|
|
Line 67: |
Line 67: |
|
| |
|
| ==Hemorrhoids== | | ==Hemorrhoids== |
| ===General===
| | {{Main|Hemorrhoid}} |
| *Benign.
| |
| | |
| Clinical features:<ref>{{Cite journal | last1 = Cazemier | first1 = M. | last2 = Felt-Bersma | first2 = RJ. | last3 = Cuesta | first3 = MA. | last4 = Mulder | first4 = CJ. | title = Elastic band ligation of hemorrhoids: flexible gastroscope or rigid proctoscope? | journal = World J Gastroenterol | volume = 13 | issue = 4 | pages = 585-7 | month = Jan | year = 2007 | doi = | PMID = 17278225 }}</ref>
| |
| *Bright red blood per rectum (BRBPR).
| |
| *Pain.
| |
| *Itching.
| |
| *Prolapse.
| |
| | |
| ===Gross===
| |
| Features:<ref name=Ref_GLP401>{{Ref GLP|401}}</ref>
| |
| *Grey mucosa.
| |
| *Pale or purple stroma.
| |
| | |
| ===Microscopic===
| |
| Features:<ref name=Ref_GLP401>{{Ref GLP|401}}</ref>
| |
| *Polypoid lesion - epithelium on three sides:
| |
| **Large dilated veins and thick-walled vessels +/- fibrin thrombi - '''key feature'''.
| |
| **Edema.
| |
| **Squamous epithelium +/- keratinization ''or'' columnar epithelium.
| |
| | |
| DDx:
| |
| *[[Fibroepithelial polyp]].
| |
| *Vascular lesions.
| |
| **[[Kaposi sarcoma]].
| |
| **[[Angiosarcoma]].
| |
| **[[Arteriovenous malformation]] - has large arteries.
| |
| | |
| Image:
| |
| *[http://www.profimedia.si/picture/longitudinal-section-of-human-rectum-hemorrhoid-tissue/0039860546/ Hemorrhoids (profimedia.si)].
| |
| | |
| ===Sign out===
| |
| <pre>
| |
| ANAL LESION, REMOVAL:
| |
| - HEMORRHOID.
| |
| </pre>
| |
| | |
| <pre>
| |
| HEMORRHOIDS, EXCISION:
| |
| - HEMORRHOIDS.
| |
| </pre>
| |
| | |
| ====Micro====
| |
| The sections show rectal and anal mucosa, and a submucosa with prominent blood vessels in a fibrotic stroma. The rectal mucosa has focal reactive nuclear changes and evidence of prior erosions. The anal mucosa is unremarkable.
| |
| | |
| =====Anal mucosa only=====
| |
| The sections show anal mucosa, and submucosa with prominent blood vessels in a
| |
| fibrotic stroma. The anal mucosa is unremarkable.
| |
|
| |
|
| =Anal neoplasia= | | =Anal neoplasia= |