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FISTULA- IN-ANO Aetiology A fistula- in - ano , or anal fistula, is a chronic abnormal commu nicati...

FURTHER READING Chu CS, Pfister DG. Opportunities and challenges: human papillomavirus and cancer....

Digital examination with the index finger With an adequately lubricated index finger, the soft tiss...

EXAMINATION OF THE ANUS Careful clinical examination will be diagnostic in the vast majority of ...

Endometriosis Endometriosis of the rectovaginal septum may present as a stricture. There is usua...

Clinical features Although superficial, acute anal fissures are characterised by severe anal pain d...

Diagnosis and management A high index of suspicion and targeted biopsy yields the diag nosis, wh...

Differential diagnosis The only conditions with which an anorectal abscess is likely to be confus...

CONGENITAL ABNORMALITIES Early in embryonic life there is a common chamber – the cloaca – into wh...

Classification The most widely used classification of anal fistulae (Parks’) is based on anal gland ...

Clinical assessment A full medical (including obstetric, gastrointestinal, anal surgical and cont...

Anal sphincter surgery In situations where conservative treatment has failed, and where a discret...

Biological agents The functional consequences of fistulotomy have led to a search for agents that...

CONDYLOMATA ACUMINATA (ANAL WARTS) There is increasing evidence that sexually transmitted infecti...

Aetiology The cause of an anal fissure, and particularly the reason why the posterior midline is ...

Anal advancement flap An anal advancement flap to cover the anal fissure should be considered in tho...

Anal canal anatomy The anus is 3–4 /uni00A0 cm long in adults, being longer in the adult male tha...

ANATOMY AND PHYSIOLOGY OF THE ANAL CANAL Surgical anatomy The anal canal starts at the level wher...

ANORECTAL ABSCESSES Aetiology Acute sepsis in the region of the anus is common, more in men than...

Advancement flaps When the sphincter complex is not too indurated and adequate intra-anal access c...