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Conventional hemorrhoidectomy provides permanent symptomatic relief for most patients, and effectively treats any external component of the hemorrhoids. However, the wounds created by the surgery are usually associated with considerable post-operative pain which necessitates a prolonged recovery period.
Excisional hemorrhoidectomy is a surgical excision of the hemorrhoid used primarily only in severe cases. [1] It is associated with significant postoperative pain and usually requires two to four weeks for recovery. [1] However, the long-term benefit is greater in those with grade III hemorrhoids as compared to rubber band ligation. [45]
Hemorrhoids are fed by arteries and drained by veins. The arterial blood supply is based on the superior rectal (hemorrhoidal) artery. Just as veins in the leg weaken and become prominent, hemorrhoidal veins also may become varicose, resulting in internal hemorrhoids or “piles”. Internal hemorrhoids are divided into four grades.
Hemorrhoidal artery embolization (HAE, or hemorrhoid artery embolization) is a non-surgical treatment of internal hemorrhoids. [ 1 ] The procedure involves blocking the abnormal blood flow to the rectal (hemorrhoidal) arteries using microcoils and/or microparticles to decrease the size of the hemorrhoids and improve hemorrhoid related symptoms ...
The rectal venous plexus consists of an external rectal plexus [4]: 598 [5]: 294 that is situated outside to the muscular wall, [3] [4]: 598 [5]: 294 and an internal rectal plexus [4]: 598 [5]: 294 that is situated in the submucosa [5]: 294 /deep to the mucosa [3] [4]: 598 of the rectum and proximal anal canal [3] at the anorectal junction.
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Diagram showing hypothesized correlation between clinical features and pathophysiology of ascites and hepatorenal syndrome. The kidney failure in hepatorenal syndrome is believed to arise from abnormalities in blood vessel tone in the kidneys. [ 2 ]
Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. [3] [4] Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5–9 mmHg; clinically significant portal hypertension is present at portal pressures greater than 10 mmHg. [5]