Perianal vein thrombosis

Synonyms: Perianal thrombosis, Anal thrombosis

introduction

In the Perianal vein thrombosis it comes to the formation of a Blood clot (thrombus) in the superficial Veins at the edge of the anus, which is in the form of a bluish knot makes noticeable. The causes for the development of the thrombosis can be varied, but those affected complain equally strong pain. General is the perianal vein thrombosis harmlessalbeit painful. A connection to the much more dangerous deep vein thrombosis or to Varicose veins does not exist. Often times the perianal vein thrombosis is associated with a Hemorrhoids confused, which is why the term "fake hemorrhoids“Is common.

causes

In most cases, the cause of perianal vein thrombosis is a strong increase in pressure in the abdomen, for example when pressing hard during bowel movements or during childbirth. Many women develop perianal vein thrombosis after childbirth.

Violent coughing or excessive physical activity, but also a genetic predisposition, can promote the development of a perianal vein thrombosis.

The consumption of coffee and alcohol as well as the consumption of spicy dishes should also be beneficial. Mostly sedentary activities can promote perianal vein thrombosis, especially sitting on cold surfaces.Last but not least, a connection with menstruation is seen in women with perianal vein thrombosis.

If diarrhea was previously performed or proctological interventions or anal sexual practices were performed, the cause of the anal vein thrombosis can also lie in these factors. In addition, perianal vein thrombosis is more common in people who have large hemorrhoidal cushions.

Read more on the topic Thrombosis causes

These causes can also lead to a pelvic vein thrombosis. This is problematic because of its symptom-free course, which is why it can be discovered too late. Also read the following article in this context: Pelvic vein thrombosis

Symptoms

In perianal vein thrombosis, one or more develop bluish, elastic knots on the edge of the anus, which are usually very painful when touched or pressed. The anal region may be swollen around the nodes. The size of the Blood clots varies between cherry pit and (more rarely) plum size.

Depending on the severity of the findings, sitting or walking is also painful for those affected. The complaints usually occur very suddenly on. In some patients comes a burning, stabbing, or itchy feeling added. Especially the one bowel movement is often associated with severe pain for those affected.

diagnosis

The diagnosis the perianal vein thrombosis is usually very easy to diagnose. The examining doctor can usually by mere inspection the anal region can already determine what it is. Due to the painfulness of the nodules, the rectal region is usually not examined with the finger (digital rectal examination).

For example, important differential diagnoses that the doctor must rule out are a Hemorrhoid disease, a abscess and a malignant disease of the anal region (Anal cancer).

Since many patients are ashamed to let the doctor examine the painful anal region, they often resort to self-medication. This should be avoided if possible. It makes more sense to let the doctor make the diagnosis, as others, more dangerous causes can hide behind the complaints.

course

Very large perianal vein thromboses can be caused by the excessive stretching of the skin Bleeding lead, whereby the thrombosis can then also empty itself. Usually, however, the knots form of its own accord without complications. Still, almost half of the patients have to have one recurrence the perianal venous thrombosis.

therapy

In most cases, the perianal vein thrombosis forms by itself back again. This can between a few days to several weeks last. If the symptoms are more severe, the patient can Painkiller administered, for example ibuprofen or diclofenac. Also anti-inflammatory and pain relievers Anoint or Suppositories can have a soothing effect. This also helps many patients cooling the anal region.

In the case of very pronounced findings and severe pain, spontaneous healing can sometimes not be waited for. In these cases, a csurgical removal the perianal vein thrombosis. The opening is usually only recommended if the perianal vein thrombosis does not last longer than three days, since spontaneous healing without opening usually occurs more easily and quickly. In addition, the older blood clots grow together with the vein wall and can then no longer be removed so easily.

The surgical procedure is under local anesthesia a small incision about 5mm long made at the level of the blood clot. The incision can then remove the clotted blood. After the procedure, patients usually feel great relief immediately. The small wound usually heals quickly and easily. To support the uncomplicated healing, warm Sitz baths with chamomile recommended following the procedure.

Complications

In principle, it is conceivable that the surgically opened region ignite can. As a rule, however, the wound heals without any consequences. In the case of recurrent anal vein thrombosis, however, it can be that by opening the node Skin tags stay behind. these are functionless skin flapswhich in principle are not a problem, but depending on their severity (also cosmetically) can be very disturbing for the person concerned.

prophylaxis

To Avoidance of perianal vein thrombosis some things can be observed. It is particularly important not to press too hard when defecating and to avoid sitting on the toilet for long periods of time. The chair shouldn't be too firm if possible, so one is recommended high fiber diet with sufficient Hydration. In the case of predominantly sedentary work, as compensation sufficient exercise be respected. In addition, the Consumption of high proof alcohol, as well as consumption strongly seasoned dishes should be avoided if possible. In patients with known Hemorrhoid disease The treatment of hemorrhoids should also be considered if perianal vein thrombosis is to be avoided in the future.