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Doppler-guided haemorrhoidal artery ligation in patients with Crohn's disease

Eliad Karin1, Shmuel Avital, Iris Dotan

  • 1Department of Surgery 'A', Tel-Aviv Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|December 24, 2010
PubMed

Insights

Doppler-guided haemorrhoidal artery ligation (DGHAL) is a safe and effective treatment for grade III haemorrhoids in Crohn's disease (CD) patients without rectal involvement. Most patients experienced symptom relief, though some recurrence was noted.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Surgical Innovation

Background:

  • Crohn's disease (CD) patients often experience symptomatic haemorrhoids.
  • Grade III haemorrhoids can significantly impact quality of life in CD patients.
  • Limited data exists on the efficacy of minimally invasive procedures for haemorrhoids in this population.

Purpose of the Study:

  • To evaluate the outcome of Doppler-guided haemorrhoidal artery ligation (DGHAL) in patients with Crohn's disease (CD) and grade III haemorrhoids.
  • To assess the safety and effectiveness of DGHAL in this specific patient group.

Main Methods:

  • Retrospective analysis of patients with CD and grade III haemorrhoids treated with DGHAL.
  • Data retrieval of perioperative and follow-up information from a dedicated DGHAL database.
  • Inclusion of patients with CD but without anorectal involvement.

Main Results:

  • The study included 13 patients (7 male, 6 female) with a mean age of 34 years.
  • No mortality or major complications (incontinence, impaction, retention, abscess, persistent pain) were observed.
  • Postoperative pain scores (VAS) significantly decreased, with full recovery by day 3. At 18 months, 77% of patients were asymptomatic or had recurrent symptoms.

Conclusions:

  • Doppler-guided haemorrhoidal artery ligation (DGHAL) is a safe procedure for treating grade III haemorrhoids in CD patients.
  • DGHAL demonstrates effectiveness in managing haemorrhoids in CD patients without anorectal involvement.
  • The procedure offers a viable treatment option with minimal complications for this patient cohort.
Abstract

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