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| Name | REMOVAL OF FIBROUS ANAL POLYP ASSOCIATED WITH ANAL FISSURE |
| Video Uploader | Video From Dr Pravin J Gupta, MBBS MS Laxmi Nagar, NAGPUR, IN |
| Upload Date | This Video Uploaded At 20-08-2024 01:19:19 |
| Video Discription | DISCLAIMER- Medical Educational Video. Not to promote sexuality or Nudity. FIBROUS ANAL POLYP REMOVAL Hypertrophied anal papillae are essentially skin tags that project up from the dentate line, or the junction between the skin and the epithelial lining of the anus. They are often found as part of the classic triad of a chronic fissure, namely the fissure itself, hypertrophied papilla above and a skin tag below. They are also found in isolation, maybe firm and palpable on a digital examination of the anus. In this situation, they must be differentiated from polyps, hemorrhoids, or other growths. Endoscopically they could be differentiated from an adenomatous polyp by their white appearance and their origin from the lower (squamous) aspect of the dentate line in the anal canal. They are usually a symptomatic but occasionally grow large enough to be felt by the patient or are likely to prolapse. Hypertrophied anal papilla should be included in the differential diagnosis of a smooth mass located near the anal verge, especially in a patient with a history of chronic anal irritation or infection. With passage of time, papillae continue to grow in size. A papilla is liable to acquire considerable fibrous thickening over a period of time when it gets a rounded expanded tip, which is known as a fibrous polyp. This is due to piling up and consolidation of chronic inflammatory tissues at the proximal part of the fissure at the dentate line. As many as 16% of the patients having chronic fissure in anus recorded the presence of papillae that turned into fibrous polyps. These papillae are presumed to be caused by edema and low-grade infection. A fibrosed-hypertrophied papilla is also frequently found at the upper part of a chronic anal fissure or guarding the internal opening of fistula in anus. In the later case however, the symptoms may completely dominate and distort the clinical findings. Dilated veins, white areas, and a large hypertrophied anal papilla are often found in prolapsing types of hemorrhoids. In the past, these structures were not given any importance and were left untreated. Those patients, in whom, the fissure in anus was treated but the concomitant papillae or polyps were left untouched, continued to complain of pruritus, wetness, or an intermittent pricking sensation in the anus. Those with fibrous polyps felt incompletely treated due to a feeling of something projecting from the anus. Even a case of giant hypertrophied anal papilla complicated with a massive anal bleeding and prolapse was reported. The hypertrophic anal papillae and fibroepithelial polyps are benign lesions consisting of myxoid or collagenous stroma covered by squamous epithelium. They contain mononucleated and multinucleated stromal cells with fibroblastic and myofibroblastic differentiation, and mast cells. The occurrence of stromal atypia usually encountered in large size hypertrophic anal papillae/fibroepithelial polyps is considered to be reactive or reparative. Awareness of stromal atypia will reduce the likelihood of the misinterpretation of these lesions as malignant tumours. With respect to aetiology, hypertrophic anal papillae and fibroepithelial polyps are considered as a hypertrophic response of the modified anoderm in the region of the anal columns to irritation, injury or infection. The hypertrophic anal papillae and fibroepithelial polyps may prolapse, bleed and cause anal discomfort, but are not usually associated with specific symptoms or with chronic idiopathic pruritus ani. Symptomatic as well as large anal papillae and fibrous anal polyps should be removed and examined histologically. |
| Category | Science & Technology |
| Tags | ANAL FISSURES #sphincterolysis | # internal sphincter manipulation | # chronic anal fissures | # spastic internal sphincter fibers | # minimally invasive for anal fissures | # anal fissure treatment | # anal fissure and sentinel pile | # anal incontinence | # painless treatment for anal fissures | #Bleeding | # laser | #Anal discomfort | #Anal pain | # Constipation | #Painful defecation | #Anal fissures | LASER | LASER ABLATION | DIODE LASER | LASER SURGERY | LASER ADVANTAGES | LASER PROCEDURES |
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