TY - CHAP M1 - Book, Section TI - Chapter 68. External Hemorrhoid Management A1 - Reichman, Eric F. PY - 2013 T2 - Emergency Medicine Procedures, 2e 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. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=57707049 ER -