ABSTRACT
Introduction. La maladie hémorroïdaire interne est la plus fréquente des affections proctologiques et constitue un motif extrêmement répandu de consultation en proctologie. L'objectif de ce travail était de décrire les aspects cliniques de la maladie hémorroïdaire interne à l'hôpital du district de la commune IV de Bamako. Patients et méthodes. Nous avons réalisé une étude transversale descriptive sur un groupe de malades vus en consultation à l'unité de Gastro-entérologie de l'hôpital du district de la commune IV de Bamako. Entre le 1er Novembre 2019 et le 31 Octobre 2020, le recrutement des patients a été réalisé. Les variables recueillies étaient les données sociodémographiques (âge, sexe, profession), les symptômes anaux (saignement anal, douleur anale, suintements muco-glaireux, prurit anal), les facteurs de risque (les troubles du transit intestinal, la période du troisième trimestre de la grossesse, l'accouchement, le post-partum immédiat), les stades de la maladie hémorroïdaire interne, les autres pathologies anales associées, les complications, l'hémogramme. Résultats. Durant la période d'étude, 128 patients ont été vus en consultation parmi lesquels 85 avaient une maladie hémorroïdaire interne, soit une fréquence de 66,40%. La procidence hémorroïdaire a été observée chez 18,8% de nos patients. En fonction de son degré, le grade I représentait 34,1%, le grade II 55,3%, le grade III 9,4% et le grade IV 1,2%. Conclusion. Cette première étude réalisée sur la maladie hémorroïdaire interne à l'hôpital du district de la commune IV de Bamako montre que la maladie hémorroïdaire interne est l'affection proctologique la plus fréquente.
Introduction. Internal haemorrhoidal disease is the most common proctological condition and is an extremely common reason of consultation in proctology. The objective of this work was to describe the clinical aspects of internal haemorrhoidal disease in the district hospital of the commune IV of Bamako. Patients and methods. We conducted a descriptive cross-sectional study on a cohort of patients seen in consultation at the Gastroenterology Unit of the District Hospital of Bamako's commune IV. The recruitment was carried out between November 1, 2019 and October 31, 2020. The variables of study were socio-demographic data (age, sex, profession), anal symptoms (anal bleeding, anal pain, muco-glue oozing, anal pruritus), risk factors (intestinal transit disorders, third trimester of pregnancy, childbirth, immediate postpartum), stages of internal haemorrhoidal disease, other associated anal pathologies, complications, blood count. Results. During the study period, 128 patients were seen in consultation, among whom 85 had internal haemorrhoidal disease (66.40%). Hemorrhoidal procidence was found in 18.8% of patients. Concerning the severity, grade I represented 34.1%, grade II 55.3%, grade III 9.4% and grade IV 1.2%. Conclusion. This pioneer study on internal haemorrhoidal disease in the district hospital of commune IV of Bamako (Mali) showed that internal hemorrhoidal disease is the most common proctological condition in Bamako.
Subject(s)
Humans , Male , Female , Pain , Signs and Symptoms, Digestive , Diagnosis , Hemorrhoids , Referral and ConsultationABSTRACT
Introduction: Neglected cases of hemorrhoids presentingwith complications like strangulation are not uncommon,as observed in our tertiary care hospital. Under the abovebackground we conducted the present study to look into theprofile and management of the patients with complicated(especially strangulated) prolapsed hemorrhoids attending toour tertiary care hospital.Material and methods: This prospective hospital based studywas conducted in unit-II of department of general surgery inShri Maharaja Harisingh (SMHS) hospital Srinagar over aperiod of 5 years from January 2013 to December 2017. Allpatients with complicated prolapsed internal hemorrhoids(strangulation with infection, ulceration, gangrene, and/or necrosis) were enrolled in this study. Patients presentingwith features suggestive of complicated prolapsed internalhemorrhoids were subjected to clinical history, local inspectionand examination to confirm the diagnosis, and were managedappropriately.Results: During the study period of 5 years, 31 patients ofcomplicated (strangulated) prolapsed internal hemorrhoidswere enrolled. The age of our patients ranged from forty-fourto seventy-two years with mean age of 59.12±6.56 (SD=6.56)years. In our study 20 patients (64.5%) were from rural areaand 11 patients (35.5%) were from urban background. Mostcommon presentation in our study was strangulated prolapsedinternal hemorrhoid with pain, ulceration and infection.Conclusion: Patients with grade 3 and 4 internal hemorrhoids,patients having difficult access to health care facilities, andpatients having poor compliance to conservative treatment,should be offered surgical intervention at the earliest beforethe complications arise. Complicated prolapsed internalhemorrhoids can be managed initially conservatively (byprone position, bed rest, saline compresses, hot baths, icepacks, soothing topical applications, laxatives, antibiotics, sitzbath with antiseptic solutions)
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Teikosan is an herbal medicine that was developed from the Japanese herbal (Kampo) medicine hochuekkito. Unlike hochuekkito, teikosan does not include Zizyphi fructus and Zingiberis rhizoma. Instead, Cnidii rhizoma, Scutellariae radix, Coptidis rhizoma, Angelicae dahuricae radix, and shakusekishi are included as constituents of teikosan. The clinical indication of teikosan is anal prolapse with pain that is more severe than that considered appropriate for hochuekkito treatment, but there have been few clinical reports before. Here, we describe a case of anal prolapse with anal pain, which was successfully treated with teikosan. A case was a 47-year-old woman whose chief complaint was anal prolapse of internal hemorrhoids with pain. She was considered as indication for hochuekkito, but her symptoms including anal pain were so severe that we prescribed teikosan, especially because Angelicae dahuricae radix, Scutellariae radix, Coptidis rhizome in teikosan were expected to improve her anal pain. After the administration of teikosan, her symptoms including anal pain have much improved. Teikosan should be considered as a therapeutic option for anal prolapse with severe anal pain or inflammation.
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A 75-year-old man with end-stage colon cancer began to experience increased pain and distress and significantly deteriorated quality of life (QOL) due to internal hemorrhoids. In order to maintain the patient's QOL, the hemorrhoids were successfully treated with aluminum potassium sulfate and tannic acid (ALTA) injection, which involves minimal patient burden and pain. The outcome of this case suggests that ALTA might be useful and effective for the treatment of internal hemorrhoids in terminally ill cancer patients.
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Objective To compare the clinical efficacy and safety between the improved ligation method and the traditional ligation method in the treatment of internal hemorrhoid. Methods Double blind and randomized study were made in 86 patients with internal hemorrhoid. The traditional method was performed by ligation of internal hemorrhoidal body, and the improved method was to ligate rectal mucous membrane above internal hemorrhoidal radicles. Results The improved method has better effect than the traditional method. The clinical symptoms of internal hemorrhoid such as bleeding,pain,constipation,edema,itching and erosion in the patients treated by the improved method were significantly improved compared with the patients treated by the traditional method(P
ABSTRACT
Three hundred cases of internal hemorrhoids hare been excised by hemorrhoide- ctomy with co laser in our hospital since July,1988The operation was performed under local anesthesia.After ligation of the hemo-rrhoid artery excision of internal hemorrhoid was carried out by co laser the stump of hemorrhoid was carbonized to promote vessel coagulation.postoperative pain was slight.Only 22 cases required narcotic analgesics. Bleeding was minimum except 2 cases with hypertension.Urinary retention developed in 2 cases.Thrombosis of external hemorrhoids developed in 3 cases.Wounds healed within 7 to 10 days.Fifty cases have been followed up for more than one year with no recurrence