Postoperative hematoma after thrombosed external hemorrhoid surgery?
Hello Dr.
Ke, I would like to ask you about postoperative symptoms.
I had an outpatient procedure for a thrombosed external hemorrhoid yesterday morning, where the clot was removed.
After the procedure, the area where the hemorrhoid was has swollen significantly, resembling a blood-filled sphere about two centimeters in size, and it appears purplish as if there is blood inside.
It has swollen enough to obstruct the anal opening.
This morning, it has slightly reduced in size, but it is still quite large.
Is this a normal postoperative condition? Additionally, I am concerned that even if the swelling goes down, will the stretched skin tissue return to its original state? I have searched online but haven't found any similar issues.
I'm feeling anxious, and I appreciate your help.
Thank you!
Chen Jing, 40~49 year old female. Ask Date: 2018/12/14
Dr. Ke Fangxu reply Surgery
After thrombectomy, there is a possibility of re-formation of a blood clot due to bleeding.
In such cases, another thrombus may need to be removed.
If a second thrombectomy is not desired, the only option is to apply ointment and take warm sitz baths, allowing it to gradually absorb and dissolve.
Swelling will definitely decrease, but the stretched skin will most likely not return to its original state and may develop into small skin tags, which is known as external hemorrhoids.
Reply Date: 2018/12/14
More Info
After undergoing surgery for a thrombosed hemorrhoid, it is common to have concerns about postoperative symptoms, particularly regarding hematoma formation and swelling. Let's break down your situation and address your concerns.
Firstly, the swelling you are experiencing at the surgical site is not unusual. After a procedure to remove a thrombosed hemorrhoid, it is typical for the area to become inflamed and swollen as part of the healing process. The presence of a hematoma, which is a localized collection of blood outside of blood vessels, can occur post-surgery, especially in areas with rich blood supply like the anal region. The fact that the swelling has slightly decreased since the surgery is a positive sign, indicating that your body is beginning to heal.
However, it is essential to monitor the swelling closely. If the hematoma continues to grow or if you experience increased pain, fever, or any signs of infection (such as redness or discharge), it would be advisable to contact your healthcare provider immediately. They may want to evaluate the area to ensure that there are no complications, such as an infection or a significant hematoma that may require drainage.
Regarding your concern about the stretched skin and whether it will return to its original state, this largely depends on the extent of the swelling and the healing process. In many cases, the skin and surrounding tissues can return to a relatively normal appearance as the swelling subsides and the body heals. However, some individuals may notice slight changes in skin texture or elasticity, especially if the swelling was significant. It is important to give your body time to heal, which can take several weeks.
To aid in your recovery, consider the following recommendations:
1. Rest and Recovery: Allow your body time to heal. Avoid strenuous activities and heavy lifting for a few weeks post-surgery.
2. Pain Management: If you are experiencing discomfort, over-the-counter pain relievers such as acetaminophen or ibuprofen can help manage pain and reduce inflammation. Always follow your doctor's recommendations regarding medication.
3. Cold Compresses: Applying a cold compress to the swollen area can help reduce swelling and provide relief. Be sure to wrap ice or a cold pack in a cloth to avoid direct contact with the skin.
4. Dietary Considerations: Maintaining a high-fiber diet and staying hydrated can help prevent constipation, which is crucial after hemorrhoid surgery. Straining during bowel movements can put additional pressure on the surgical site.
5. Follow-Up Care: Attend any scheduled follow-up appointments with your healthcare provider. They will monitor your healing progress and address any concerns you may have.
6. Avoiding Irritants: Keep the area clean and avoid any products that may irritate the skin, such as harsh soaps or perfumed products.
In conclusion, while the swelling and hematoma you are experiencing can be concerning, they are often part of the normal healing process after thrombosed hemorrhoid surgery. Monitor your symptoms, follow your doctor's advice, and give your body the time it needs to recover. If you have any further concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for guidance. Your health and peace of mind are paramount, and they can provide the support you need during your recovery.
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