Anoscopy
Last reviewed: 23.04.2024
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[Indications
Anoscopy is of great importance for the detection of hemorrhoids, the differentiation of true polyps from hypertrophied anal papillae, which are hyperplasia of the mucous membrane in the anal sinuses (blinkers) as a result of chronic inflammation with fissures of the anus, hemorrhoids or proctitis. With the help of anoscopy, it is possible to distinguish anal polyps from thrombosed internal hemorrhoids, which appear as a rounded form of purplish-bluish or whitish color, which does not have a neck and a foot characteristic for polyps.
Anoscopy and sigmoidoscopy are used to assess symptoms and condition of the rectum and anus (eg, obvious rectal bleeding, discharge, prolapse, rectal pain ).
Method of carrying out anoscopy
Anoscopy can be performed without preparation. The anoscope is inserted to its full length as a solid sigmoidoscope, as described above, usually in the patient's position on the left side.
The perianal region and the distal part of the rectum can be examined by an anoscope 7 cm in length, the rectum and sigmoid colon - by a rigid 25-centimeter or flexible 60-centimeter instrument. Sigmoscopy by a flexible endoscope is much more convenient for the patient and allows you to take a photo and a tissue biopsy. Only a large practical experience allows us to conduct a solid sigmoscope to the rectosigmoid section (15 cm), without causing discomfort and pain during the procedure.
Sigmoscopy is performed after a purifying enema for emptying the rectum. Intravenous premedication is usually not required. The patient assumes a position on the left side. After external examination and finger examination of the rectum, the device is processed with ointment and can be easily inserted 3-4 cm above the anal sphincter. At this point, the obturator of the solid sigmoidoscope is removed and the instrument is advanced under direct visual control.
Contraindications
Absolute contraindications are absent. Patients with arrhythmias or newly transferred myocardial ischemia should be deferred until stabilization of the concomitant pathology; otherwise, the cardiologist should be monitored. Antibiotics are prescribed for patients requiring endocarditis prophylaxis .