Ver el código de «External hemorrhoid excision»

==Indications==
*Acute (<72 hours) thrombosed [[external hemorrhoid]]
*Pain/discomfort affects daily life

==Contraindications==
*Immunocompromised patient
*Pediatric patient
*Pregnant patient
*Portal hypertension
*Coagulopathy

==Equipment Needed==
*Scalpel
*Local anesthetic

==Procedure==
#Place patient in side-lying or prone position
#Apply lidocaine/prilocaine cream 1 hr prior to procedure
#*Apply tape to each buttock with force directed laterally for better visualization
#Inject local anesthetic (e.g. [[bupivacaine]] 0.5% with epi) with 30-gauge needle directly into dome of hemorrhoid as a ''single'' injection
#*Alternatively, a [[perianal block]] can be used for local analgesia
#Make elliptical incision in overlying skin to expose the thrombosis
#*Remove the clot and the overlying skin through the incision site
#Control bleeding by tucking corner of a small piece of gauze into the wound and tape buttocks together
#*Leave in place for a few hours
#Apply pressure dressing have patient remove 6-12 hr later when takes first stiz bath
#Patient may apply soothing ointments (preparation H, Anusol HC, [[Lidocaine]] ointment) after dressing is removed
#Provide follow up in 24-48hr

==Complications==
*Continued bleeding
*Recurrence
*Infection
*[[anal fistula|Fistula]]
*[[perianal Abscess|Abscess]]
*[[anal tags|Skin tags]]

==See Also==
*[[Hemorrhoids]]
*[[Anorectal disorders]]
*[[Internal hemorrhoid]]
*[[External hemorrhoid]]

==External Links==
*[https://www.merckmanuals.com/professional/gastrointestinal-disorders/anorectal-disorders/hemorrhoids?query=external%20hemorrhoid Merk Manual - How To Do Hemorrhoidal Thrombectomy]

===Videos===
{{#widget:YouTube|id=KU1c1JfpJHM}}

==References==
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[[Category:Procedures]]
[[Category:GI]]