Anal endosonography in haemorrhoidal disease: do anatomical changes have clinical implications?

Poen,; Felt-Bersma,; Cuesta, José A.; Meuwissen,

doi:10.1046/j.1463-1318.1999.00038.x

Cited by 11 publications

(4 citation statements)

References 26 publications

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“…Grades III and IV hemorrhoids revealed blood flow with different directions which could be observed as a “mosaic pattern” (Figures 3 and 4, Table 2). In patients with grade III or IV hemorrhoids, color Doppler ultrasound showed multidirectional, turbulent flow consistent with an arteriovenous flow pattern, which seemed similar to the mosaic pattern mentioned in other studies of arteriovenous malformation[16,17]. In patients with grade III and IV hemorrhoids, the number of patients with the “mosaic pattern” as revealed by TRUS, TPUS, and TVUS was 22, 12, and 4, respectively.…”

Section: Resultssupporting

confidence: 82%

Sonographic appearance of anal cushions of hemorrhoids

Aimaiti¹,

Re²,

Ibrahim³

et al. 2017

WJG

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AIMTo evaluate the diagnostic value of different sonographic methods in hemorrhoids.METHODSForty-two healthy volunteers and sixty-two patients with grades I-IV hemorrhoids received two different sonographic examinations from January 2013 to January 2016 at the First and Second Hospitals of Xinjiang Medical University in a prospective way. We analyzed the ultrasonographic findings of these participants and evaluated the outcomes. Resected grades III and IV hemorrhoid tissues were pathologically examined. The concordance of ultrasonographic results with pathology results was assessed with the Cohen’s kappa coefficient.RESULTSAll healthy volunteers and all patients had no particular complications related to sonography. There were no statistically significant differences between the participants regarding age (P = 0.5919), gender (P = 0.4183), and persistent symptoms (P > 0.8692). All healthy control participants had no special findings. However, 30 patients with hemorrhoids showed blood signals around the dentate line on ultrasonography. When grades I and II hemorrhoids were analyzed, there were no significant differences between transrectal ultrasound (TRUS), transperianal ultrasound (TPUS), and transvaginal ultrasound (TVUS) (P > 0.05). Grades III and IV hemorrhoids revealed blood flow with different directions which could be observed as a “mosaic pattern”. In patients with grades III and IV hemorrhoids, the number of patients with “mosaic pattern” as revealed by TRUS, TPUS and TVUS was 22, 12, and 4, respectively. Patients with grades III and IV disease presented with a pathologically abnormal cushion which usually appeared as a “mosaic pattern” in TPUS and an arteriovenous fistula in pathology. Subepithelial vessels of resected grades III and IV hemorrhoid tissues were manifested by obvious structural impairment and retrograde and ruptured changes of internal elastic lamina. Some parts of the Trietz’s muscle showed hypertrophy and distortion. Arteriovenous fistulas and venous dilatation were obvious in the anal cushion of hemorhoidal tissues. After pathological results with arteriovenous fistulas were taken as the standard reference, we evaluated the compatibility between the two methods according to the Cohen’s kappa co-efficiency calculation. The compatibility (Cohein kappa co-efficiency value) between “mosaic pattern” in the TPUS and arteriovenous fistula in pathology was very good (ĸ = 0.8939). When compared between different groups, TRUS presented the advantage that the mosaic pattern could be confirmed in more patients, especially for group A. There was a statistical difference when comparing group A with group B or C (P < 0.05 for both). There were obvious statistical differences between group A and group B with regard to the vessel diameter and blood flow velocity measured by TRUS (P < 0.05).CONCLUSIONPatients with grades III and IV hemorrhoids present with a pathologically abnormal cushion which usually appears as a “mosaic pattern” in sonography, which is in accord with an arteriovenous fistula in path...

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Section: Resultssupporting

confidence: 82%

Sonographic appearance of anal cushions of hemorrhoids

Aimaiti¹,

Re²,

Ibrahim³

et al. 2017

WJG

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“…Poen et al [15] already found, with two-dimensional endosonography, no difference in appearance of the anal configuration after treatment with either rubber band ligation or infrared coagulation. In our study no significant alterations or sphincter defects were found and these endosonographic findings confirmed that band ligation is a safe technique.…”

Section: Discussionmentioning

confidence: 93%

Elastic band ligation of hemorrhoids: Flexible gastroscope or rigid proctoscope?

Cazemier

Felt-Bersma²,

Cuesta³

et al. 2007

WJG

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“…Imaging studies should be considered when there is suspicion of an underlying diseases. The only study investigating the role of EUS in hemorrhoidal disease is from Poen et al [107] and concluded that hemorrhoids are associated with endosonographic thickening of submucosal tissue, internal and external anal sphincter, but EUS changes cannot predict treatment outcome or symptom recurrence. The conclusions of the abovementioned studies regarding imaging techniques in anorectal abscesses can be extended to complicated hemorrhoids workup, even if they were not aimed to analyze specifically the role of imaging in hemorrhoidal disease; however, the recommendations are weak.…”

Section: B -In Patients With Suspected Complicated Hemorrhoids Which Are the Appropriate Imaging Investigations?mentioning

confidence: 99%

Anorectal emergencies: WSES-AAST guidelines

et al. 2021

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Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management. While most of the underlying conditions do not need inpatient management, some of them could be life-threatening and need prompt recognition and treatment. It is well known that an incorrect diagnosis is frequent for anorectal diseases and that a delayed diagnosis is related to an impaired outcome. This paper aims to improve the knowledge and the awareness on this specific topic and to provide a useful tool for every physician dealing with anorectal emergencies.The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the boards of the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the WSES-AAST-WJES Consensus Conference on Anorectal Emergencies, and for each statement, a consensus among the WSES-AAST panel of experts was reached. We structured our work into seven main topics to cover the entire management of patients with anorectal emergencies and to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.

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Anal endosonography in haemorrhoidal disease: do anatomical changes have clinical implications?

Cited by 11 publications

References 26 publications

Sonographic appearance of anal cushions of hemorrhoids

Sonographic appearance of anal cushions of hemorrhoids

Elastic band ligation of hemorrhoids: Flexible gastroscope or rigid proctoscope?

Anorectal emergencies: WSES-AAST guidelines

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