Thrombosed external hemorrhoids often occurs in grade III-IV internal hemorrhoids, and can cause excruciating pain, and patients will often present acutely. In such cases, surgical evacuation of the hemorrhoid can produce immediate relief.
The treatment of choice is hemorrhoidectomy with partial lateral internal sphincterotomy, which consists in incised the mucosa on each side of the hemorrhoid and extended outward toward the anoderm. The anoderm and the hemorrhoidal mass are elevated off the transverse fibers of the internal sphincter muscle. Then the mucosa is approximated with continuous 3-0 absorbable sutures, leaving 2 to 3 mm of the anoderm left open for drainage.
Regards,
Jon Mikel Iñarritu, M.D.
Link to: Hemorrhoidal Prolapse
Not sure where they come from, not sure I want to know. I am 53 yo female, I am recovering from major hemorrhoid surgery, 4 regions (?) with several in each (just hope that this means I’ll have no more, ever). Was told short of prolapsed, the worse case dr had seen. Went in for exploratory, turned into five-hour surgery and what I went through is considered outpatient surgery, personally I think that the idea is insane (or at least the patient thinks that they are going insane from the pain). No words can describe it. Pain medication sent home with was insufficient (hydrocodone), had to go to ER, got Dilaudid to use in conjunction. Recovery seems slow motion…days are long. I am six weeks now and yesterday, I started passing blood clots after being virtually symptom free for more than two weeks. Got to go back to dr, dread visit. NOTE in my case it is suspected that it is genetic. Mom, Dad and two brothers have also had surgery.
being a medical student, i am not so much concerned about rx procedures, though they are darn sure interesting to read about!
just to confirm, haemarrhoids are a result of portal HT, of which the consequence is portosystemic venous shunts occuring in the anal-rectal region. (upper end of anal canal where there is a venous water shed)
how then do u get internal vs external haemarrhoids? (feel free not to ans to tuft me to the textbooks)