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Cryptitis
From WikEM
Contents
Background
- Cryptitis is associated with repetitive sphincter trauma from spasm, recurrent diarrhea, or passage of large/hard stools.
- Pathophysiology
- Anal crypts are mucosal pockets that lie between the columns of Morgagnia
- Formed by the puckering action of the sphincter muscles
- Superficial trauma (diarrhea, trauma from hard stool) → breakdown in mucosal lining
- Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands
- Can lead to anal fissure, anal fistula, perirectal abscesses
- Bacteria enter, inflammation extends into lymphoid tissue of the crypts / anal glands
- Anal crypts are mucosal pockets that lie between the columns of Morgagnia
Clinical Features
- Anal pain
- Sphincter spasm
- Itching with or without bleeding
- Hypertrophied papillae
Differential Diagnosis
Anorectal Disorders
- Anal tags
- Hemorrhoids
- Cryptitis
- Anal fissure
- Anal fistula
- Anorectal abscess
- Proctitis
- Rectal prolapse
- Rectal foreign body
- Pruritus ani
- Pilonidal cyst
- Constipation
- Condyloma acuminata
- Anal cancer
- Colorectal tumor
- Pedunculated polyp
- Crohn Disease
- Syphilitic fissure
- GC/Chlamydia
Evaluation
- Anoscopy shows inflammation, erythema, and pus
Management
- Bulk laxatives, additional roughage, sitz baths (treats underlying cause)
- Surgical referral is indicated when:
- Infection has progressed and the crypt will not drain adequately on its own
- Surgical treatment is excision
See Also
References
Authors
Jordan Swartz, Manpreet Singh, Ross Donaldson, Claire, Neil Young
