Anoscopy: Difference between revisions
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**Culture tube and swab | **Culture tube and swab | ||
**Biopsy forceps | **Biopsy forceps | ||
[[File:Anoscopic Exam Photo.jpg|thumb|Use of anoscope for internal inspection of the lower rectum]] | |||
==Procedure== | ==Procedure== | ||
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==Complications== | ==Complications== | ||
*Tearing of perianal skin/mucosa | |||
*Abrasion or tearing of hemorrhoidal tissue | |||
*Infection (rare)<ref>London S, Hoilat GJ, Tichauer MB. Anoscopy. [Updated 2021 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459324/</ref> | |||
==See Also== | ==See Also== | ||
*[[Rectal Foreign Body]] | |||
*[[Anorectal Disorders]] | |||
==External Links== | ==External Links== | ||
*[https://www.merckmanuals.com/professional/gastrointestinal-disorders/how-to-do-gastrointestinal-procedures/how-to-do-anoscopy?query=anoscopy Merk Manual - How To Do Anoscopy] | |||
*[https://journals.lww.com/em-news/blog/theproceduralpause/pages/post.aspx?PostID=88 Emergency Medicine News - The Anoscope for Foreign Bodies in the Rectum] | |||
===Videos=== | |||
*{{#widget:YouTube|id=DraK34z4lFk}} | |||
==References== | ==References== | ||
Latest revision as of 18:19, 18 August 2021
Overview
- The use of an anoscope to visually inspect the anus, anal canal, and internal sphincter
- Helpful in identifying causes of rectal bleeding
- Up to 50% of rectal bleeding is falsely attributed to hemorrhoids when internal examination is not used[1]
Indications
- Evaluation of bright red bleeding
- Evaluation anorectal symptoms (anal pain, discharge, protrusions, or pruritus)
- Evaluation/treatment of rectal foreign bodies
Contraindications
Absolute Contraindications
- Imperforate anus
- Bowel Perforation
- Significant active bleeding
Relative Contraindications
- Severe anal pain
- Recent anal surgery
Equipment Needed
- Gloves
- Anoscope (Reusable or disposable)
- Adults: 7-cm (typically 19-mm diameter) anoscope; slotted or non-slotted
- Pediatrics: 8-mm to 14-mm diameter
- Light source (often built into disposable anoscopes)
- Lubricating jelly (and topical anesthetic jelly if patient has severe anal pain)
- Cotton swabs
- If needed:
- Fecal occult blood test
- Culture tube and swab
- Biopsy forceps
Procedure
- Position the patient (lithotomy position or left lateral decubitus w/ knees flexed toward chest)
- Pull buttock apart, inspect the external area
- Perform digital rectal exam with lubricated, gloved finger (use topical anesthetic jelly if needed and wait 1-2 minutes prior to anoscopy)
- Lubricate the anoscope and the central guide plug (obturator)
- Slowly insert the anoscope fully, maintaining pressure on the obturator.
- If obturator slips or falls out during insertion, remove anoscope completely and repeat procedure
- Once inserted, remove the obturator (keep it nearby if needed again)
- Slowly withdraw, rotate (if non-slotted anoscope), and visual the entire circumference of the canal
- Perform any biopsies (if above dentate line) or cultures as needed
Complications
- Tearing of perianal skin/mucosa
- Abrasion or tearing of hemorrhoidal tissue
- Infection (rare)[2]
See Also
External Links
- Merk Manual - How To Do Anoscopy
- Emergency Medicine News - The Anoscope for Foreign Bodies in the Rectum
Videos
- {{#widget:YouTube|id=DraK34z4lFk}}
References
- ↑ Gudur A, Shanmuganandamurthy D, Szep Z, Poggio JL. An Update on the Current Role of High Resolution Anoscopy in Patients With Anal Dysplasia. Anticancer Res. 2019 Jan;39(1):17-23.
- ↑ London S, Hoilat GJ, Tichauer MB. Anoscopy. [Updated 2021 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459324/