2020年11月5日星期四

what does a hemorrhoids look like,Chapter 29 What are the special examination methods for anorectal diseases?

    Of course, for some common diseases, you only need to do some routine inspections. For some difficult or special diseases, some special inspections are needed. I preliminarily summarized that the special inspection methods for anorectal diseases such as hemorrhoids and anal fistula are:

    (1) Electronic colonoscopy: The electronic colonoscope transmits the image of the colonic mucosa to the computer processing center through the electronic camera probe installed at the front end of the colonoscope, and then displays it on the monitor screen. The tiny colorectal mucosa can be observed Variety. Such as cancer, polyps, ulcers, erosions, bleeding, pigmentation, varicose and dilatation, hyperemia, edema, etc., the images are clear and lifelike. The electronic colonoscopy can also be sent into the biopsy forceps through the instrument channel of the colonoscope to obtain tissues the size of rice grains, and perform pathological biopsy tests or other special staining, and the histological characterization of the nature of mucosal lesions, such as the degree of inflammation, the degree of differentiation of cancer, etc. Grading helps to understand the severity of the disease, guide the formulation of the correct treatment plan or judge the treatment effect. Through the channel of the enteroscope instrument, some diseases or lesions of the colon such as polyps, bleeding, foreign bodies, etc. can be treated under endoscopic treatment.

    (2) Anorectal color Doppler ultrasound: Ultrasonography in the anal canal and rectum can determine the location of the anorectal abscess, the extent of the pelvic floor cyst, and the direction of the anal fistula, so as to guide surgical treatment, which is of great significance

    (3) Barium enema: The barium enema can well show the shape and contour of the colon on the filling image. After discharge, the shape of the mucous membrane can be observed, and the movement state of the colon can be observed. Basically clarify the location and size of inflammation, polyps, and cancer. For small lesions of the colon, double-contrast air-barium imaging is possible. Eat a low-residue diet the day before the check-up, fast at night without water, and clean the intestines with a bowel cleaner, and clean the enema early in the morning of the check-up.

    (4) Fistula angiography: generally use lipiodol or diatrizoate meglumine, inject fistula angiography from the outer opening of the fistula to understand the position of the fistula, length, direction, whether there are cavity branches, the position of the inner mouth, and the depth from the body surface And its relationship with surrounding organizations.

    (5) Defecography: Defecography is an X-ray examination method specifically used to understand constipation caused by functional outlet obstruction. Functional outlet obstruction constipation refers to a series of functional abnormalities in the rectum and anal canal that only appear during defecation.

    Supraanal distance, yipubic distance, anal canal length, rectal presacral distance, etc., to judge puborectal muscle hypertrophy, adhesion, spasm, achalasia of the anal canal, rectal mucosal prolapse, rectal intussusception, prerectal bulge (Rectal protrusion), sigmoid colon or small intestine hernia, anterior compression, pelvic floor and perineal descent syndrome, etc.

    (6) Colon transit test: The colon transit test is the only inspection method for slow colonic transit diseases. This inspection method judges the colonic peristaltic movement speed and the smoothness of the anal outlet through the transmission speed and position of the marker in the colon. It is slow to the functional colon. Constipation caused by transmission and constipation caused by functional outlet obstruction are of great significance in clinical diagnosis.

    (7) Anorectal pressure measurement: The anorectal pressure is measured to determine the anorectal function, which has certain diagnostic significance for patients with incontinence in defecation, Hirschsprung disease, etc. It is also helpful for the diagnosis of constipation.

    (8) Pelvic floor electromyography examination: through the detection of pelvic floor muscle electromyography, using computer software system to understand the atlas of muscle electromyographic activity, evaluate the pelvic floor muscle innervation and analyze the causes of incontinence and constipation. It is of great significance in the diagnosis of myogenic anorectal diseases.

    In addition, there are pelvic floor CT, MRI and other inspection methods, which are of great value in the diagnosis and treatment of many anorectal diseases such as hemorrhoids and anal fistulas. Based on your condition and the results of routine examinations, I will analyze and judge whether there is a need for further special examinations related to anorectal diseases in order to diagnose and treat your disease more accurately.

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