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Proctoscopic Doppler ultrasound in diagnostics and treatment of bleeding hemorrhoids
D Jaspersen1, T Koerner, W Schorr
12nd Department of Internal Medicine, Städtisches Klinikum Fulda, Academic Hospital, University of Marburg, Germany.
Purpose:
Endoscopic Doppler sonography is a relatively new technique in the diagnostics of intestinal hemorrhage. It has been used mainly for bleeding gastroduodenal ulcers, but can also be utilized in the lower digestive tract.
Methods:
In the study presented 80 patients with symptomatic hemorrhoids of first degree and previous hemorrhage were randomized in two groups. The 40 patients in Group A were examined by transproctoscopic Doppler ultrasound. After measuring the vessels depth, local injection treatment with 5 percent phenol almond oil followed. The patients in Group B had been given conventional sclerotherapy without the aid of Doppler investigation. The success of treatment was checked using Doppler sonographics six weeks later and the results were statistically compared.
Results:
In the patients in Group A, the hemorrhoids proved to be totally eliminated in 93 percent vs. 38 percent of the patients in Group B (P, 0.1 percent).
Conclusions:
Proctoscopic Doppler ultrasound is useful in the evaluation and sclerotherapy of symptomatic first-degree hemorrhoids.