Cryptitis: Difference between revisions
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==Background== | ==Background== | ||
*Anal crypts are mucosal pockets that lie between the columns of | [[File:Gray1080.png|thumb|The interior of the anal cami and lower part of the rectum, showing the anal columns and the anal valves between their lower ends (columns in image numerous than typical).]] | ||
[[File:Gray1078.png|thumb|Coronal section of rectum and the anal canal.]] | |||
[[File:Rectum anatomy en.png|thumb|Anatomy of the anus and rectum.]] | |||
*Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent [[diarrhea]], or passage of large/hard stools. | |||
===Pathophysiology=== | |||
*Anal crypts are mucosal pockets that lie between the columns of Morgagni (i.e., anal columns) | |||
**Anal columns are a number of vertical folds, produced by an infolding of the mucous membrane and some of the muscular tissue in the upper half of the lumen of the anal canal. | |||
**Formed by the puckering action of the sphincter muscles | **Formed by the puckering action of the sphincter muscles | ||
*Superficial trauma (diarrhea, trauma from hard stool) | *Superficial trauma ([[diarrhea]], trauma from hard stool) → breakdown in mucosal lining | ||
**Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands | **Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands | ||
***Can lead to fissure | ***Can lead to [[anal fissure]], [[anal fistula]], [[perirectal abscesses]] | ||
==Clinical Features== | ==Clinical Features== | ||
*Anal pain | *Anal pain | ||
*Sphincter spasm | *Sphincter spasm | ||
*Itching | *Itching with or without bleeding | ||
*Hypertrophied papillae | *Hypertrophied papillae | ||
==Diagnosis== | |||
==Differential Diagnosis== | |||
{{Anorectal DDX}} | |||
==Evaluation== | |||
*Anoscopy shows inflammation, erythema, and pus | *Anoscopy shows inflammation, erythema, and pus | ||
== | ==Management== | ||
#Bulk laxatives, additional roughage, sitz baths (treats underlying cause) | #Bulk [[laxatives]], additional roughage, sitz baths (treats underlying cause) | ||
#Surgical referral is indicated when: | #Surgical referral is indicated when: | ||
# | #*Infection has progressed and the crypt will not drain adequately on its own | ||
# | #*Surgical treatment is excision | ||
==Disposition== | |||
*Outpatient | |||
==See Also== | |||
*[[Anorectal Disorders]] | |||
== | ==External Links== | ||
==References== | |||
<references/> | |||
[[Category:GI]] | [[Category:GI]] | ||
Latest revision as of 20:41, 23 April 2025
Background
- Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent diarrhea, or passage of large/hard stools.
Pathophysiology
- Anal crypts are mucosal pockets that lie between the columns of Morgagni (i.e., anal columns)
- Anal columns are a number of vertical folds, produced by an infolding of the mucous membrane and some of the muscular tissue in the upper half of the lumen of the anal canal.
- Formed by the puckering action of the sphincter muscles
- Superficial trauma (diarrhea, trauma from hard stool) → breakdown in mucosal lining
- Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands
- Can lead to anal fissure, anal fistula, perirectal abscesses
- Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands
Clinical Features
- Anal pain
- Sphincter spasm
- Itching with or without bleeding
- Hypertrophied papillae
Differential Diagnosis
Anorectal Disorders
- Anal fissure
- Anal fistula
- Anal malignancy
- Anal tags
- Anorectal abscess
- Coccydynia
- Colorectal malignancy
- Condyloma acuminata
- Constipation
- Crohn's disease
- Cryptitis
- GC/Chlamydia
- Fecal impaction
- Hemorrhoids
- Levator ani syndrome
- Pedunculated polyp
- Pilonidal cyst
- Proctalgia fugax
- Proctitis
- Pruritus ani
- Enterobius (pinworms)
- Rectal foreign body
- Rectal prolapse
- Syphilitic fissure
Non-GI Look-a-Likes
Evaluation
- Anoscopy shows inflammation, erythema, and pus
Management
- Bulk laxatives, additional roughage, sitz baths (treats underlying cause)
- Surgical referral is indicated when:
- Infection has progressed and the crypt will not drain adequately on its own
- Surgical treatment is excision
Disposition
- Outpatient
See Also