RT Book, Section
A1 Reichman, Eric F.
SR Print(0)
ID 57707049
T1 Chapter 68. External Hemorrhoid Management
T2 Emergency Medicine Procedures, 2e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-161352-1
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=57707049
RD 2024/04/19
AB The  primary  disease  process  affecting  external  hemorrhoids  is  thrombosis.  The  mainstay  of  treatment  is  excision.  It  is  important  to  remember  that  the  excision  is  to  alleviate  or  palliate  the  pain.  The  natural  history  of  an  untreated  thrombosed  external  hemorrhoid  is  to  rupture  and  spontaneously  evacuate  the  clot  or  to  resorb  the  clot  over  time.  Therefore,  treatment  should  give  the  maximum  amount  of  pain  relief  with  the  least  chance  of  complications.  To  make  this  decision  it  will  be  important  to  obtain  a  good  history  of  the  length  of  the  pain,  how  severe  it  is,  and  whether  there  has  been  improvement.  It  is  important  to  perform  a  physical  examination  to  rule  out  prolapsed  grade  IV  internal  hemorrhoids,  perianal  abscesses,  and  other  perianal  masses.