2021年2月2日星期二

hemorrhoids external causes,Clinical case---External stripping and internal ligation of mixed hemorrhoids

    The patient Luo, male, 50 years old, was admitted to the hospital with "mixed hemorrhoids" because of repeated prolapse of anal contents for more than 10 years. The patient's anal contents can be relapsed, accompanied by a little blood and pain, and loose stools. Specialist examination: Take the left decubitus position, the prolapse of hemorrhoids in front of the anal margin can be seen at the anal margin, about 3*3cm in size, the pedunculated polyps in the rectum can be palpable on digital anal examination, and the internal hemorrhoid mucosa at 3, 7, and 11 points can be seen under anoscope Congestion and bulge, of which the hemorrhoids protrude larger at 11 o'clock, and prolapse outside the anus with anoscope. After admission, he was diagnosed with mixed hemorrhoids and rectal polyps (as shown in the picture below).

    After completing the relevant examinations, the patient underwent combined hemorrhoid external dissection and internal ligation under lumbar shu anesthesia combined with local anesthesia. Routine anti-inflammatory and hemostatic treatments were given after the operation, and the specialists were given dressing changes. The postoperative recovery was good.

    discuss:

    Mixed hemorrhoids are a common disease in clinical practice. There is a folk saying that "nine hemorrhoids in ten people" is enough to explain the high incidence of it. The incidence of hemorrhoids is distributed in all age groups, and the difference in sexually transmitted diseases between men and women is not very obvious. The most important cause is still related to living habits. Squatting for a long time when defecation, usually like to sit for a long time, addiction to spicy food (wine, pepper) is the main cause of the disease. The main clinical manifestations of hemorrhoids are blood in the stool and prolapse. Depending on the degree of blood in the stool, dripping or jet-like bleeding may occur; depending on the degree of prolapse, it can be manifested as reversible prolapse, necessitated prolapse and hemorrhoid incarceration. Due to blood in the stool and prolapse, other related symptoms can be derived, such as perianal dampness, anal swelling, pain, anemia, etc. These symptoms of hemorrhoids can seriously interfere with the daily life and work of the patients. After repeated conservative treatments, some of them eventually have to undergo surgery.

    In order to avoid the troubles caused by hemorrhoids, we should usually pay attention to prevention. Regular bowel movements, proper activities, and a light diet are the three magic weapons to prevent hemorrhoids.

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