Pathophysiologie des Hämorrhoidalleidens

Abstract

It is not easy to define haemorrhoidal complaints precisely since this automatically means the entire aetiology and pathogenesis. What Stelzner describes as a complex compound of arteriovenous links in the rectal mucosa with an interlace of unstriated muscles, elastic fibres and connective tissue forms the anatomic base of the "corpus cavernosum recti". This cavernous vascular padding is a crucial component of the continence organ and ensures a gas-tight seal. According to Thomson's studies, haemorrhoids are to be regarded as a consequence of the disintegration of muscular and elastic components, caused by a distal shift of the vascular padding. The changes can cause growth up to prolapse, as well as haemorrhage or congestion. The reasons have not yet been conclusively clarified. Malfunctioning intestines--in particular constipational changes with hard stool--seem to be causal factors. The mechanisms of function and control of arteriovenous links as well as the influence of hereditary, social and cultural disposition continue to be unclear.

Grade II-III Hemorrhoidal Disease Treatment: Rubber Band Ligation versus Hemorrhoidal Artery Ligation

“…1 Also taking into account their roles in continence, minimal tissue damage should be targeted during surgery. 3 Despite Milligan-Morgan hemorrhoidectomy and modified versions accepted as the gold standard treatment of hemorrhoidal disease; surgeons intend to prefer minimally invasive outpatient techniques because of hemorrhoidectomy complications such as postoperative pain and sphincter damage.…”

“…1 Hemoroidectomy which includes hemorrhoidal cushions' removal from anal canal, is the choice of treatment, though its high complication rates; such as fecal incontinence, anal stricture and high postoperative pain. 2 Hemorrhoidal cushions are the part of normal anatomy and physiology of anal canal and also have an important role in anal continence, 3 so keeping in mind this hemoroidectomy shouldn't be gold standard for hemorrhoidal disease treatment.…”

Significance of obstructed defecation in hemorrhoidal disease: Results of a prospective study

“…Nicht selten sind Hämorrhoiden mit Symptomen einer chronischen Obstipation -speziell mit einer Entleerungsstörung (Defäkationsob-struktion) -assoziiert und die Patienten leiden unter hartem Stuhlgang, Stuhlschmieren und einem Gefühl der unvollständigen Entleerung, wobei lang dauerndes heftiges Pressen nicht untypisch ist [11]. In der operativen Behandlung des Hämorrhoidalleidens (Hämor-rhoiden III.…”

Transanal Suture Rectopexy for Haemorrhoids: Chivate’s Painless Cure for Piles

“…These portal veins are trapped and blocked in the seromuscular wall during strong contraction of the rectum during defaecation. At the same time, arterial blood supply is continued, which keeps on engorging haemorrhoidal plexus and piles mass progressively [6]. Rectal bleeding is the main symptom of internal haemorrhoids.…”