Alfi Surgery /English edition
Saudi ArabiaEgypt

Common Anal Conditions · Version 2.0

List of Tables and Algorithms

Dr. Tamer Rushdy Elalfy · 4 min read

Front matter: Table F.1 — Version 1.0 versus Version 2.0 scope · Table F.2 — New content in Version 2.0 · Table F.3 — Safety-relevant corrections and clarifications.

Appendix B: Table B.1 — Indications, doses, and adverse effects · Table B.2 — Interactions, special populations, and when to avoid.

Chapter 01

Table 1.1 — The four landmarks that dictate every clinical decision.

Table 1.2 — Continence questions and what they localise.

Table 1.3 — Dangerous mimics of anal pain and leakage.

Algorithm 1.1 — Localising pain and leakage, including the cauda equina red flag.

Chapter 02

Table 2.1 — The master symptom matrix.

Table 2.2 — Thrombosed external haemorrhoid versus perianal abscess.

Table 2.3 — Full-thickness rectal prolapse versus prolapsed internal haemorrhoids.

Table 2.4 — Dangerous mimics of “piles”.

Algorithm 2.1 — Acute anal pain, lump, or “piles”.

Chapter 03

Table 3.1 — Goligher classification and first-line approach.

Table 3.2 — BPRST stages and strategy.

Table 3.3 — Office procedures matched to patient factors.

Table 3.4 — Special populations.

Table 3.5 — Haemorrhoid mimics.

Algorithm 3.1 — Haemorrhoidal disease.

Chapter 04

Table 4.1 — Acute versus chronic fissure.

Table 4.2 — Treatment options and verdicts.

Table 4.3 — Fissure mimics.

Algorithm 4.1 — Anal fissure.

Chapter 05

Table 5.1 — Abscess spaces and diagnostic traps.

Table 5.2 — Parks classification and sphincter risk.

Table 5.3 — The first-hour Fournier’s bundle.

Table 5.4 — Abscess and fistula mimics.

Algorithm 5.1 — Suppurative disease.

Chapter 06

Table 6.1 — Pruritus ani: causes and action plan.

Table 6.2 — Fast guides: foreign bodies, STI proctitis, functional anorectal pain.

Table 6.3 — Gap-filler mimics.

Algorithm 6.1 — Everyday non-haemorrhoidal presentations.

Chapter 07

Table 7.1 — Anal and perianal malignancies.

Table 7.2 — Squamous intraepithelial lesions.

Table 7.3 — IANS 2024 screening start points.

Table 7.4 — From the first examination to the MDT.

Table 7.5 — Benign-looking lesions that may be malignant.

Algorithm 7.1 — Non-healing or suspicious anorectal lesion.

Chapter 08

Table 8.1 — Common causes and must-not-miss diagnoses by context.

Table 8.2 — Characterising the bleeding.

Table 8.3 — Alarm features.

Table 8.4 — Treat now or investigate first.

Table 8.5 — Choosing the test.

Table 8.6 — Rectal bleeding documentation template.

Table 8.7 — Rectal bleeding mimics.

Algorithm 8.1 — Visible rectal bleeding in the ER or clinic.

Chapter 09

Table 9.1 — Perianal manifestations of Crohn’s disease.

Table 9.2 — Idiopathic versus Crohn’s-associated perianal disease.

Table 9.3 — Work-up for suspected perianal Crohn’s disease.

Table 9.4 — Treatment principles.

Table 9.5 — Mimics of perianal Crohn’s disease.

Algorithm 9.1 — Perianal disease with possible Crohn’s disease.

Chapter 10

Table 10.1 — Faecal incontinence patterns.

Table 10.2 — Medication contributors.

Table 10.3 — Conservative measures.

Table 10.4 — Tests and their indications.

Table 10.5 — Continence referral template.

Table 10.6 — Continence and constipation mimics.

Algorithm 10.1 — Faecal incontinence and chronic constipation.

Chapter 11

Table 11.1 — The 5 Ps sexual history.

Table 11.2 — Infectious causes of anorectal symptoms.

Table 11.3 — Adult treatment regimens.

Table 11.4 — STI mimics and look-alikes.

Algorithm 11.1 — Rapid STI and proctitis pathway.

Chapter 12

Table 12.1 — Anorectal trauma: mechanisms, assessment, and principles.

Table 12.2 — Foreign body assessment and removal.

Table 12.3 — The post-assault medical bundle.

Table 12.4 — Documentation principles.

Table 12.5 — Hidden injuries and disguised presentations.

Algorithm 12.1 — Injury, foreign body, or disclosed assault.

Chapter 13

Table 13.1 — Problems and first-line care.

Table 13.2 — Medicines in pregnancy and breastfeeding.

Table 13.3 — Procedures in pregnancy.

Table 13.4 — Pregnancy and postpartum mimics.

Algorithm 13.1 — Pregnant or postpartum patient.

Chapter 14

Table 14.1 — Paediatric anorectal conditions.

Table 14.2 — Safeguarding indicators and actions.

Table 14.3 — Paediatric mimics.

Algorithm 14.1 — Child with an anorectal symptom.

Chapter 15

Table 15.1 — Ten rare conditions: presentation and red flags.

Table 15.2 — Ten rare conditions: work-up, management, and urgency.

Table 15.3 — Rare conditions and what they are mistaken for.

Algorithm 15.1 — When the common diagnosis does not fit.

Chapter 16

Table 16.1 — Colonoscopy red flags — summary.

Table 16.2 — Six high-alert medication traps.

Table 16.3 — The three-column triage matrix.

Algorithm 16.1 — The safety net.

Chapter 17

Table 17.1 — The five-step examination.

Table 17.2 — Clock-face descriptions by position.

Table 17.3 — Examination traps.

Algorithm 17.1 — The tolerable anorectal examination.

Chapter 18

Table 18.1 — Nursing checklist by phase.

Table 18.2 — SBAR escalation thresholds.

Algorithm 18.1 — Post-operative ward escalation.

Chapter 19

Table 19.1 — Master comparison table of ten core conditions.

Algorithm 19.1 — The 03:00 one-page triage.