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coccygea) A dimple in the skin beneath the tip of the coccyx, sometimes amounting to a short bli...

Special investigations A successful outcome after fistula surgery requires careful assessment of ...

The epithelium and subepithelial structures The pink columnar epithelium lining the rectum extend...

Treatment of complications Strangulation and thrombosis are relatively uncommon. The patient pres...

Proctoscopy Proctoscopy , performed with the patient in the same position, allows a detailed insp...

Rectal examination The finger encounters a sharply defined shelf-like interruption of the lumen. I...

Sigmoidoscopy Although sigmoidoscopy is strictly an examination of the rectum, it should always ...

Presentation A perianal abscess, confined by the terminal extensions of the longitudinal muscle, i...

Principles of fistula surgery The aim of surgery is to keep the patient continent and comfortable...

Proctalgia fugax This problem is characterised by attacks of severe pain arising in the rectum, ...

Postanal dermoid The space in front of the lower part of the sacrum and coccyx may be occupied ...

Postoperative care In many countries, haemorrhoidectomy is performed on a day-case basis. The pat...

Postoperative complications Postoperative complications may be early or late. Early complications...

PRURITUS ANI This is intractable itching around the anus, a common and embarrassing condition. Us...

Pathology Occlusion of gland ducts leads to bacterial proliferation, gland rupture and the spread...

Pilonidal sinus The term pilonidal sinus describes a condition found in the natal cleft overlying...

Other anal malignancies Adenocarcinoma within the anal canal is usually an extension of a distal ...

Other techniques Video-assisted anal fistula treatment (V AAFT) involves the introduction of a ri...

PHYSIOLOGICAL ASPECTS OF THE ANAL SPHINCTERS AND PEL VIC FLOOR Anal continence and defecation ar...

Operations to augment the anal sphincters If the degree of sphincter disruption or weakness is ...