Disorders of the perineum and anus

image of Disorders of the perineum and anus
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The perineum is made up of the structures which make up the boundary of the pelvic outlet. It extends externally from the dorsal aspect of the scrotum or vulva to the base of the tail; its lateral margins extend to the skin covering the tubers ischii and superficial gluteal muscles. The deep portion is delineated by the ischial arch ventrally, the third coccygeal vertebra dorsally and, in the dog, by the sacrotuberous ligament laterally. Due to the absence of sacrotuberous ligament in the cat the lateral margins are less well defined. The perineum essentially surround the anal and urogenital canals. Within the perineum the most important structures are those which make up the pelvic diaphragm; namely levator ani and coccygeal muscles. This chapter looks at Anatomy and physiology; Diagnostic approach; and Clinical disorders of the perineum and anus.

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22.1 Horizontal section through the perineal area. Drawn by Ellen Williams, Mold, Flintshire.
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22.2 Schematic drawing of perineal anatomy. Drawn by Ellen Williams, Mold, Flintshire.
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22.3 Schematic drawing of the anal canal. Drawn by Ellen Williams, Mold, Flintshire.
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22.4 Digital rectal examination. Drawn by Ellen Williams, Mold, Flintshire.
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22.5 Rectal examination shows lack of lateral support in a patient with a perineal hernia.
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22.6 Digital per rectum palpation of the anal sacs. Drawn by Ellen Williams, Mold, Flintshire.
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22.7 Radiograph showing an enlarged iliac lymph node.
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22.8 Ultrasound scan of a perineal prostatic cyst.
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22.11 Radiograph of a Boxer puppy with Type III . (Courtesy of FE Crowsley)
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22.12 Anogenital cleft in a male Domestic Short-hair kitten.
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22.13 Catheterization of a Domestic Short-hair kitten with an anogenital cleft prior to surgical reconstruction.
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22.14 Anal furunculosis.
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22.15 Anal prolapse secondary to a rectal mass. (Courtesy of James Simpson)
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22.16 Circumanal gland tumour (perianal adenoma). (Courtesy of James Simpson)
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22.18 Perineal swelling associated with a bilateral perineal hernia.
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22.19 Radiograph of a mineralized prostatic cyst extending into the perineum.
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22.20 Intraoperative view of a perineal paraprostatic cyst.
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