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