Treatment of grade III haemorrhoids with anorectal thrombosis

Korolenko K., Korolenko V. & Tominets M.
Colorectal Disease 2013, 15 (Suppl. 3), 48-116, Poster P297 from ESCP Meeting 2013 in Belgrade

Acute anorectal thrombosis is common complication in 40% to 67% of patients. Various treatment methods can be found in literature. Some authors recommend conservative treatment, others prefer surgery. Conservative methods result in recurrence (78% - 95%). Surgery (removal of internal and external complexes) is associated with serious complications. We aimed to improve the results and safety of hemorrhoids treatment with anorectal thrombosis.

Since March 2008 75 patients with combined thrombosed piles of grade III underwent surgery on admission day. Operation included removal of thrombosed piles with catgut suturing followed by THD procedure with anopexy. Age 20-72 years, 71.5% males.

Patients reported pain at the site of thrombosed piles excision. No post operation complication were seen. Hospital stay took 1 to 3 days. Patients fully recovered in 5-10 days. In 4 years follow-up no patient had recurrence of anorectal thrombosis. 2.5% of patients experienced a small amount of bleeding during defecation, which was managed with conservative treatment.

This study confirms that surgical treatment of anorectal thrombosis with simultaneous THD procedure for grade III hemorrhoids. This method does not increase complications and is maximally radical. In 5-10 days patients recovered completely.