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. 2022 May;407(3):1251-1256.
doi: 10.1007/s00423-021-02415-2. Epub 2022 Jan 22.

Perianal thrombosis: no need for surgery

Ingo Alldinger  1 , Zoe Poschinski  2 , Silke Ganzera  2 , Christian Helmes  2
Affiliations

Perianal thrombosis: no need for surgery

Ingo Alldinger et al. Langenbecks Arch Surg. 2022 May.

Abstract

Aim: There is little evidence for the best therapy for perianal thrombosis. No prospective trials exist. Even quality of retrospective data is low, due to low patient numbers or vague follow-up data.

Patients and methods: Six hundred nineteen patients with thrombosis of internal or external hemorrhoids who presented in our clinic between March 2017 and August 2018 were enrolled in the study. All patients were treated conservatively, with sitz baths and oral pain medication, if needed. No surgery was performed. Follow-up data was obtained by personal examination. Data was gathered prospectively, and data analysis was retrospective.

Results: Five hundred four patients had perianal thrombosis (81.4%), and 115 patients had thrombosed hemorrhoids. Mean pain on a numerical rating scale (0-10) was 3.8 for perianal thrombosis and 5.2 for thrombosed hemorrhoids. Five hundred forty-eight patients (88.5%) did not need a sick leave. On follow-up, patients stated that their pain had largely resolved after 5 days and completely disappeared after 10 days. Local recurrence rate after perianal thrombosis was 6.3%.

Conclusion: Perianal thrombosis and thrombosed hemorrhoids heal well without surgery. There is no evidence for advantages surgical therapy could offer.

Keywords: Perianal thrombosis; Proctology; Thrombosed hemorrhoid.

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References

    1. Chan KK, Arthur JD (2013) External haemorrhoidal thrombosis: evidence for current management. Tech Coloproctol 17(1):21–5 - DOI
    1. Davis BR et al (2018) The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum 61(3):284–292 - DOI
    1. Cavcic J et al (2001) Comparison of topically applied 0.2% glyceryl trinitrate ointment, incision and excision in the treatment of perianal thrombosis. Dig Liver Dis 33(4):335–40 - DOI
    1. Greenspon J et al (2004) Thrombosed external hemorrhoids: outcome after conservative or surgical management. Dis Colon Rectum 47(9):1493–8 - DOI
    1. Seifert E (1953) We need a stronger separation between external and internal hemorrhoids. Wien Med Wochenschr 103(27):496–9 - PubMed

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