Waxy Hemmorrhoids - Forum

Arizona

Waxy Hemmorrhoids - Ärzteforum

Post#1 »

8 yo female with illeocolonic Crohn's disease.

Bowel disease in remission on Asacol.

Never had fistula in ano, etc, but Waxy hemorrhoids for years.

Now has increase in size of these there are at least 10, some as large as 3-5cm. There's mild anal stenosis on digital, but no functional impairment.

Needless to say, they are painful, difficult to keep clean and interfere with intercourse (vaginal, they cause pain, not obstruction -- this is America -- 18 is old to first be sexually active).

What approach would you take?


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Surgeon

Re: Waxy Hemmorrhoids - Ärzteforum

Post#2 »

These are characteristics skin tabs ("elephant ears") of Crohn's Disease. Conventional thinking is not to excise them as this could lead to non-healed wounds which could be a bigger problem than she now has. If the patient insists and understands these risks and still wants them excised, I would excise a single one and see if it healed satisfactorily before proceeding to the remainder. Of those that I have excised, most of the wounds, but certainly not all, healed, usually slowly.

Avicenna

Re: Waxy Hemmorrhoids - Ärzteforum

Post#3 »

I would agree only that I would be less worried. Remove a few and see what happens then come back for those remaining. Some CD patients walk around with these chronically inflammed waxy skin tags not bothering them a lot. But this seems to be more than usual. Don't be too extensive with the resections - just take it with diathery at its base.

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A Doctor

Re: Waxy Hemmorrhoids - Ärzteforum

Post#4 »

Since most of these skin tags are painless, I would look for other causes of pain especially an abscess or fissure.

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Resident

Re: Waxy Hemmorrhoids - Ärzteforum

Post#5 »

It seems this patient has external hemorroids not internal. Exicsion under MAC
without overdue tissue removal would suffice. This is assuming that there is
no evidence of perineal disease.

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