Peri-anal Masses

Re: Peri-anal Masses

Yantha Smyth — Wed, 12 Mar 2014 13:21:28 GMT

That's great to hear!

Re: Peri-anal Masses

Anthony Dennison — Wed, 12 Mar 2014 12:45:38 GMT

Update:

Both masses came back as Hepatoid gland adenomas, clear margins and favourable prognosis.

Re: Peri-anal Masses

Hannah Wynne Richards — Thu, 06 Mar 2014 15:41:24 GMT

It's easy to panic when you're newly qualified.

Wynne

Re: Peri-anal Masses

Anthony Dennison — Thu, 06 Mar 2014 12:54:45 GMT

Many thanks for all your replies, has confirmed I think I was worrying over nothing! Both masses have been sent for histo, so I'll put the report up when I get it.

The owner came in this morning to say everything was working normally, so I'm happy now!

Re: Peri-anal Masses

Yantha Smyth — Wed, 05 Mar 2014 18:26:21 GMT

The anal sac would have been deep to the external anal sphincter muscle- btwn internal and external sphincters as far as I recall, so if the mass was in the sq only it sounds to me like this was genuinely a mass not sac. I think you have to do a fair bit of damage to the sphincter to cause a problem, I think damaging the nerve supply is more of an issue than the muscle fibres themselves. Not very technical, but I hope it helps to reassure you

Re: Peri-anal Masses

Tim Charlesworth — Wed, 05 Mar 2014 18:22:03 GMT

I agree that you'll be absolutely fine. The innervation to the anal sphincter comes in just ventral of the middle of the sphincter on each side (branches off the pudendal). You'd have to cut quite deep through both nerves to have any problems wrt postop faecal incontinence etc. Wrt to the muscle itself - in theory you could remove <50% of this and still maintain continence so even if you have scraped the surface of the muscle you are very unlikely to have caused any significant trauma. I suspect it is possible to inadvertently remove the the anal sac (I only say this as people still remove prostate glands thinking that they are abdominally retained testes but that's a different story) but this would be within the fibres of the anal sphincter itself and you would have had to dissect through this to remove the gland. Also the gland would have probably emptied on manipulation during the surgery unless you emptied it preop. If in doubt - cut into the gland and it should be a slivery-grey colour on the internal (glandular) surface. Even if you did remove the anal sac - it wouldn't matter! Did you send them for histopath?

Re: Peri-anal Masses

Hannah Wynne Richards — Wed, 05 Mar 2014 18:13:05 GMT

1) Stop worrying

2) Slice into it. If it's the anal sac, you'll soon know.

Wynne