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2 results

  • Chapter 27 - Non-Neoplastic Diseases of the Anal Canal

  • Edited by Roger M. Feakins
  • Book:
    Non-Neoplastic Pathology of the Gastrointestinal Tract
    Published online:
    06 June 2020
    Print publication:
    09 July 2020, pp 434-445

  • Summary

    The most common non-neoplastic conditions in the anal canal include haemorrhoids, fissures, fibroepithelial polyps and associated abscesses, manifestations of Crohn’s disease, human papilloma virus infection, and other sexually transmitted infections (some of which are secondary to HIV). Several dermatoses that are not site-specific may also involve the anal canal and perianal areas. These include eczema, psoriasis, lichen planus, lichen sclerosus, acanthosis nigricans, and hidradenitis suppurativa. Non-neoplastic polypoid lesions may occur, and these include condylomata acuminata and inflammatory cloacogenic polyps. Congenital abnormalities include imperforate anus and anal duplication. The former rarely, if ever, comes to attention of the histopathologist whereas the latter is occasionally encountered.

  • Neuropathy – overview

  • from Chief complaints and diagnoses
  • Edited by Stephen H. Thomas
  • Book:
    Emergency Department Analgesia
    Published online:
    18 December 2009
    Print publication:
    25 September 2008, pp 289-300

  • Summary

    This chapter addresses perianal painful conditions encountered in the ED setting. Laxatives are the initial therapy for perianal pain from a variety of conditions. Topically applied nitroglycerin is widely recommended for pain caused by either anal fissures or thrombosed external hemorrhoids. The utility of NSAIDs in post-hemorrhoidectomy pain is demonstrated by trials of perioperative administration of agents such as ketorolac and diflunisal. For patients with chronic anal fissure or painful external hemorrhoids who fail nitroglycerin therapy, or who have intolerable side effects to the drug, calcium channel blockers have been recommended as an alternative means to reduce anal tone and relieve symptoms. Perianal pain may also be the presenting complaint for patients with Condylomata acuminatum.The systemic condition lichen sclerosus, usually treated with potent topical corticosteroids, causes perianal (and vulvar) pain that can be significantly alleviated with topical 1% pimecrolimus cream.