A Surgeon's Clinical Manual of Anorectal Disease Table of ContentsEditorial Office

Appendix C — Sample Case Sheets and Examination Proformas

This appendix gives practical templates for everyday use. They follow the same sequence taught throughout this manual, from history to management plan. Adapt the wording to your own patient, and add local letterhead as needed.

C.1 General Anorectal Case Sheet

Patient Details

Name: ________________________________________

Age / Sex: ________________________________________

Date: ________________________________________

Occupation: ________________________________________

Contact number: ________________________________________

Presenting Complaint

Main complaint, with duration: ________________________________________

Associated symptoms: ________________________________________

History of Presenting Complaint (follow Chapter 2)

Bleeding: colour, amount, timing: ________________________________________

Pain: site, character, timing, relation to defecation: ________________________________________

Swelling or lump: onset, whether it reduces: ________________________________________

Discharge: type, amount: ________________________________________

Change in bowel habit: ________________________________________

Prolapse: frequency, whether it reduces spontaneously: ________________________________________

Bowel habit and stool consistency: ________________________________________

Red Flag Screen

Unexplained weight loss ☐

Persistent change in bowel habit ☐

Anaemia or unexplained fatigue ☐

Age over 50 with new symptoms ☐

Family history of colorectal cancer ☐

Past History

Previous anorectal surgery: ________________________________________

Obstetric history (if relevant): ________________________________________

Relevant medical conditions (diabetes, IBD, HIV): ________________________________________

Medications: ________________________________________

Examination (follow Chapters 3 to 6)

General examination: pallor, weight, abdomen, groin nodes: ________________________________________

Inspection: findings at rest and on straining: ________________________________________

Digital rectal examination: tone, tenderness, mass, blood on glove: ________________________________________

Proctoscopy / sigmoidoscopy findings: ________________________________________

Provisional Diagnosis: ____________________________________________________________

Investigations Planned: ____________________________________________________________

Management Plan: ____________________________________________________________

Follow-Up Arranged: ____________________________________________________________

C.2 Digital Rectal Examination — Quick Findings Template

Resting tone (normal / reduced / increased): ________________________________________

Squeeze tone (normal / reduced): ________________________________________

Tenderness (present / absent), site: ________________________________________

Mass (present / absent), position, mobility: ________________________________________

Sphincter defect (present / absent), position: ________________________________________

Prostate (if male): size, consistency: ________________________________________

Blood on glove (present / absent): ________________________________________

Stool in rectum (present / absent), consistency: ________________________________________

C.3 Sample Operative Note — MOLIS

Date: ________________________________________

Indication: ________________________________________

Anaesthesia: ________________________________________

Position: ________________________________________

Operative site (o'clock position): ________________________________________

Findings: ________________________________________

Internal sphincter delivered to wound surface (yes / no): ________________________________________

Corrugator cutis ani identified and preserved (yes / no): ________________________________________

Depth of division: ________________________________________

Haemostasis: ________________________________________

Estimated blood loss: ________________________________________

Postoperative instructions: ________________________________________

C.4 Postoperative Follow-Up Proforma

Date of review: ________________________________________

Days since surgery: ________________________________________

Wound (healing / not healing), any discharge: ________________________________________

Pain (resolved / ongoing): ________________________________________

Bowel habit: ________________________________________

Continence (normal / any change, specify): ________________________________________

Further follow-up needed (yes / no); if yes, date: ________________________________________

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