直腸肛門病変の診察法

How to examine the anorectum

要旨

　おもに肛門疾患の診察法と3大痔疾患について解説した。肛門疾患の診察は，問診，視診，指診，肛門鏡診の順番で行う。最も重要である問診によって疾患を推測することができ，視診や指診で得られる情報から病名を絞り込むことができる。最終的に，肛門鏡で直接見て診断するが，ピットフォールに注意が必要である。内視鏡医が知っておくべき痔核，裂肛，痔瘻の基本的知識とそれらと紛らわしい疾患についてまとめた。

　In this article, I describe the examinations for anal lesion and the three major hemorrhoidal diseases. Examinations for them are conducted in the following order: medical interview, visual examination, digital examination, and anoscopy. The most important step is the medical interview, which allows us to imagine the possible names of disease, and the information obtained from visual and digital examinations which allows the name of the disease to be narrowed down. Ultimately, the diagnosis is made by direct examination with an anoscope, but it is necessary to be aware of pitfalls. I have describeded the basic information that endoscopists should have about hemorrhoids, anal fissures, and anal fistulas, as well as diseases that may be confused with them.