Hemorrhoids

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Background

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Internal and external hemorrhoids divided by pectinate (dentate) line
  • Pathologic state cccurs when internal or external hemorrhoid plexus become engorged, prolapsed, or thrombosed
  • Bleeding is usually limited (surface of stool, on toilet tissue, at end of defecation)
    • Passage of blood clots requires evaluation for colon lesions

Risk Factors

Types

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Internal hemorrhoid chart

Internal hemorrhoid grades
Grade Description Diagram Picture
I
  • Luminal protrusion above dentate line
  • No prolapse
  • Painless bleeding
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II
  • Prolapse with spontaneous reduction
  • Prolapse during straining
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III
  • Prolapse requires manual reduction
  • Prolapse during straining
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IV
  • Prolapse—nonreducible
  • Can result in edema and strangulation
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See Also

References