대한대장항문학회

An external thrombotic hemorrhoid is a very painful disease with a high incidence<br>rate. The chief complaints encountered by the surgeon are protrusion and pain.<br>However, because the spontaneous healing rate is very high, there is no consensus on<br>whether conservative management or surgery is a more effective treatment policy. In an<br>attempt to resolve this problem, we performed a clinical analysis of fifty patients with<br>external thrombotic hemorrhoids who were treated by conservative management at<br>Song-Do Colorectal Hospital from October 1996 to December 1996. We recorded the time<br>required for the protrusion and the pain to disappear and performed manometry to check<br>the sphincter pressure and tissue pathology to determine the pathogenesis of the<br>external thrombotic hemorrhoid. The results are as follows:<br>1) Based on pathology, the cause of the external thrombotic hemorrhoids was venous<br>thrombosis due to venous stasis, not a hematoma due to venous rupture.<br>2) Manometry showed that the resting sphincter pressure and the squeezing sphincter<br>pressure for the patients with external thrombotic hemorrhoids was higher than those of<br>the control group, which was the reason for the venous stasis.<br>In conclusion, because an external thrombotic hemorrhoid is just a thrombosis due to<br>venous stasis, the thrombosis can be improved by using methods such as a warm sitz<br>bath and analgesics to decrease the sphincter pressure. Hence, conservative management<br>should be the preferred treatment in almost all cases.<br>