Procedure

Anoscopy

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Anoscopy, Anoscope, Ive's Slotted Anoscope

  • See also
  1. Anorectal Exam
  2. Internal Hemorrhoid
  • Indications
  1. Rectal Bleeding
  2. Rectal Pain, Anal Pain or Perianal pain
  3. Pruritus Ani
  4. Rectal Prolapse
  5. Hemorrhoids
  6. Anal Fissures
  7. Anal Fistula
  8. Perianal condyloma
  9. Mass palpated on Digital Rectal Exam
  10. Adjunct to lower endoscopy
    1. Flexible Sigmoidoscopy
    2. Colonoscopy
  • Equipment
  1. Ive's Slotted Anoscope
  2. Light Source
  3. Lubricant
  • Technique
  1. Patient positioned in left lateral decubitus position
  2. Test light source
  3. Insert introducer completely into Anoscope
  4. Apply K-Y Jelly lubricant to Anoscope
  5. Repeat for all 3 to 4 segments (90 to 120 degrees each)
    1. Gently insert Anoscope until flange reaches anus while patient lightly bears down
    2. Remove introducer
    3. Observe mucosa while slowly withdrawing Anoscope
    4. Rotate Anoscope 90-120 degrees and re-introduce
      1. Consider insertion at the typical Hemorrhoid sites (see below)
  6. Hemorrhoid sites
    1. Left lateral
    2. Right posterior
    3. Right anterior
  • References
  1. Warrington (2023) Crit Dec Emerg Med 37(11): 15
  2. Varma in Pfenninger and Fowler (1994) Procedures for Primary Care Physicians, Mosby, Chicago, p. 902-6