Rectal prolapse looks obvious… until the shelf exam tries to trick you with hemorrhoids, mucosal prolapse, and the wrong operation.

In this episode of Surgery Shelf Prep, Chris and Mars break down rectal prolapse step-by-step: how to identify it fast using concentric versus radial folds, why adults need colonoscopy to rule out a lead point malignancy, and how to choose the right surgery based on patient frailty. We also hit emergency management of an incarcerated prolapse, plus high-yield procedures like abdominal rectopexy, Altemeier, and Delorme. Perfect for med students who want clean algorithms and fewer missed questions.

Hemorrhoids are common and easy points—but they’re a high-yield shelf exam trap, especially when the question is really testing anatomy, rectal bleeding workup, and when to escalate treatment.

In this episode of Surgery Shelf Prep, Chris and Mars break down internal versus external hemorrhoids using the dentate line, the classic “painless dripper” versus “painful blueberry” presentations, and the stepwise management from fiber and sitz baths to rubber band ligation and excisional hemorrhoidectomy. We also cover the seventy-two-hour rule for thrombosed external hemorrhoids, when rectal bleeding needs colonoscopy, and the key distractors like rectal varices and Crohn’s disease.

Anal cancer is the classic “hemorrhoids” misdirection—and the shelf loves it. If you miss the risk factors, the lymph node drainage, or the treatment algorithm, you’ll bleed points fast.

In this episode of Surgery Shelf Prep, Chris and Mars break down the high-yield presentation, key risk factors like Human Papillomavirus and Human Immunodeficiency Virus, why the dentate line predicts inguinal node spread, and the must-know management pearl: first-line treatment is combined chemoradiation, not surgery. We also cover staging imaging, when salvage abdominoperineal resection is indicated, and the common distractors that try to trick you on exam day.