12-15-2007, 06:28 PM
answer?
|
q1 - darkhorse
|
12-16-2007, 07:31 AM
The answer is D.
The patient has a chronic anal fissure. Anal fissures are often diagnosed by history alone, with severe anal pain made worse with defecation. There is often mild associated bleeding, but less than that seen with hemorrhoidal bleeding. The blood is usually described as staining the toilet paper or coating the stool. Associated conditions include constipation, trauma, Crohn's disease, and infections, including tuberculosis and syphilis. Acute anal fissures appear like a linear laceration, whereas chronic fissures show evidence of hypertrophied anal papillae at the proximal end with a skin tag at the distal end. Often the circular fibers of the internal anal sphincter can be seen at the base of the fissure. Acute anal fissures are treated conservatively with increased dietary fiber intake, topical anesthetics or glucocorticoids, and sitz baths. Treatment for chronic anal fissures is aimed at finding methods to decrease anal sphincter tone. Topical nitroglycerin or botulinum toxin injections may be used. In some cases surgical therapy becomes necessary with lateral internal sphincterotomy and dilatation.
12-16-2007, 09:09 AM
It looks like anal fissure -----> Nitro ointment . D)
|
| « Next Oldest | Next Newest » |