Editing Haemorrhoids (section)

=== '''Thrombosed     external haemorrhoid''' ===

**
** Lots of variation in      semantics, but many say this is the same entity as a perianal haematoma -      others differentiate between the two and call a perianal haematoma an      extravascular haematoma which gives a more circular lump, probably with a      skin bridge, NOT mucosa
** Acute severe pain,      exacerbated by sitting or defecation, which may be preceded by an episode      of constipation or diarrhoea
** Can sometimes be complicated      by necrosis, which should usually have some sort of external      manifestation - surrounding cellulitis or systemic features
** Usually associated with      internal haemorrhoids too, but those usually remain soft because the      thrombosis is in the superficial channels
** Usually resolves within 72      hours
** Trial sitz baths, topical      lignocaine and stool softeners
** Surgery for severe pain or      significant bleeding - excise the thrombosed haemorrhoid but leave the      rest alone