Overview
Where are external hemorrhoids (piles) located?
What are the risk factors for thrombosed external hemorrhoid?
What are the treatment options for thrombosed external hemorrhoids?
What is the role of excision in the treatment of thrombosed external hemorrhoids?
When is excision indicated in the treatment of external hemorrhoids?
What are the absolute contraindications to emergent excision of thrombosed external hemorrhoids?
What are the relative contraindications to emergent excision of thrombosed external hemorrhoids?
Periprocedural Care
What patient education should be given regarding excision of thrombosed external hemorrhoids?
What equipment is required for thrombosed external hemorrhoid excision?
What type of anesthesia is indicated in thrombosed external hemorrhoid excision?
How should patients be positioned for a thrombosed external hemorrhoid excision?
How should patients be monitored following excision of thrombosed external hemorrhoids?
Technique
How is exposure to thrombosed external hemorrhoid increased prior to excision?
Where is local anesthetic injected for excision of thrombosed external hemorrhoids?
How is a sterile field created for excision for thrombosed external hemorrhoids?
How is an elliptical incision made in thrombosed external hemorrhoid excision?
How should blood clots be removed from thrombosed external hemorrhoids?
How is gauze packed following thrombosed external hemorrhoid excision?
How is the wound dressed following thrombosed external hemorrhoid excision?
What is the postoperative care for thrombosed external hemorrhoid excision?
What are the possible complications of thrombosed external hemorrhoid excision?
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Excision of thrombosed external hemorrhoid. Taping of patient before procedure (thrombosed external hemorrhoid is at 9-o'clock position).
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Excision of thrombosed external hemorrhoid. Preparation of light source for sterile field.
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Excision of thrombosed external hemorrhoid. Injection of local anesthetic at hemorrhoid base and within hemorrhoid.
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Excision of thrombosed external hemorrhoid. Application of povidone-iodine antiseptic.
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Excision of thrombosed external hemorrhoid. Primary elliptical incision over hemorrhoid.
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Excision of thrombosed external hemorrhoid. Further incision with removal of clot.
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Excision of thrombosed external hemorrhoid. Gauze packing after procedure.
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Excision of thrombosed external hemorrhoid. Dressing after excision.
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Excision of thrombosed external hemorrhoid. Dressing after excision.
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Thrombosed hemorrhoid, treated with incision and removal of clot. Image courtesy of Dr. Jonathan Adler.
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Anatomy of external hemorrhoid. Image courtesy of MedicineNet, Inc.