In this report, the diagnostic and therapeutic methods concerning anal diseases in out patient clinic were reported as follows;
1) Interview with patients.
Analgia, anal bleeding and hemorrhoidal node, which are the common complaints of anal diseases, should be asked in detail.
2) Physical examinations.
Anus and rectal mucosa are firstly palpated by naked finger after supine position and examined by the proctoscope.
In the cases of anal fistula, not only the external orifice of fistula but localization of originated focus has to be carefully examined.
3) Therapeutic managements.
a) Internal hemorrhoids:
Internal hemorrhoids with first degree are treated by the local injection method with less than 0.5 ml of 5% phenol glycerin solution which is called as the sclerotherapy.
To treat internal hemorrhoids with second degree, the sclerotherapy shows not so satisfactory results because of its temporary effect. However, recently; Helio hemorrhoidal ligater method shows good results.
b) External hemorrhoids:
External hemorrhoid with thrombus can be treated with local injection of less than 1.0 ml of 33% phenol glycerin solution after ligation which is called as the necrosing therapy.
c) Anal fissure:
Anal fissure with Trias symptoms, namely, sentinel pile, anal ulcer and hypertrophic papilla, needs to be removed.
The necrosing therapy as mentioned above is also useful to remove anal fissure. However, anal fissure with deep ulceration and with hypertrophic sphincter muscle cannot be treated in out patient clinic.
d) Periproctal abscess and anal fistula:
The periproctal abscess is firstly treated by incision and drainage in out patient clinic. However, anal fistula in consequence of incision has to be treated after hospitalization.
4) Conclusively, anal diseases well selected by careful examination are considered to be well treated in out patient clinic by using suitable procedure.