Initial Presentation, Evaluation and Management of Acute Anorectal Malignancies

  • Anjali S. Kumar


Anorectal malignancies, while rising in incidence, are often difficult to detect. Because surgeons may be the only providers completing the patient’s three-part anorectal exam – including external exam, digital anorectal exam (DARE), and anoscopy/sigmoidoscopy – they have a responsibility to be sensitive to the patient’s vulnerable condition and to document all pertinent details. This article highlights key aspects of each step to note in practice. An anal exam under anesthesia should also be considered for patients presenting with acute pain, uncontrolled bleeding, or obstruction. Throughout these processes, intentional positioning and language use are key to optimize patient comfort and maintain trust in the provider-patient relationship.


Anal cancer Anorectal malignancy Anoscopy Perineum Rectal cancer Rectal exam Regional anesthesia 



The authors gratefully acknowledge Mariah Conley for editorial assistance.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Anjali S. Kumar
    • 1
  1. 1.Elson Clinical Education, Surgery, Elson S. Floyd College of MedicineWashington State UniversityEverett/Spokane/Tri-Cities/VancouverUSA

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