Perianal hematoma is a

hematoma A hematoma, also spelled haematoma, or blood suffusion is a localized bleeding outside of blood vessels, due to either disease or trauma including injury or surgery and may involve blood continuing to seep from broken capillary, capillaries. A he ...

located in, or on the border of the

anus The anus (Latin, 'ring' or 'circle') is an opening at the opposite end of an animal's digestive tract from the mouth. Its function is to control the expulsion of feces, the residual semi-solid waste that remains after food digestion, which, d ...

.''Australian Doctor'' Patient information sheet – Author: Professor John Murtagh It is sometimes inappropriately referred to as an external

hemorrhoid Hemorrhoids (or haemorrhoids), also known as piles, are vascular structures in the anal canal. In their normal state, they are cushions that help with stool control. They become a disease when swollen or inflamed; the unqualified term ''hemo ...

Signs and symptoms

The symptoms of a perianal hematoma can present over a short period of time. Pain, varying from mild to severe, will occur as the skin surrounding the rupture expands due to pressure. This pain will usually last even after the blood has clotted, and may continue for two to four days.

Causes

Perianal hematoma are caused by the rupture of a small

vein Veins are blood vessels in humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are the pulmonary and umbilical veins, both of which carry oxygenated b ...

that drains

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...

from the anus. This rupture may be the result of forceful or strained bowel movement,

anal sex Anal sex or anal intercourse is generally the insertion and thrusting of the erect penis into a person's anus, or anus and rectum, for sexual pleasure.Sepages 270–271for anal sex information, anpage 118for information about the clitoris. ...

or caused by heavy lifting,

cough A cough is a sudden expulsion of air through the large breathing passages that can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three pha ...

ing or straining. Once the rupture has formed, blood quickly pools within a few hours and, if left untreated, forms a

clot A thrombus (plural thrombi), colloquially called a blood clot, is the final product of the blood coagulation step in hemostasis. There are two components to a thrombus: aggregated platelets and red blood cells that form a plug, and a mesh of c ...

Diagnosis

Management

Management of thrombosed perianal hematoma has been poorly studied as of 2018. If diagnosed within the first few hours of presentation, the pooling blood may be evacuated using a

syringe A syringe is a simple reciprocating pump consisting of a plunger (though in modern syringes, it is actually a piston) that fits tightly within a cylindrical tube called a barrel. The plunger can be linearly pulled and pushed along the inside ...

. Once the blood has clotted, removal by this method is no longer possible and the clot can be removed via an incision over the lump under local anesthetic. The incision is not stitched but will heal. Care needs to be taken in regard to bleeding from the wound and possible infection with fecal bacteria. If left alone it will usually heal within a few days or weeks. The topical application of a cream containing a

heparinoid Heparinoids are glycosaminoglycans which are chemically and pharmacologically related to heparin. They include oligosaccharides and sulfated polysaccharides of plant, animal, or synthetic origin. Multiple scientific studies have been conducted o ...

is often advised to clear the clot.

References

{{reflist Gross pathology Gastrointestinal tract disorders