The patient, male, 6 years old, "has a protruding anus mass during defecation for 3 years" came to the clinic. The physical examination showed that the anal margin was slightly protruding, which was obvious after squatting, and it was distributed in a circle around the anal margin with dark purple color. Diagnosed as "circular varicose external hemorrhoids". Considering the good cooperation of the child, he underwent "external hemorrhoid vein mass dissection" under local anesthesia. During the operation, anal papilla hypertrophy was found at 3 and 9 o'clock, and the anal papilla was ligated. The symptoms disappeared the next day after the operation, and the wound healed in one week.
In the past, it was believed that children were not susceptible to hemorrhoids, but now the incidence of anorectal diseases in children is very high. Anal fistulas, abscesses, and anal fissures in children are very common clinically. This may be related to the current diet. Hemorrhoids in children are mostly external hemorrhoids, but internal hemorrhoids are rare. In this case, anal papilla hypertrophy was also found at the same time.
How is anorectal disease in children treated and when can surgery be performed? There is currently no unified view. The author believes that most of the anorectal diseases in children should be treated with diet and medication, especially non-infectious diseases such as hemorrhoids and anal fissures. If anal fistula and perianal abscess are subcutaneous, they can be operated early as long as they can cooperate. If the sphincter is involved, it is best to operate after 10 years of age, but do not use thread hanging method. There are two reasons for the operation of the child in this case. One is that the condition is serious and it is circular, and the other is that it can cooperate well. But during the operation, the method must be reasonable, try to protect the skin of the anal margin, and do not use laser, HCPT and other electrical cutting equipment. [Aid Xinjiang cases]