Chapter17: INTESTINES:Hemorrhoids Flashcards
Hemorroids develop secondary to what?
Hemorrhoids affect about 5% of the general population and develop secondary to persistently elevated venous pressure within the hemorrhoidal plexus.
What is the most frequent predisposing
influences in hemorroids?
are straining at stool because of constipation and the venous stasis of pregnancy
What is the pathogenesis of hemorroids?
The pathogenesis of hemorrhoids (anal varices) is similar to that of esophageal varices, although anal varices are both more common and less serious.
Variceal dilations of the anal
and perianal venous plexuses form collaterals that connect the portal and caval venous
systems, thereby relieving the venous hypertension.
What are external hemorroids?
Collateral vessels within the inferior hemorrhoidal plexus are located below the anorectal line and are termed external hemorrhoids
What is internal hemorroids?
while those that result from
dilation of the superior hemorrhoidal plexuswithin the distal rectum are referred to as
internal hemorrhoids.
What is the appearance of hemorroids histologically?
Histologically, hemorrhoids consist of thin-walled, dilated, submucosal vessels that protrude beneath the anal or rectal mucosa.
In their exposed position, they are subject to trauma and tend to become inflamed, thrombosed, and, in the
course of time, recanalized.
Superficial ulceration may occur.
What is the clinical presentation of hemorroids?
Hemorrhoids often present with pain and rectal bleeding, particularly bright red blood seen on
toilet tissue.
Except for pregnant women, hemorrhoids are rarely encountered in persons under age 30.
Hemorrhoids may also develop as a result of portal hypertension, where the implications are more ominous.
Hemorrhoidal bleeding is not generally a medical emergency and can be treated by sclerotherapy, rubber band ligation, or infrared coagulation.
Extensive or severe internal or external hemorrhoids may be removed surgically by hemorrhoidectomy.
