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Procedure - PowerPoint PPT Presentation


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Procedure. The  digital rectal examination:- 1- The patient undresses 2- Then is placed in a position where the  anus  is accessible (lying on the side, squatting on the examination table, bent over the examination table, or lying down with feet in stirrups).

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The digital rectal examination:-

1- The patient undresses

2- Then is placed in a position where the anus is accessible (lying on the side, squatting on the examination table, bent over the examination table, or lying down with feet in stirrups).

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3-If the patient is lying on their side, the physician will usually have them bring one or both legs up to their chest. If the patient bends over the examination table, the physician will have them place their elbows on the table and squat down slightly. If the patient uses the supine position,

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the physician will ask the patient to slide down to the end of the examination table until their buttocks are positioned just beyond the end. The patient then places their feet in the stirrups.

4-The physician spreads the buttocks apart and will usually examine the external area (anus and perinium) for any abnormalities such as hemorrhoids, lumps, or rashes. Then, as the patient relaxes, the physician slips a gloved and lubricated finger into the rectum through the anus and palpates the insides for approximately sixty seconds.

indications
Indications:-

1-Diagnosis of rectal tumors and other forms of cancer;

2-Diagnosis of prostatic disorders,  tumors and benign prostatic hyperplasia;

3-Estimation of the tonicity of the analsphincter, which may be useful in case of fecal incontinence or neurologic diseases, including traumatic spinal cord injuries;

4-Infemales, for gynecological palpations of internal organs

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5-Examination of the hardness and color of the feces (i.e. in cases of constipation, and fecal impaction);

6- Prior to a colonoscopy or proctoscopy;

to evaluate hemorrhoids.

7-In newborns to exclude imperforate anus.

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The DRE is inadequate as a screening tool for colorectal cancer because it examines less than 10% of the colorectal mucosa; sigmoidoscopyis preferred. However, it is an important part of a general examination, as many tumors or other diseases are made manifest in the distal part of the rectum.

Sometimes proctoscopy may also be part of a rectal examination.