Hemorrhoids

Ensure you have the right diagnosis.
- cancer
- prolapse
- disordered defecation
- fissure. Hemorrhoidectomy in a fissure patient will result in excessive pain, poor healing. Consider doing lateral sphinceterotomy at the same time.

Treatment options:
- patients with bleeding disorders consider an operative approach to hemorrhoid management
- use of banding in these patients can result in bleeding when the hemorrhoid sloughs off in 5-10 days.

Suture material
- catgut us often used as a suture material because it is absorbed quickly
- potential for infection when long absorbing suture is used.

Infection
- can manifest as pain greater than anticipated, urinary retention and fever.
- manage patient by taking to or, remove elastic band and start on IV abx

Reference:
ACS surgery

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