2021年1月31日星期日

hemorrhoids and anal fissures,"Scary" anal papilloma

    To talk about the anal nipple, we must first talk about the anatomy of this part of the anal canal. In the previous explanation, it was mentioned that the dental line is an anatomical landmark that separates the rectum and anal canal, and above it is the anal column formed by the contraction of the sphincter. Like the name, it is like where the pillar and pestle are located, usually the number is 6-10. There is a depression between the pillars called anal recesses (anal sinuses), the anal sinus is connected to the anal glands, the doorway has a layer of flaps called the anal flap, and it is on the same horizontal line as the small cone or triangular protrusion at the base of the anal column. Anal nipples. Therefore, the anal papilla is all the structure of the human body itself, not a product of pathology.

    Anal papilloma is mostly caused by inflammatory stimuli such as anal sinusitis and anal fissure, coupled with long-term constipation, excessive defecation time, excessive exertion, or diarrhea that causes the anal papilla to be proliferated by excessive stimulation, and it will become hypertrophy over time Then it becomes anal papilloma.

    Anal papilloma has an insidious onset and slow course. The initial manifestations are anal sinusitis or anal fissure: anal discomfort, falling sensation, tingling, and local irritation and burning during defecation. As the course of the disease progresses, the nipple enlarges, and there will be a feeling of foreign body in the anus and incomplete defecation. The enlarged nipple may protrude out of the anus during defecation, and there will be pain and occasional blood in the stool. When the enlarged nipples are stimulated or ruptured, the secretion of the anal glands increases, and the area around the anus is moist and itchy. Over time, perianal eczema will develop.

    When the hypertrophic nipple protrudes out of the anus, it is often regarded by the patient as a prolapse of hemorrhoids, which is often ignored because it is not painful, itchy, or bleeding. It has to be said that when there is no professional knowledge, it is really difficult to distinguish the two. Although the symptoms of anal nipple prolapse are similar to those of internal hemorrhoids, the characteristics are different. The prolapsed nipples are mostly brown or white, hard, not smooth, small cones or triangular protrusions, and the head is large and pedicled. Internal hemorrhoids are bulges of submucosal veins. When there is no incarceration, they are mostly dark red, soft, smooth, and mostly round protrusions without pedicles.

    Some people mistakenly call anal papilloma "rectal polyps". In fact, although the two are somewhat similar in appearance, there are essential differences. Rectal polyps come from the rectal mucosa, located in the middle and lower part of the rectum, pink, soft, and painless. , Is divided into neoplastic polyps and non-neoplastic polyps. Neoplastic such as tubular adenoma, tubular villous adenoma, villous adenoma, etc., are prone to malignant transformation; non-neoplastic adenomas include inflammatory polyps, hyperplastic polyps, etc. Bleeding. Anal papilloma is born near the tooth line, covered with skin, smooth, tender, not easy to bleed, and hard in texture.

    The shape of the anal papilla after hypertrophy and hyperplasia can be described as strange, varying in length from 1-7cm, of course, it is not that longer, but it is very small. In most cases, it is just a small cone or triangular protrusion, but when the course of the disease is long, various shapes may evolve on this basis, even ginger-like.

    In terms of treatment, it is quite simple, as long as the nipple pedicle is clamped and then ligated and removed.

    Although it is called anal papilloma, it is a benign tumor and basically does not become cancerous. Even if it grows into a ginger-like shape, it is not the same as the cauliflower-like shape of a malignant tumor. Of course, it is necessary to do a pathological examination to confirm the diagnosis after surgery, just in case.

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