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Chapter 10 Examination of the anus
Checklist
WIPER
Chaperone and good light source
Gloves and lubricating gel
Patient on couch, left lateral position, knees up towards the chest
Physiological parameters
General
Perineal excoriation or dermatitis
Abnormal discharge at the anal verge: pus, blood, faeces
External
Inspection of gluteal cleft: pilonidal disease (sinus or abscess)
Inspection of perineum:
erythema, abnormal moisture or purulent discharge
haemorrhoids, abscesses, fissures, fistulas, skin tags
scars or wounds from previous abscess drainage
setons
anorectal prolapse (ask patient to cough)
Palpation:
anal sphincter contour