II. Pathophysiology

  1. Complication of External Hemorrhoid
  2. May follow sudden episode of increased anal pressure
    1. Coughing, sneezing, lifting or Defecation

III. Symptoms

  1. Severe Anorectal Pain
  2. Exascerbated by sitting, standing, or defecating

IV. Signs

  1. Tender and inflammed External Hemorrhoid
  2. Hemorrhoid is tense, firm with underlying bluish clot

V. Management

  1. General measures
    1. See Hemorrhoid Management
    2. Sitz baths
    3. Keep stool soft
    4. Topical Nifedipine 0.3% and Lidocaine 1.5% ointment
      1. Apply twice daily for 1-2 weeks for analgesia
    5. Topical Nitroglycerin 0.4% ointment (Glyceryl Trinitrate)
  2. Thrombosed Hemorrhoidectomy
    1. Indicated if thrombosed for <72 hours (not effective if longer duration)
    2. See Thrombosed Hemorrhoidectomy

VI. Course

  1. Resolves in days to weeks regardless of surgery
  2. Surgical excision within 72 hours shortens course

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Related Studies

Ontology: Thrombosed hemorrhoids (C0235326)

Concepts Acquired Abnormality (T020)
ICD9 455.7
ICD10 I84.7 , K64.5
SnomedCT 195462003, 75955007
English HAEMORRHOIDS THROMBOSED, HEMORRHOIDS THROMBOSED, Thrombosed haemorrhoids NOS, thrombosed hemorrhoids (diagnosis), thrombosed hemorrhoids, Thrombos hemorrhoids NOS, hemorrhoids thrombosed, hemorrhoid thrombosed, hemorrhoids thrombosis, hemorrhoid thrombosis, thrombosis hemorrhoid, Thrombosed hemorrhoids NOS, Thrombosed hemorrhoids NOS (disorder), Thrombosed haemorrhoids (NOS), Thrombosed hemorrhoids (NOS), Unspecified thrombosed haemorrhoids, Haemorrhoids thrombosed, Unspecified thrombosed hemorrhoids, Hemorrhoids thrombosed, Thrombosed haemorrhoids, Thrombosed hemorrhoids (disorder), Thrombosed hemorrhoids, hemorrhoids; thrombosed, thrombosed; hemorrhoids, Thrombosed hemorrhoids, NOS, Thrombosed hemorrhoids, unspecified whether internal or external
German HAEMORRHOIDEN THROMBOTISCH, Nicht naeher bezeichnete thrombosierte Haemorrhoiden, Haemorrhoiden mit Thrombose (NNB), Haemorrhoiden, Thrombose, unspezifische Haemorrhoiden mit Thrombose
Portuguese HEMORROIDAS TROMBOSADAS, Hemorróidas trombosadas, Hemorróidas trombosadas NE
French HEMORROIDES THROMBOSEES, Hémorroïdes thrombosées non précisées, Hémorroïdes thrombosées SAI, Hémorroïdes non précisées thrombosées, Hémorroïdes thrombosées
Spanish HEMORROIDES TROMBOSADAS, hemorroides trombosadas, SAI (trastorno), hemorroides trombosadas, SAI, Hemorroides trombosadas no especificadas, Hemorroides trombosadas (NEOM), Hemorroides trombosadas NEOM, Hemorroides trombosadas, hemorroides trombosadas (trastorno), hemorroides trombosadas
Korean 상세불명의 혈전성 치질
Czech Trombotizované hemoroidy (NOS), Blíže neurčené trombotizované hemoroidy, Trombotizované hemoroidy
Dutch getromboseerde hemorroïden (NAO), hemorroïden getromboseerd, niet-gespecificeerde getromboseerde hemorroïden, getromboseerd; hemorroïden, hemorroïden; getromboseerd, Niet gespecificeerde hemorroïden met trombose
Hungarian Haemorrhoidok thrombotizált, Thrombotizált aranyeres csomók (k.m.n.), Thrombotizált haemorrhoidok (k.m.n.), Nem meghatározott thrombotizált aranyeres csomók, Thrombotizált haemorrhoidok, Nem meghatározott thrombotizált haemorrhoidok
Italian Trombosi emorroidaria (NAS), Emorroidi trombizzate, Emorroidi non specificate trombizzate
Japanese ケッセンセイジカクNOS, 詳細不明の血栓性痔核, ショウサイフメイノケッセンセイジカク, 血栓性痔核(NOS), 血栓性痔核, ケッセンセイジカク