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[Late, life-threatening bleeding after hemorrhoidectomy].

C Jensen¹, H Jørgensen

¹Hillerød Sygehus, organkirurgisk afdeling A.

Ugeskrift for Laeger

|October 6, 2001

Summary

Severe rectal bleeding after hemorrhoidectomy can be life-threatening, especially in patients with cirrhosis. Prompt diagnosis and treatment are crucial to differentiate hemorrhoids from anorectal varices and prevent fatal outcomes.

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Area of Science:

Gastroenterology
Hepatology
Colorectal Surgery

Background:

Hemorrhoidectomy is a common surgical procedure.
Alcohol-induced cirrhosis can lead to coagulopathy and portal hypertension.
Rectal bleeding is a potential complication following hemorrhoidectomy.

Observation:

Two patients with severe, late rectal bleeding post-hemorrhoidectomy were analyzed.
Both patients had underlying alcohol-induced cirrhosis.
One patient experienced fatal bleeding due to delayed diagnosis and treatment.

Findings:

Distinguishing between hemorrhoids and anorectal varices is critical in patients with cirrhosis.
Massive bleeding can occur days after hemorrhoidectomy, mimicking hemorrhoidal bleeding.
Coagulation disturbances in cirrhotic patients exacerbate bleeding risks.

Implications:

Clinicians must consider anorectal varices in patients with cirrhosis presenting with severe rectal bleeding post-hemorrhoidectomy.
Early diagnostic and therapeutic interventions are vital for improving patient outcomes.
This case series highlights the potential for catastrophic bleeding and emphasizes the need for heightened vigilance in at-risk populations.

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