A retrospective group of 100 patients with pathologically diagnosed thrombosed hemorrhoids and a prospective group of 30 patients with acute thrombosed hemorrhoids were studied. Thromboses had not been recognized clinically in 55 of 100 retrospective cases. The following conclusions were made: 1) All thrombosed hemorrhoids in the study were intravascular. Although the possibility of perianal hematoma cannot be excluded entirely, it is not the usual situation, and was not seen in this study; 2) There appears to be no systemic hypoor hypercoagulable state or bacterial cause of the thromboses. Focal hypercoagulability must be considered. A mechanism of thrombogenesis is postulated, based on stasis and local trauma and subsequent activation of the extrinsic clotting system; 3) Immediate operative intervention appears to be the best available treatment; 4) All patients were treated by classical radical closed hemorrhoidectomy, with no postoperative wound infection.
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Ganchrow, M.I., Bowman, H.E. & Clark, J.F. Thrombosed hemorrhoids: A clinicopathologic study. Dis Colon Rectum 14, 331–340 (1971). https://doi.org/10.1007/BF02553417
- Prospective Group
- Anal Ulcer
- Retrospective Group
- External Thrombosed Hemorrhoid