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Minor anal pathology: Rectal prolapse, perianal abscesses, hemorrhoids, anal fissures, and pilonidal disease
Published in Alejandra Vilanova-Sánchez, Marc A. Levitt, Pediatric Colorectal and Pelvic Reconstructive Surgery, 2020
Caitlin A. Smith, Alessandra C. Gasior, Devin R. Halleran
Most pediatric hemorrhoids will resolve with lifestyle modification. The primary treatment of hemorrhoids is lifestyle and behavior modifications to avoid constipation, avoid straining, and avoid prolonged periods of sitting on the toilet. Additionally, 64 oz. of water per day, and 25–35 g of water-soluble fiber should be recommended. Liver failure is another less common etiology of hemorrhoids. In this setting, treatment of the elevated portal pressures is necessary as rectal varices may be confused with rectal hemorrhoids.
Bleeding from the Colon and Rectum
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Charles B. Whitlow, Ben Hopkins
Haemorrhoid bleeding secondary to portal hypertension and cirrhosis can account for 2% to 10% of acute LGIB. Whilst rectal varices occur in 38% to 95% of patients with varices related to portal hypertension, serious bleeding is rare.5,41 However, bleeding can be quite severe, and up to half of the patients may require intervention, as this can be fatal.
Liver, biliary system and pancreas
Published in Michael Gaunt, Tjun Tang, Stewart Walsh, General Surgery Outpatient Decisions, 2018
Satyajit Bhattacharya, Adrian O’Sullivan
The main causes of haemorrhage are oesophageal varices and gastric fundal varices. Colonic and rectal varices are detectable but seldom cause haemorrhage. After diagnosis of varices, 30% of patients bleed within two years – then a smaller proportion bleed each year after that. Increased risk of bleeding is associated with the following endoscopic characteristics: size graded from I (small) up to III, cherry-red spots, overlying varices, red whale markings and blue varices (as opposed to white). Grade I varices may be reversible with improvement of the liver condition. Other grades do not regress.
Recognizing skin conditions in patients with cirrhosis: a narrative review
Published in Annals of Medicine, 2022
Ying Liu, Yunyu Zhao, Xu Gao, Jiashu Liu, Fanpu Ji, Yao-Chun Hsu, Zhengxiao Li, Mindie H. Nguyen
Severe portal hypertension of various aetiologies including cirrhosis promotes collateral circulation leading to oesophageal, gastric, abdominal and rectal varices. Abdominal varicose veins can be manifested in the superficial veins of the chest and abdomen presenting a net shape, or abdominal veins with obvious varicose beads or masses. Severe abdominal varicose veins appear as distended veins that radiate from the umbilicus across the abdominal wall resembling a ‘caput medusa’ because the affected veins resemble the snake-like hair of Medusa, a gorgon from Greek mythology (Figure 1(h)) [22].