Anorectal disorders

DDX

1. Anal Tags
2. Hemorrhoids
3. Cryptitis
4. Anal Fissure
5. Anal Fistula
6. Anorectal Abscess
7. Proctitis
8. Rectal Prolapse
9. Rectal Foreign Body
10. Pruritus Ani
11. Pilonidal Cyst

Algorithmic Diagnostic Approach

Pain and Bleeding

1. External hemorrhoid
2. Prolapsed internal hemorrhoid
3. Anal Fissure
   1. Off midline = cancer, HIV, TB, Crohn's

Pain, No Bleeding

1. Swelling
   1. Abscess
      1. Perirectal
      2. Ischiorectal
      3. Intersphincteric
      4. Supralevator
   2. Pilonidal Cyst
   3. Anal Fistula
   4. Hidradenitis suppurativa
2. No swelling
   1. Proctalgia Fugax

Bleeding, No Pain

1. Cancer
2. Internal hemorrhoid

Painless Swelling

1. Itch: Condyloma acuminata (warts 2/2 HPV)
2. No itch: Rectal prolapse

Itching

1. Discharge: Proctitis
2. No discharge: Pruritus Ani

See Also

• Diagnoses by Body Part (Main)