CLINICAL-MORPHOLOGICAL CLASSIFICATION OF ACUTE THROMBOSIS OF THE EXTERNAL HEMORRHOID NODE IN RELATION TO A DIFFERENTIATED APPROACH IN ITS TREATMENT

Abstract

Acute thrombosis of the external hemorrhoid node is one of the common manifestations of hemorrhoids and a frequent reason for seeking specialized medical care. Despite existing prospective studies proving the effectiveness of operative treatment, there is no clear position in determining the indications, timing and methods of surgery, nor the combination of the latter with conservative therapy.The article formulated and described the original clinical-morphological classification of acute thrombosis of the external hemorrhoid node based on the data of its ultrasound examination (ultrasound). Effectiveness of various methods of treating acute thrombobosis of external hemorrhoid node, carried out on the basis of proposed classification, is evaluated.Purpose of the study. Improving treatment outcomes for patients with acute thrombosis of the external hemorrhoid node.Results. Ultrasound types of thrombosis of external hemorrhoidal node are revealed:– mononuclear (in ultrasound, it is a single thrombus or a dense, intimately soldered group of thrombotic masses of an an- or isoechogenic structure with untested swelling of the skin and subcutaneous fat (PWD), from 10 mm or more in size);– polynuclear (clusters of thrombotic masses of an- or isoechogenic structure up to 10 mm in size, located at a short distance from each other, with moderate swelling of the skin and subcutaneous fat);– edema (during sonography, multiple small, up to 2–3 mm, anechogenic thrombotic masses are visualized against the background of pronounced edema of subcutaneous fat fiber and skin).Effectiveness of various methods of treating patients with acute thrombosis of external hemorrhoid node in groups formed on the basis of proposed classification is evaluated. It has been found that in patients with edematous sonographic type of thrombosis, it is more advisable to apply only conservative therapy or carry out surgical treatment after completion of taking diosmin-containing preparations. Such tactics reduced the duration of treatment and reduced pain syndrome. In patients with a mononuclear type of thrombosis of the external hemorrhoidal node, a similar result was noted during surgery and the beginning of conservative therapy on the day of circulation.Conclusion. Application of ultrasound diagnostics allows establishing the type of hemorrhoid node thrombosis and using the obtained data when choosing treatment tactics. A differentiated approach to treating this category of patients, based on the proposed classification, allows improving the treatment results of patients with acute thrombosis of the external hemorrhoid node.