Difference between revisions of "Hemorrhoid"

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#redirect [[Anus#Hemorrhoids]]
'''Hemorrhoid''' is a benign pathology of the rectal venous plexus, that may mimic more serious pathology, i.e. [[cancer]].
 
==General==
*Benign.
 
Clinical features:<ref>{{Cite journal  | last1 = Cazemier | first1 = M. | last2 = Felt-Bersma | first2 = RJ. | last3 = Cuesta | first3 = MA. | last4 = Mulder | first4 = CJ. | title = Elastic band ligation of hemorrhoids: flexible gastroscope or rigid proctoscope? | journal = World J Gastroenterol | volume = 13 | issue = 4 | pages = 585-7 | month = Jan | year = 2007 | doi =  | PMID = 17278225 }}</ref>
*Bright red blood per rectum (BRBPR).
*Pain.
*Itching.
*Prolapse.
 
==Gross==
Features:<ref name=Ref_GLP401>{{Ref GLP|401}}</ref>
*Grey mucosa.
*Pale or purple stroma.
 
===Microscopic===
Features:<ref name=Ref_GLP401>{{Ref GLP|401}}</ref>
*Polypoid lesion - epithelium on three sides:
**Large dilated veins and thick-walled vessels +/- fibrin thrombi - '''key feature'''.
**Edema.
**Squamous epithelium +/- keratinization ''or'' columnar epithelium.
 
DDx:
*[[Fibroepithelial polyp]].
*Vascular lesions.
**[[Kaposi sarcoma]].
**[[Angiosarcoma]].
**[[Arteriovenous malformation]] - has large arteries.
 
Image:
*[http://www.profimedia.si/picture/longitudinal-section-of-human-rectum-hemorrhoid-tissue/0039860546/ Hemorrhoids (profimedia.si)].
 
==Sign out==
<pre>
ANAL LESION, REMOVAL:
- HEMORRHOID.
</pre>
 
<pre>
HEMORRHOIDS, EXCISION:
- HEMORRHOIDS.
</pre>
 
===Micro===
The sections show rectal and anal mucosa, and a submucosa with prominent blood vessels in a fibrotic stroma.  The rectal mucosa has focal reactive nuclear changes and evidence of prior erosions. The anal mucosa is unremarkable.
 
====Anal mucosa only====
The sections show anal mucosa, and submucosa with prominent blood vessels in a
fibrotic stroma. The anal mucosa is unremarkable.
 
==See also==
*[[Anus]].
 
==References==
{{Reflist|2}}
 
[[Category:Anus]]
[[Category:Gastrointestinal pathology]]

Revision as of 01:27, 20 December 2013

Hemorrhoid is a benign pathology of the rectal venous plexus, that may mimic more serious pathology, i.e. cancer.

General

  • Benign.

Clinical features:[1]

  • Bright red blood per rectum (BRBPR).
  • Pain.
  • Itching.
  • Prolapse.

Gross

Features:[2]

  • Grey mucosa.
  • Pale or purple stroma.

Microscopic

Features:[2]

  • Polypoid lesion - epithelium on three sides:
    • Large dilated veins and thick-walled vessels +/- fibrin thrombi - key feature.
    • Edema.
    • Squamous epithelium +/- keratinization or columnar epithelium.

DDx:

Image:

Sign out

ANAL LESION, REMOVAL:
- HEMORRHOID.
HEMORRHOIDS, EXCISION: 
- HEMORRHOIDS.

Micro

The sections show rectal and anal mucosa, and a submucosa with prominent blood vessels in a fibrotic stroma. The rectal mucosa has focal reactive nuclear changes and evidence of prior erosions. The anal mucosa is unremarkable.

Anal mucosa only

The sections show anal mucosa, and submucosa with prominent blood vessels in a fibrotic stroma. The anal mucosa is unremarkable.

See also

References

  1. Cazemier, M.; Felt-Bersma, RJ.; Cuesta, MA.; Mulder, CJ. (Jan 2007). "Elastic band ligation of hemorrhoids: flexible gastroscope or rigid proctoscope?". World J Gastroenterol 13 (4): 585-7. PMID 17278225.
  2. 2.0 2.1 Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 401. ISBN 978-0443066573.