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Anal sphincter injuries are uncommon injuries outside of obstetric practice — but they may cause disastrous complications. We present a case of complete anal sphincter disruption from anal intercourse in a 25 year old woman. Clinical management is presented and technical details of the repair are discussed. She had an uneventful post-operative course and good continence after days of follow up. This is one of a handful of reported cases of anal sphincter disruption secondary to anal intercourse. The established risk factors in this case included receptive anal intercourse coupled with alcohol use. We review the pertinent surgical principles that should be observed when repairing these injuries, including anatomically correct repair and appropriate suture choice. There is little evidence to support simultaneous faecal diversion for primary repair of acute perineal lacerations. Acute post-coital sphincter injuries should be treated operatively on an emergent basis, without diversion because they are low energy injuries with minimal tissue loss and excellent blood supply. Although repair of each injury should be individualized, the majority of these injuries do not require concomitant protective colostomy creation.
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An anal fissure is a tear in the lining of the lower rectum anal canal that causes pain during bowel movements. Anal fissures don't lead to more serious problems. Most anal fissures heal with home treatment after a few days or weeks. These are called short-term acute anal fissures. If you have an anal fissure that hasn't healed after 8 to 12 weeks, it is considered a long-term chronic fissure. A chronic fissure may need medical treatment. Anal fissures are a common problem. They affect people of all ages, especially young and otherwise healthy people. Fissures can also be caused by a rectal exam, anal intercourse, or a foreign object. In some cases, a fissure may be caused by Crohn's disease.

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This year-old man presented with a very painful infection. There was a large abscess which was easily palpable with surrounding cellulitis. It clearly needed incision so he was admitted for this to be done under general anaesthetic. There was no obvious underlying cause, such as inflammatory bowel disease or diabetes. Following drainage, the abscess cavity required regular dressing but healed well. This man rather sheepishly requested help with the removal of this perianal lesion. It had been present for some years, but his new partner did not like it, making him seek help. He was referred and it was removed easily. Histology confirmed the benign nature of the lesion. The cause is unknown, but patients often have more than one lesion, and as in this case, they can become quite large.

Hemorrhoids, also called piles, happen when clusters of veins in your rectum or anus get swollen or dilated. When these veins swell, blood pools and causes the veins to expand outward into the membranes around your rectal and anal tissue. This can become uncomfortable or painful. But when they expand, they can look like red or discolored bumps or lumps. In fact, less than 5 percent of people who get hemorrhoids have symptoms. Even less need treatment. At least three of every four adults will get them at one point in their life. But see your doctor right away if your hemorrhoids are causing you pain, or disrupting your normal activities and bowel movements.

Internal hemorrhoids are found in your rectum. Sometimes internal hemorrhoids can swell and stick out of your anus. This is known as a prolapsed hemorrhoid. But they can cause symptoms if they grow larger, including:. Feces traveling through your rectum can also irritate an internal hemorrhoid. This can cause bleeding that you may notice on your toilet tissue. A prolapsed hemorrhoid occurs when internal hemorrhoids swell and stick out of your anus. A doctor may assign a grade to a prolapsed hemorrhoid based on how far it sticks out:.

Prolapsed hemorrhoids look like swollen red lumps or bumps outside your anus. You may be able to see them if you use a mirror to examine this area. Prolapsed hemorrhoids may have no other symptom than the protrusion, or they may cause pain or discomfort, itchiness, or burning. External hemorrhoids occur on your anus, directly on the surface of where your bowel movements come out. But see your doctor if they cause pain or discomfort that interrupts your daily life. The symptoms of external hemorrhoids are essentially the same as those of internal ones.

A thrombosed hemorrhoid contains a blood clot thrombosis within the hemorrhoid tissue. They may appear as lumps or swelling around your anus. Thrombosed hemorrhoids are essentially a complication of a hemorrhoid, in which a blood clot forms.

See your doctor as soon as possible if you notice increasing pain, itchiness, or inflammation around your rectal and anal area. Thrombosed hemorrhoids need to be treated quickly to prevent complications from a lack of blood supply to your anal or rectal tissue. Anything that puts pressure or strain on your anus or rectum can cause the veins to dilate. Some common causes and risk factors include:. Internal hemorrhoids can become prolapsed hemorrhoids if you continue to do any of these things that may have caused your hemorrhoid in the first place.

See your doctor if you start to notice pain and discomfort around your anus, especially when you sit or have a bowel movement. In some cases, your hemorrhoids may need to be removed to prevent pain and long-term complications. Some procedures for removal include:. Complications of hemorrhoids are rare. If they do happen, they may include:. Prolapsed and thrombosed hemorrhoids are much more likely to cause discomfort or increase your risk of complications.

Seek emergency medical attention if your hemorrhoids cause pain and discomfort, or if you notice any symptoms like bleeding or prolapse. Hemorrhoids that are treated quickly have a better chance of healing without causing any further complications. Hemorrhoids are an extremely common problem, causing symptoms of pain, itching, and rectal bleeding. While they typically go away on their own, you…. Prolapsed hemorrhoids are hemorrhoids that bulge outward from the anus.

They can be painful. In many cases, you may be able to treat them with…. Learn about thrombosed hemorrhoids and how they are different from regular hemorrhoids. Hemorrhoids affect nearly 3 out of 4 adults. The pain, tenderness, bleeding, and intense itching that accompany hemorrhoids are often enough to drive you up the wall. Here are 15 foods to prevent….

Chronic hemorrhoids can last weeks with regular symptom flare-ups. Learn about doctor-directed self-care, plus details on more aggressive treatment…. Pregnancy hemorrhoids are a common and uncomfortable problem of pregnancy. They're often caused by extra pressure from your growing baby, as a result…. Infected hemorrhoids are rare but can happen if you're prone to certain types or if you're more at risk for infections in general.

Some procedures to…. Is popping a hemorrhoid like popping a pimple? Not quite. Learn why this isn't an effective treatment option for hemorrhoids and which safer home…. Hemorrhoids, sometimes called piles, are swollen and distended veins in the anus and lowest part of the rectum. Hemorrhoids can be painful and itchy…. What Are the Different Types of Hemorrhoids? Pictures of the different types of hemorrhoids. Internal hemorrhoids. External hemorrhoids. Thrombosed hemorrhoid. What causes hemorrhoids? When should I see my doctor?

How are they diagnosed? How are they treated? What are possible complications of hemorrhoids? Hemorrhoid Surgery. Essential Oils for Hemorrhoids. Food for Piles: 15 Foods to Fight Hemorrhoids. Read this next. Why Do Hemorrhoids Itch?

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