Professional Documents
Culture Documents
• Haemorrhoides (Greek)
Haem = blood, rhoos = flowing
flowing of blood
Anorectal Anatomy
HEMORRHOIDS
Normal anatomical structures
Increased
arterial flow
Disfunction of
arteriovenous shunt
Extended
venous back flow
Microvascular stastis
Venous
stasis
Capillary fragility
Hyperpermeability
Local inflammatory
process
Haemorrhoidal prolaps
Prolaps with vein dilatation
Assessment of Patients
HISTORY :
- Colour & Character of the Bleeding
- Discomfort to Defecation
- Unequivocal History of Relief from Reduction of the
Prolapse into the Anal Canal
PALPATION : - Gentleness
- Slowly with adequate lubrication
Endoscopy
o Proctoscopy : - the presence of internal vascular
cushions ( bleeding ?)
dd/ of causes of rectal or anal bleeding
External Hemorrhoids:
o Sudden, Severe Perianal Pain
o Perianal Mass
Staging of Internal Hemorrhoids
Management for Hemorrhoid
Internal Hemorrhoid:
Grade 1 conservative
infra red photocoagulation
Grade 2 conservative
infra red photocoagulation
rubber band ligation
Grade 4 hemorrhoidectomy
• Straining
• Schistosomiasis dan Amubiasis
• Gangguan Neurologis
• Melahirkan Pervaginam
• Konstipasi
Gejala Klinis
• Sigmoidoskopy
• Barium Enema
• Videoproctography
Pemeriksaan Fisiologis
• Manometri Anal
• Saline infusion test
• Rectal Sensation and Compliance
• Anal Reflex
• Electromyography and Nerve Conduction
Terapi Konservatif
*Tests:
• proctoscopy
• sigmoidoscopy
• rectal culture
Proctitis
• Treatment: treatment of the underlying cause usually
cures the problem. Proctitis caused by infection is
treated with antibiotics specific for the causative
organism. Corticosteroid or mesalamine suppositories
may relieve symptoms in Crohn's disease or ulcerative
colitis.
Thank
You