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

1. The patient is positioned in such a way that allows easy access to the anal area.
2. Local anesthesia is administered to numb the area.
3. The surgeon cleans the area with an antiseptic solution and makes a small incision over the thrombosed hemorrhoid.
4. The clot and surrounding hemorrhoidal tissue are removed using surgical instruments.
5. The incision site may be left open to drain naturally or sutured closed, depending on the situation.
6. 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.