Incision and Excision of Hemorrhoidal Thrombosis
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Hemorrhoidal disease is one of the most troublesome and least talked about conditions. It is very widespread. Not only can it make the life of the person who has it difficult, but it can become complicated. Moreover, since people are ashamed to talk about it and prefer to remain silent, complications are not that rare. In fact, the majority of people are consulting for a complication, not a hemorrhoidal attack. One of the most common complications of hemorrhoidal disease is hemorrhoidal thrombosis. As soon as the diagnosis is made, one hears quickly of incision and excision. Although these are medical terms, this does not necessarily mean mandatory passage to the block and general anesthesia.
What is hemorrhoidal thrombosis?
To understand incision and excision, you must first understand your condition and have a clear idea of what you have. The doctor told you about hemorrhoidal thrombosis but did not have time to explain medicine years in a few minutes and on leaving the office you are still confused. We explain everything!
I invite you first to understand what a disease or hemorrhoid crisis is:
Back on topic. When one suffers from hemorrhoidal disorders, blood circulates badly in the anal region and tends to stagnation. Imagine that it is water with the earth that rushes and stagnates. At some point, it solidifies to form rocks. It is the same principle of thrombosis. The blood stagnates and creates what is called a blood clot. Blood clots can block the vein and prevent blood from circulating, just like a rock in a conduit. The blood then begins to collect and creates a pocket. Since the thread tends to expand, the wall extends, and this creates the pouch. Except that we are talking about the anal area here which is an extremely innervated area. The thrombosis then causes a very high pain and one sees a blue ball which can be extremely painful to the touch: It is the pocket of which one spoke. In general, thrombosis mainly affects the external hemorrhoids, but it is not impossible that it is of internal origin.
However, like hemorrhoids, hemorrhoidal thrombosis may disappear on its own as it can cause such pain that can go so far as to prevent the patient from sitting down requiring critical management.
What are the symptoms of hemorrhoidal thrombosis?
When the symptoms begin to appear, the patient will not have time to wonder what it is and will consult very quickly. That said, everyone reacts differently.
Pain is the most prominent symptom of hemorrhoidal thrombosis, but it remains very subjective as a sign. Most people report a very sharp pain and brutal setup. However, pain tolerance varies from one person to another and what one person considers extremely painful may be a little embarrassment for another person, or at all for people with sensory disabilities. It then remains the aspect. We notice what is called a protuberance, a blue ball and very annoying and extremely painful which temporarily subsides after passage to the toilet.
The most important thing to remember is that hemorrhoidal thrombosis is a complication of hemorrhoidal disease and is an urgent need to be treated as quickly as possible to prevent the symptoms from getting worse.
How to treat hemorrhoidal thrombosis?
In some cases, hemorrhoidal thrombosis starts as a hemorrhoidal attack. Just take painkillers and anti-inflammatories to relieve the discomfort caused by its occurrence. It is necessary to change his hygiene of life and to make baths of the seat to diminish the pain. You will find more tips here:
However, with all the will you can demonstrate, hemorrhoidal thrombosis can persist, and in this case, one should not hesitate to consider using invasive treatments with his doctor. We are talking here about incision and excision of a hemorrhoidal thrombosis.
Incision of hemorrhoidal thrombosis:
The incision of a hemorrhoidal thrombosis is the act of making an incision in the thrombosis to evacuate the clot or clots to relieve the patient.
In which case?
The incision is mainly for patients with one or more visible and palpable clots. However, this becomes unnecessary if medical treatment can relieve and cure, useless and confusing if the clot goes back several weeks and utterly impossible if the thrombosis is external circular, i.e., it invades the entire anal area, The whole anus is rare, but it can happen, if it is internal and prolapsed, it becomes therefore not visible and palpable or if it is oedematous, in the latter case, the realization of the gesture becomes technically impossible.
How’s it going?
Even if we call this an operation, it can happen in the office of a doctor, a non-specialized environment. It is the process of extracting a wisdom tooth, no need for general anesthesia.
The specialist physician proceeds by installing you comfortably on the side, in lateral decubitus as it is called in medical jargon and will ask you to hold your buttock or will resort to an external help to expose the area well. It will make you after a painless injection of a local anesthetic after disinfecting the area gently. His gestures will be gentle to avoid hurting you. The needle is minuscule as the injection is subcutaneous. It is like the insulin needle that people with diabetes use alone at home. You will only feel a slight pressure when injecting and then nothing. This is where the doctor will proceed with the incision with a bistoury to extract the clot. Since the incision is small enough, you will not have stitches, and you will go home without pain!
What are the possible complications?
Since this is a very minimal gesture, the complications are very limited. A small bleeding can occur, but it will soon be mastered by the doctor because the incision will not be deep enough to cause significant bleeding. The only significant risk may lie in a possible allergy to the local anesthetic. However, it is relatively rare, and the doctor will have in his office the equipment necessary to get you first aid while waiting to take you to a specific environment.
What to do next?
After the incision, you should make sure to make a toilet with a neutral soap to avoid infection that is very dreaded because of the location of the scar. You will also have a simple protection with a compress for a few days and possibly a healing ointment or anti-hemorrhoid. It is also important to ensure that the cause of the problem is resolved to avoid recidivism. It is also necessary to rest and take analgesics during the time that the crisis passes, as well as NSAIDs (non-steroidal anti-inflammatory: corticoids). If the pain persists with the same intensity after two days, it is necessary to consult urgently.
You may also be interested in: 5 Tips For Treating Hemorrhoidal Thrombosis
Excision of hemorrhoidal thrombosis:
Excision is the removal of the entire thrombosed hemorrhoidal sac.
That is to say, unlike the incision of hemorrhoidal thrombosis, one does not merely cut and remove the clot, but one removes all that is also around.
In which case?
As for incision, excision is indicated in case of painful thrombosis, which does not respond to drug treatment. However, although hemorrhoidal thrombosis always tends to evolve towards healing, some patients can not be patient or can not afford it, such as athletes who often show new outbursts on exercise recovery or The thrombosis becomes very voluminous that it forms a disgraceful marisque. In this case, excision is preventive. On the other hand, a thrombosis must be excised during the evacuation by Canada sphacell, that is to say that the clot is evacuated unexpectedly, occasionally causing bleeding.
Note that this treatment is also reserved for external thromboses, non-edematous, which do not respond to drug treatment. It is not indicated for people on anticoagulant because of the significant bleeding risk and people with Cohn’s disease because of the equally important infectious risk.
How’s it going?
The preparation takes place exactly as for the incision, only the technique of “incision” changes. In fact, instead of the scalpel, one proceeds with scissors and the wound is much wider to avoid any folding which can give rise to a marisque. The clot is removed in the vascular sac to prevent recurrence.
What are the possible complications?
Pain, bleeding, recurrence of the seat or remote and more rarely infection. The allergic risk also to local anesthetics.
What to do next?
The same as with incision treatment but with much more attention given that the wound is much wider. The doctor may prescribe antibiotics and venotropic to prevent recurrence.
Can these invasive treatments be avoided?
YES ! The answer is definitely yes!
Indeed, it must be understood that a hemorrhoidal thrombosis evolves spontaneously towards healing. Therefore, if one follows a strict hygiene of life and one arms oneself of patience, one can avoid them. The problem may also be remedied before the complication occurs. If you are fed up with treatments that do not give anything, here is the solution tested and effective to relieve and heal quickly!
We recommend reading the article: What to do in case of a hemorrhoidal crisis during pregnancy?