小结
Definition
História e exame físico
Principais fatores diagnósticos
- rectal bleeding
- intermittent protrusion
- perianal pain/discomfort
Outros fatores diagnósticos
- anal pruritus
- tender palpable perianal lesion
- anal mass
Fatores de risco
- age between 45-65 years
- constipation
- pregnancy or space-occupying pelvic lesion
- hepatic insufficiency
- ascites
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- anoscopic exam
- colonoscopy/flexible sigmoidoscopy
- CBC
- stool for occult heme
Algoritmo de tratamento
initial presentation: nonpregnant
initial presentation: pregnant
treatment failure of rubber band ligation, sclerotherapy, infrared coagulation, hemorrhoidal arterial ligation, or stapled hemorrhoidopexy
Colaboradores
Autores
Mohamed A. Thaha, PhD, FRCS (Gen Surg), PG Cert Hlt Econ
Senior Lecturer and Consultant in Colorectal Surgery
National Bowel Research Centre (NBRC)
Blizard Institute
Faculty of Medicine & Dentistry
Queen Mary University of London
Colorectal & Pelvic Floor Services
Royal London Hospital
Barts Health NHS Trust
London
UK
Declarações
MAT declares that he has no competing interests.
Robert J.C. Steele, MD, FRCS
Professor of Surgery
Ninewells Hospital & Medical School
University of Dundee
Dundee
UK
Declarações
RJCS declares that he has no competing interests.
Jayan Dewanta Jayasinghe, MD, FRCS (Gen Surg), FEBS (Coloproctology)
Senior Colorectal Fellow
Barts Health NHS Trust
Colorectal & Pelvic Floor Services
Royal London Hospital
London
UK
Declarações
JDJ declares that he has no competing interests.
Agradecimentos
Mr Mohamed A. Thaha, Mr Jayan D. Jayasinghe, and Professor Robert J.C. Steele would like to gratefully acknowledge Dr Kurt G. Davis, the previous contributor to this topic.
Declarações
KGD declares that he has no competing interests.
Revisores
Tisha N. Lunsford, MD, FACG, AGA
Director of Motility
Mayo Clinic Arizona
Phoenix
AZ
Declarações
TNL declares that she has no competing interests.
George Reese, MB BS MRCS
Honorary Clinical Research Fellow
Division of Surgery
Oncology
Reproductive Biology and Anaesthetics
Imperial College
St Mary's Hospital
London
UK
Declarações
GR declares that he has no competing interests.
Alexander von Roon, MRCS
Clinical Research Fellow
Department of Biosurgery and Surgical Technology
Imperial College
St Mary's Hospital
London
UK
Declarações
AVR declares that he has no competing interests.
Diagnósticos diferenciais
- Anal fissure
- Crohn disease
- Ulcerative colitis
Mais Diagnósticos diferenciaisDiretrizes
- The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of hemorrhoids
- Australian Department of Health pregnancy care guidelines: common conditions during pregnancy
Mais DiretrizesFolhetos informativos para os pacientes
Anal tears
Hemorrhoids
Mais Folhetos informativos para os pacientesConectar-se ou assinar para acessar todo o BMJ Best Practice
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