Excision of thrombosed hemorrhoid, external
CPT4 code
Name of the Procedure:
Excision of thrombosed hemorrhoid, external
Common Name(s): Hemorrhoid removal, External hemorrhoid excision
Medical Term: Thrombosed external hemorrhoid excision
Summary
The procedure involves the surgical removal of an external hemorrhoid that has developed a blood clot (thrombosis), causing significant pain and swelling. It is a minor operation typically performed under local anesthesia.
Purpose
The primary purpose of this procedure is to alleviate severe pain and discomfort caused by a thrombosed external hemorrhoid. The goal is to remove the clot and hemorrhoid tissue, thereby reducing symptoms and preventing further complications such as infection.
Indications
- Severe pain and swelling in the anal area
- Presence of a firm, tender lump near the anus
- Bleeding from the hemorrhoid
- Inability to manage symptoms with conservative treatments
Preparation
- Follow fasting instructions provided by the healthcare provider if anesthesia is used.
- Inform the surgeon about any medications, including blood thinners, which may need to be paused.
- Complete any required pre-operative assessments or diagnostic tests such as blood work or a physical exam.
Procedure Description
- The patient is positioned in such a way that allows easy access to the anal area.
- Local anesthesia is administered to numb the area.
- The surgeon cleans the area with an antiseptic solution and makes a small incision over the thrombosed hemorrhoid.
- The clot and surrounding hemorrhoidal tissue are removed using surgical instruments.
- The incision site may be left open to drain naturally or sutured closed, depending on the situation.
- The area is then covered with sterile gauze.
Duration
The procedure typically takes between 15 to 30 minutes.
Setting
The procedure is usually performed in an outpatient clinic, a physician’s office, or a surgical center.
Personnel
- Surgeon or a qualified healthcare professional
- Nurse or medical assistant
Risks and Complications
- Common risks: Bleeding, temporary pain at the site
- Rare risks: Infection, difficulty urinating, excessive bleeding, recurrence of hemorrhoids
Benefits
- Immediate relief from pain and swelling
- Quick return to normal activities
- Prevention of further complications associated with thrombosed hemorrhoids
Recovery
- Patients can usually go home the same day.
- Instructions may include taking over-the-counter pain relievers, soaking in warm baths, and applying prescribed ointments.
- Avoid strenuous activities for a few days.
- Follow-up appointment with the healthcare provider may be scheduled.
Alternatives
- Conservative treatments: Sitz baths, over-the-counter pain relievers, topical treatments
- Other medical procedures: Rubber band ligation, sclerotherapy, infrared coagulation
- Pros of excision: Immediate relief and reduction of symptoms
- Cons of excision: Minor surgical risks associated with the procedure
Patient Experience
- During the procedure: Minimal to moderate discomfort due to local anesthesia
- After the procedure: Some pain and discomfort at the site for a few days, managed with medication and home care measures.
- Pain management options typically include over-the-counter analgesics and warm baths for relief.