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Injection of sclerosing solution, hemorrhoids
CPT4 code
Name of the Procedure:
Injection of Sclerosing Solution, Hemorrhoids
Summary
In this procedure, a sclerosing solution is injected into hemorrhoids to shrink them. The solution causes the blood vessels in the hemorrhoids to collapse and form scar tissue, alleviating symptoms.
Purpose
The procedure addresses symptomatic hemorrhoids that cause discomfort, bleeding, itching, or pain. The goal is to reduce the size of hemorrhoids, alleviate symptoms, and improve the patient's quality of life.
Indications
- Persistent bleeding from hemorrhoids
- Symptomatic internal hemorrhoids causing discomfort or pain
- Hemorrhoids that do not respond to conservative treatments (e.g., dietary changes, topical medications)
Preparation
- No significant preparation is generally required.
- The patient may be advised to avoid certain medications like blood thinners.
- Diagnostic rectal examination or anoscopy might be performed to assess hemorrhoids.
Procedure Description
- The patient is positioned comfortably, often in a prone or left-side position.
- The affected hemorrhoid(s) are exposed using an anoscope.
- A sclerosing solution is injected directly into the hemorrhoidal tissue using a fine needle.
- The solution causes the vascular structure of the hemorrhoid to collapse and form scar tissue.
- The injection site might be compressed briefly afterward to reduce bleeding.
Duration
The procedure typically takes around 15 to 30 minutes.
Setting
It is usually performed in an outpatient clinic or a doctor's office.
Personnel
- A qualified physician, often a gastroenterologist or colorectal surgeon.
- A nurse or medical assistant to provide support and comfort to the patient.
Risks and Complications
- Mild pain or discomfort at the injection site
- Infection at the injection site
- Bleeding
- Allergic reaction to the sclerosing solution
- Rarely, abscess formation or tissue necrosis
Benefits
- Reduction in hemorrhoid size and associated symptoms
- Minimally invasive with quick recovery
- Can prevent the need for more invasive surgical interventions
Recovery
- Patients can usually resume normal activities shortly after the procedure.
- Over-the-counter pain relief may be used if there is mild discomfort.
- Follow-up appointments may be scheduled to monitor progress and effectiveness.
Alternatives
- Conservative treatments (e.g., dietary changes, topical medications)
- Rubber band ligation
- Hemorrhoidectomy (surgical removal of hemorrhoids)
- Infrared coagulation
Pros and Cons of Alternatives:
- Conservative treatments are non-invasive but may not be effective for severe cases.
- Rubber band ligation is effective but might cause more discomfort.
- Hemorrhoidectomy is very effective but involves more pain and longer recovery.
- Infrared coagulation is less invasive but can require multiple sessions.
Patient Experience
- Minimal discomfort during the procedure, with slight pressure or stinging sensation.
- Post-procedure, mild soreness that can be managed with over-the-counter pain relievers.
- Rapid return to normal activities with minimal downtime.
Pain management typically involves simple analgesics, and patients may be advised to maintain a high-fiber diet to prevent recurrence.