Infarcted haemorrhoids are the result of infarction within the venous saccules of the anal cushions. They are sometimes termed 'strangulated' even though the cushions become engorged as opposed to devoid of blood.
The patient reports severe pain and discomfort at the site. There may be local swelling. The haemorrhoid appears black-blue and there may be local oedema.
The treatment of choice is bed rest, analgesia and stool softeners to limit straining. Reduction of the haemorrhoid has little effect on pain. Most infarcted haemorrhoids do not require surgical intervention but instead the symptoms resolve with time. If there is frank and widespread necrosis, local debridement may be undertaken to reduce discomfort.
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