Peri-anal Haematoma

A perianal haematoma is a blood clot in one of the most sensitive tissues of the body near or within the anus. As the condition presents suddenly it is often called an “Attack of Piles”.

Whilst straining or soon after this the patient experiences pain and a swelling appears.

Figure 1.

The swelling may remain quite small and soft and the pain may resolve within a few days. The body absorbs the blood and all that remains is a small skin tag usually of no significance.

figure 2.

If the swelling is larger or if the pain is severe with a tense blister, urgent medical intervention is called for (figure 2). The blood in the tender lump is evacuated by the doctor who uses a numbing local anaesthetic prior to the procedure, causing immediate relief.

figure 3.

Occasionally the blister bursts spontaneously. This relieves the pain and bleeding results. (figure 3)

figure 4.

Very large and painful haematomas require an excision under local and possibly general anaesthesia. (figure 4)

figure 5.

Figure 5 above shows the large blood clots removed from such a condition.

After Care:

The patient should bathe the area regularly in slightly salty water and if there is pain analgesics should be taken as prescribed by the doctor. Usually the pain disappears rapidly.

IMPORTANT

Follow Up:

This is necessary as by treating the emergency the cause of the problem has not necessarily been discovered.

Your doctor will advise you with regard to constipation and will ensure that your internal haemorrhoids are treated. Similar future attacks become less likely by this.

Important investigations may be necessary. The most important of these is a colonoscopy which rules out various bowel conditions such as cancer, polyps, colitis and diverticulitis. For further information please talk to your Doctor

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