What Is a Thrombosed Hemorrhoid?

Thrombotic external hemorrhoids are clinically frequently-occurring. They are often caused by over-eating spicy food, making stools close to the toilet, rupturing subcutaneous veins around the anus, and blood stasis subcutaneously. Clinically, patients often complain of conscious swelling of the anus, pain and foreign body sensation. Examination shows that there are grape-like dark purple tumors around the anus or under the skin of the anal canal, sometimes with superficial erosion and bleeding.

Visiting department: Anorectal surgery
Common causes: Perianal subcutaneous blood vessels increase in pressure, resulting in excessive expansion and rupture

Common symptoms: Lumps in the anus with severe pain and restricted movement
Contagious: no

Causes of thrombotic external hemorrhoids

Generally caused by drinking, spicy food, constipation, toilet squatting, sedentary and other reasons caused by increased perianal subcutaneous blood pressure, excessive expansion and rupture.

Clinical manifestations of thrombotic external hemorrhoids

After defecation or strenuous activity, I feel a bump in the anus, severe pain, restricted movement, and even restlessness. There is a tender mass under the skin of the anal margin. Defecation, sitting, walking, and even coughing can all make the pain worse. Examination reveals grape-like dark purple masses around the anus or under the skin of the anal canal, sometimes with mild erosion and bleeding on the surface.

Examination of thrombotic external hemorrhoids

Surgical anal inspection, digital anal examination.

Diagnosis of thrombotic external hemorrhoids

Key points for diagnosis:

1. After defecation or strenuous activity, the anus has a prominent lump, severe pain, and limited movement.

2. The mass is dark purple, round or oval, ranging in size, slightly hard, and obvious tenderness.

3. If the mass is too large, it can cause ischemic necrosis of the anal skin, or it can be ulcerated and discharged by itself. The wound heals itself or forms an anal fistula.

Differential diagnosis of thrombotic external hemorrhoids

Internal hemorrhoid incarceration

Internal hemorrhoids on the tooth line prolapse and incarceration, the pain is longer, the flap is edema, the subsidence is slow, and the surface erosion of the hemorrhoid core is accompanied by infection and odor when infected.

Anal fissure

Anal pain is periodic, blood in the stool, and local examination shows a vertical slit or anal fissure triad at 6 or 12 o'clock.

Treatment of thrombotic external hemorrhoids

1. Lighter or non-acute phase, mainly hot compress and hot water bath.

2. Surgical treatment:

(1) Squeeze therapy for thrombotic external hemorrhoids: disinfect the anus with 0.1% Xinjieer before operation, and 2% procaine 2ml is injected into the head and surrounding skin of the external thrombotic hemorrhoids. Put a sterile gauze on the hemorrhoids, then rub the gauze with your right thumb, food, and middle fingers, and crush the spherical block of the external hemorrhoids with a strong force. If you feel a crushed soil when you knead, press 3 5 Minutes.

(2) Thrombectomy, or thrombectomy, is to make a radial or spindle incision in the center of the thrombus, then use a hemostat to separate and remove the blood clot.

Prevention of thrombotic external hemorrhoids

Prevention of thrombotic external hemorrhoids, timely treatment of anal inflammatory diseases, drink less alcohol, eat less spicy and stimulating food, pay attention to drink plenty of water, eat more vegetables, fruits, exercise more, maintain smooth stool and develop good bowel habits; pregnant women should Participate in appropriate activities to shorten the delivery process as much as possible to reduce the pressure on the anorectum; try to avoid heavy physical labor that exceeds your ability.