Hemorrhoids: UNI-MED SCIENCE

1. Hemorrhoids 10 1.1. Definition 10 1.2. Anatomy 10 1.3. Physiology 11 2. Hemorrhoidal Diseases 14 2.1. Definition and Classification 14 2.2. Pathomorphology 16 2.3. Epidemiology of Hemorrhoids and Hemorrhoidal Disease 17 2.4. Etiopathogenesis of Hemorrhoidal Disease 21 2.4.1. Nutrition and Digestion 21 2.4.2. Sphincter Hypertonia 23 2.4.3. Portal Hypertension 25 2.4.4. Genetic Disposition 26 2.4.5. Angiogenesis 26 2.4.6. Paraplegia 26 2.5. Symptoms and Complications of Hemorrhoidal Disease 31 2.5.1. Hemorrhage 31 2.5.2. Discharge 32 2.5.3. Anal Eczema 33 2.5.4. Pruritus ani 38 2.5.5. Hemorrhoidal Prolapse 39 2.5.6. Anal Pain 40 2.6. Course and Grading of Hemorrhoidal Disease 44 2.7. Hemorrhoidal Disease in Pregnancy and the Puerperium 45 2.8. Influence on Quality of Life 46 2.9. Diagnostic Procedure and Differential Diagnosis of Hemorrhoidal Disease 47 2.10. History of Therapeutic Procedures 52 2.11. Conservative and Semi-operative Treatment of Hemorrhoidal Disease 65 2.11.1. Basic Therapy 65 2.11.2. Pharmacotherapy 65 2.11.3. Topical therapy of hemorrhoidal disease 68 2.11.4. Injection Therapy (Sclerotherapy) 75 2.11.5. Rubber Band Ligation 86 2.11.6. Cryotherapy 98 2.11.7. Infrared Coagulation (IRC, Photocoagulation) 103 2.11.8. Direct Current Electrotherapy 105 2.11.9. Bipolar Diathermy Coagulation (BICAP) 107 2.11.10. Maximal Sphincter Dilatation 108 2.11.11. Sphincterotomy 111 2.11.12. Hemorrhoid Artery Ligation (HAL/DG-HAL) 112 2.12. Operative Treatment of Hemorrhoidal Disease 114 2.12.1. A Preliminary Note on the Operative Therapy 114 2.12.2. Open Hemorrhoidectomy according to Milligan-Morgan 116 2.12.3. Closed Hemorrhoidectomy according to Ferguson 128 2.12.4. Closed Hemorrhoidectomy according to Fansler-Anderson 134 2.12.5. Submucosal Hemorrhoidectomy according to Parks 138 2.12.6. Stapled Hemorrhoidectomy / Hemorrhoidopexy according to Longo 144 2.12.7. Hemorrhoidectomy according to Whitehead 150 2.12.8. Hemorrhoidectomy by means of Laser 156 2.13. Famous People with Hemorrhoidal Disease 157 2.14. Saint Fiacre, Patron Saint of Hemorrhoidal Sufferers 159 3. Associated Diseases 164 3.1. Types of Anorectal Prolapse 164 3.1.1. Hemorrhoidal Prolapse 164 3.1.2. Anal Prolapse (Anodermal Prolapse) 164 3.1.3. Rectal Prolapse 165 3.2. Anal Thrombosis 167 3.3. Anal Skin Tags 170 3.4. Cryptitis 172 3.5. Hypertrophied Anal Papilla 173 3.6. Anal Fissure 174 3.7. Anogenital Syndrome 177 3.8. Proctalgia Fugax 178 3.9. Anorectal Incontinence 181 Index 182