... Hemorrhoids are dilated perianal veins that become thrombosed or can rupture, producing subcutaneous or submucosal hematomas. They are usually due to chronic constipation but may be the
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Is it true or false melena? False melena may be induced by iron ingestion, bismuth ingestion, charcoal ingestion, red wine ingestion, and many other substances. ... DIAGNOSTIC WORKUP
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Is it severe? The presence of severe rectal bleeding would suggest ulcerative colitis, amebic dysentery, bacillary dysentery, intussusception, mesenteric ... DIAGNOSTIC WORKUP
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Is there bleeding? The presence of bleeding with pain suggests an anal fissure, hemorrhoids, carcinoma, rectal prolapse, and intussusception.
Is there a mass? The presence of ... DIAGNOSTIC WORKUP
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Is it mucopurulent or feculent? A mucopurulent discharge suggests an anal fistula, perirectal abscess, proctitis, anal ulcer, or rectal prolapse. A feculent ... DIAGNOSTIC WORKUP
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Is it painful? A painful rectal mass should suggest perirectal abscess, thrombosed hemorrhoid, anal ulcer, ruptured ectopic pregnancy, tubo-ovarian abscess, and ... DIAGNOSTIC WORKUP
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Hemorrhoids are not protruding “varicose veins”—they are distinct from the rectal varices of portal hypertension. Rather, hemorrhoids are downwardly... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Rectal complaints are common and distressing for patients. Although most causes of rectal pain and bleeding are benign and treatable, carcinoma must be considered and ruled out in older patients (>40 years) and those with... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Any mass in the anal canal or rectum should be considered cancer until ruled out. Colorectal cancer must be considered, as it is the second leading cause of cancer death in the U.S., with greater than 40,000 mortalities each year. Early... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Lower GI tract bleeding occurs distal to the ligament of Treitz (which separates the duodenum from the jejunum) and refers to the passage of either bright red blood per rectum ... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... This discussion considers the causes of bright red or maroon stools. (The causes of melena or black stools are the same as the causes of hematemesis; the differential diagnosis is given on page 261.) Bright-red blood may
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... Practically the whole specialty of proctology is devoted to taking care of patients with rectal pain. To develop the differential diagnosis it is useful first to divide the conditions into extrinsic and intrinsic.
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... Aside from the common external hemorrhoids (which will not be seen in many cases unless the patient is asked to bear down), anal masses may include any of the following:
Skin tag from previous ruptured or incised hemorrhoids
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... Rectal discharges are usually bloody, but the two notable exceptions to this are a ruptured perirectal abscess and an anal fistula (really the end result of the former). Use
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... Of course, the physician is looking for a rectal carcinoma when performing a routine rectal examination, but what else might be found? Use the mnemonic VINDICATE to have a list of possibilities clearly in
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... Hematemesis means vomiting or regurgitation of frank bright red blood or coffee-ground material that is positive for occult blood. It may be differentiated from hemoptysis because it usually gives
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. The characteristic color results from bacterial degradation and hydrochloric acid acting on the blood as it... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Hemorrhoids are varicosities in the superior or inferior hemorrhoidal venous plexus. Dilation and enlargement of the superior plexus produce internal hemorrhoids; dilation and enlargement of the inferior plexus produce external hemorrhoids... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Anal fissure is a laceration or crack in the lining of the anus that extends to the circular muscle. Most fissures heal on their own and don’t require treatment, aside from good diaper hygiene. However, some fissures may require... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Anorectal abscess is a localized collection of pus due to inflammation of the soft tissue near the rectum or anus. Inflammation may produce an anal fistula — an abnormal opening in the... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... In anorectal stricture, also known as anorectal stenosis or contracture, the anorectal lumen size decreases and stenosis prevents dilation of the sphincter.
Causes
... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Rectal polyps are masses of tissue that rise above the mucosal membrane and protrude into the GI tract. Types of polyps include common polypoid adenomas, villous adenomas, hereditary polyposis, focal polypoid hyperplasia, and... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Rectal prolapse is the circumferential protrusion of one or more layers of the mucous membrane through the anus. Prolapse may be complete (with displacement of the anal sphincter or bowel... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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Melena
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. Characteristic color results from bacterial degradation and hydrochloric acid acting on the blood as it... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the patient may refer to... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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... The passage of bloody stools, also known as hematochezia, usually indicates—and may be the first sign of—GI bleeding below the ligament of Treitz. However, this sign&mdash... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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Rectal Bleeding
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Ted Epperly
Rectal bleeding is a common problem encountered by primary care providers across the United States. Annually, approximately 3% of the... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Differential Overview
❑ Hemorrhoid
❑ Rectal fissure
❑ Prostatitis
❑... Diagnostic Approach ... Clinical Findings
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... Hemorrhoidal varices are part of the normal anatomy. Dilation and enlargement of the superior plexus of the superior hemorrhoidal veins located above the dentate line produce internal hemorrhoids. Enlargement of the plexus of the inferior... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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Melena
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. Characteristic color results from bacterial degradation and hydrochloric acid acting on the... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Melena
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. Characteristic color results from bacterial degradation and hydrochloric acid acting on the blood as it travels through... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... A common sign of upper GI bleeding, melena is the passage of black, tarry stools containing digested blood. The characteristic color results from bacterial degradation and hydrochloric... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the patient may refer to all local pain as... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... The passage of bloody stools, also known as hematochezia, usually indicates—and may be the first sign of—GI bleeding below the ligament of Treitz. However, this sign&mdash... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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This discussion considers the causes of bright red or maroon stools.
(The causes of melena or black stools are the same as the causes of
hematemesis; the differential diagnosis is given on page... Pictures
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...
Practically the whole specialty of proctology is devoted to taking care
of patients with rectal pain. To develop the differential diagnosis it is
useful first to divide the conditions into ... Pictures
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...
Aside from the common external hemorrhoids (which will not be seen in
many cases unless the patient is asked to bear down), anal masses may
include any of the following:
... Pictures
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...
Rectal discharges are usually bloody, but the two notable exceptions to
this are a ruptured perirectal abscess and an anal fistula
(really... Pictures
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...
Of course, the physician is looking for a rectal carcinoma when
performing a routine rectal examination, but what else might be found? Use
the mnemonic VINDICATE to have a list of... Pictures
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...
Hematemesis means vomiting or regurgitation of frank bright red
blood or coffee-ground material that is positive for occult blood. It may be
differentiated... Pictures
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