FISSURE
•DEF: An Anal Fissure is a small tear in the thin, moist
tissue (mucosa) that lines the anus.
•An anal fissure may occur when one passes hard or
large stools during a bowel movement.
•Anal fissures typically cause pain and bleeding with
bowel movements.
•A client may experience spasms in the ring of muscle
at the end of the anus (anal sphincter).

6. •Anal fissures are very common in young
infants but can affect people of any age.

7. RISK FACTORS
•Constipation. Straining during bowel movements and
passing hard stools increase the risk of tearing.
•Childbirth. Anal fissures are more common in women after
they give birth.
•Crohn's disease. This inflammatory bowel disease causes
chronic inflammation of the intestinal tract, which may make
the lining of the anal canal more vulnerable to tearing.
•Anal intercourse.
•Age. Anal fissures can occur at any age, but are more
common in infants and middle-aged adults.

8. SYMPTOMS
Signs and symptoms of an anal fissure include:
•Pain, sometimes severe, during bowel movements
•Pain after bowel movements that can last up to several
hours
•Bright red blood on the stool or toilet paper after a
bowel movement
•A visible crack in the skin around the anus
•A small lump or skin tag on the skin near the anal
fissure

9. TREATMENT
•Most anal fissures get better with simple
treatments, such as increased fiber intake or
sitz baths.
•Some people with anal fissures may
need medication or, occasionally,
surgery(lateral internal
sphincterotomy).

10. ANAL FISTULA

11. ANAL FISTULA
•DEF: An anal fistula is a small tunnel that connects an
abscess, an infected cavity in the anus, to an opening
on the skin around the anus.
•Just inside the anus are a number of small glands that
make mucus.
•Occasionally, these glands get clogged and can
become infected, leading to an abscess.
•About half of these abscesses may develop into a
fistula.

12. SIGNS AND SYMPTOMS
•Frequent anal abscesses
•Pain and swelling around the anus
•Bloody or foul-smelling drainage (pus) from an
opening around the anus.
•Pain with bowel movements
•Bleeding
•Fever, chills and a general feeling of fatigue

13. TREATMENT
•Surgery- fistulotomy where the fistula is closed
off.
•Antibiotic treatment to treat the abscess before
fistulotomy is performed.
•a sitz bath
•stool softeners or laxatives for a week.

14. ANAL ABSCESS

15. ANAL ABSCESS/ ISCHIO-RECTAL ABSCESS
•An anal abscess is a painful condition in which a
collection of pus develops near the anus.
•Most anal abscesses are a result of infection
from small anal glands.

16. CAUSES OF ANAL ABSCESSES
•An anal fissure, a tear in the anal canal,
that becomes infected
•Sexually transmitted infections
•Blocked anal glands
•Inflammatory bowel disease such as
Crohn's disease or ulcerative colitis

17. TREATMENT
•Drainage of abscess
•Antibiotic treatment

18. HIRSCHSPRUNG'S DISEASE

19. HIRSCHSPRUNG'S DISEASE
•Hirschsprung's disease is a condition that affects the
large intestine (colon) as a result of missing nerve
cells in the muscles of the baby's colon.
•The condition is present at birth (congenital). It
mostly occurs as a genetic condition
•Without these nerve cells stimulating gut muscles to
help move contents through the colon, the contents
can back up and cause blockages in the bowel.

20. Signs and symptoms
•When the symptoms start is dependent on how big the
area that isn’t supplied with nerves is.if the area is big,
symptoms are seen within 48 hours of birth, if it’s a small
area, it can take up to 8 years of life to diagnose.
• Each child may experience symptoms differently, but
common symptoms in infants include:
•failure to have a bowel movement in the first 48 hours of
life
•abdominal distention (stomach bloating)
•gradual onset of vomiting
•constipation or failure to pass regular bowel movements

21. TREATMENT
• Surgery-removal of the affected part of the intestines is
done.

22. SPECIAL INVESTIGATIONS

23. 1. PROCTOSCOPY
•Proctoscopy is a common Surgical procedure in
which an instrument called a proctoscope is
used to examine the anal cavity, rectum, or
sigmoid colon.
• A proctoscope is a hollow tube, usually with a
tiny light at the end, that can also be used to
take tissue samples for biopsies as a cancer
screening tool.

24. PROTOSCOPY

25. COLONOSCOPY
•A colonoscopy is an exam used to look for
changes — such as swollen, irritated tissues,
polyps or cancer — in the large intestine (colon)
and rectum.
•During a colonoscopy, a long, flexible tube
(colonoscope) is inserted into the rectum

26. COLONOSCOPY

27. BARIUM ENEMA
•A barium enema is a test that helps to highlight
the large bowel so it can be clearly seen on an X-
ray.
•During the test, a white liquid called barium is
passed into your bowel through your bottom.

28. BARUIM ENEMA