HAEMORRHOIDS

DR. GERARD G PHILIPS, SpB

DEFINISI

• Pembengkakan dan pelebaran vena yang bisa terjadi di atas linea

dentata maupun di bawah linea dentata
ETIOLOGY
BAB Mengedan dan Konstipasi
Keganasan
Kehamilan

Obesitas Anal Intercourse

Terlalu lama duduk
Merokok
Hipertensi Portal dan Varises pada Anorectal

Diare kronis Kurangnya Konsumsi Serat

Keturunan
ETHIOPATOGENESIS
BAB MENGEDAN DAN KONSTIPASI
Low Fibre Diet

Less bulky stools

Straining at defecation

Increase Intra anal

Pressure

Decrease Venous Return

Enlarge Haemorrhoidal venous

cushions
ANATOMY
CLASIFICATION
I. Internal Haemorrhoids
II. External Haemorrhoids
III. Mixed Haemorrhoids
CLASIFICATION OF INTERNAL
HAEMORRHOIDS
• GRADE I : Painless bleeding, no prolapse

• GRADE II : prolapse on defecation that reduces spontaneously

• GRADE III : Prolaps that has to be reduced mannually

• Grade IV : Permanent Prolapse

Symptoms of Internal Haemorrhoids

• Painless Bleeding

• Prolapse

• Perianal pruritus and irritation

• Discomfort

• Acute pain when incarcerated/strangulated

Symptoms of External Hemorrhoids

• Hemoroid external yang mengalami trombosis akan menyebabkan

rasa nyeri yang akut pada rectum

• Terdapat skin tag

Theraphy
NON SURGICAL
• Rbber band ligation
• Sclerotheraphy
• Coagulation
• Elektrocautery
• Cryotheraphy
• Laser theraphy

SURGERY
• HAEMORRHOIDECTOMY : - Open : Milligan Morgan Operation
- Closed : Stapled Haemorrhoidopexy
Komplikasi Haemorrhoidectomy
• Early:
- Nyeri
- Retensi urine akut
- Perdarahan

• Late:
- Perdarahan
- Anal fissure
- Anal stricture
- incontinensia
TERIMA KASIH