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Post hemorrhoidectomy complications: CT imaging findings

Published:December 28, 2019DOI:https://doi.org/10.1016/j.clinimag.2019.12.015

      Highlights

      • Data on the radiologic findings of post hemorrhoidectomy complications is limited.
      • Complications include rectal submucosal edema, proctitis and rectal perforation.
      • Patients may even require urgent surgery and intensive care hospitalization.
      • Although uncommon, these complications carry a risk for significant consequences.

      Abstract

      Introduction

      We aimed to describe computed tomography (CT) findings of early complications after interventional hemorrhoid treatments in emergency department (ED) patients.

      Materials and methods

      We identified all ED patients requiring abdominal and/or pelvic CT between February 2012 and February 2019, and included only patients who underwent CT for suspected early (up to 30 days) post hemorrhoidectomy procedure complications. Presenting symptoms, salient CT findings and clinical outcomes were collected.

      Results

      Overall, 48,425 abdominal and/or pelvic CTs were performed. Of these, we identified 12 patients (8 male, 4 female) who underwent CT in our ED following hemorrhoidectomy procedures. At presentation, peri-anal or abdominal pain was the most common symptom. One patient presented with hemodynamic instability.
      CT findings included proctitis (4/12), rectal perforation (2/12), peri-anal abscess (1/12) and peri-anal fistula (1/12). Two of the patients with proctitis presented with significant submucosal edema.
      On follow-up, three patients required intensive care hospitalization, and two of those underwent emergent laparotomy. The third patient died due to secondary infection during his hospitalization.

      Conclusion

      Hemorrhoidectomy procedures may result in severe complications which should be recognized by ED radiologists. These complications carry a potential risk for significant clinical consequences. Both clinicians and radiologists should be aware of the possibility of such complications when patients present to the ED early after hemorrhoid procedures.

      Keywords

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