Procedures Consult Mobile
Quick ReviewFull DetailsChecklist
Help  |  Print
- Full procedure text, video and illustrations available with the full product
  • Initial evaluation of rectal bleeding, pain, itching, discharge, or masses
  • In association with sigmoidoscopy and colonoscopy (screening or diagnostic)
  • Evaluation of trauma, inflammatory bowel disease (follow-up), and sexual abuse
  • Retrieval of foreign body or treatment of fecal impaction
  • Screening for anal HPV in high-risk individuals (high-resolution anoscopy only)
  • Unwilling patient
  • Severe debilitation or unstable medical condition
  • Acute abdomen (relative contraindication)
  • Marked anal canal stenosis
  • Anoscope and light source
  • Gloves
  • Lubricant
  • Large-tipped cotton swabs
  • Biopsy forceps, if needed
  • Monsel's solution (ferric subsulfate solution)
  • 3% acetic acid solution (high-resolution anoscopy only)
  • Colposcope with 10 to 40× magnification (high-resolution anoscopy only)
  • Dentate or pectinate line: The squamocolumnar junction located 2 to 3 cm proximal to the anal verge. No sensory nerve fibers are located above the dentate line—only visceral type.
  • Internal hemorrhoids: Located at and just proximal to the dentate line
  • External hemorrhoids: Located distal to the dentate line at the anal verge

Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures


Thoroughly explain to the patient the findings and any treatment recommendations.

  • Discomfort from the examination
  • Tearing of the perianal skin, mucosa, or hemorrhoidal tissue
  • Bleeding after biopsy
  • Infection is possible after biopsy but almost never occurs.
About Procedures Consult | Help | Contact Us | Terms and Conditions | Privacy Policy
Copyright © 2019 Elsevier Inc. All rights reserved.