Proctological examination

Abstract

More is missed by not looking than by not knowing. This statement by Thomas McCrae (1870-1935) underlines the paramount importance of clinical examination in proctological diagnosis. Numerous anorectal problems can be diagnosed simply by careful inspection of the perianal area. Although a proctological consultation may well represent a routine professional activity for the doctor, it has to be remembered that it is quite a different matter for the patient. He or she often finds a procedure of this kind difficult to cope with, particularly if it is the first time. There are various personal, psychological, and social reasons why a fairly long interval of time may elapse between the appearance of the first symptoms and the proctological consultation. Likewise, it is not uncommon, even at the present time, for patients to be subjected to a prolonged treatment for a proctological complaint without any prior local examination being made. Thus, advanced lesions may sometimes be discovered at the specialist's initial consultation. © 2010 Springer-Verlag Berlin Heidelberg.