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Hemorrhoids

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Abstract

  • Hemorrhoids are normal components of anorectal anatomy.

  • Hemorrhoids are vascular cushions in the submucosal space of the anal canal.

  • Hemorrhoids are classically described as occurring in the left lateral, right anterior, and right posterior position. However, this finding was identified in less 20 % of cadavers.

  • They are composed of blood vessels, connective tissue, and smooth muscles.

  • The smooth muscle is known as Treitz’s muscle and originates from conjoined longitudinal muscle and internal sphincter.

  • Histologically, hemorrhoids lack a muscular wall and are therefore sinusoids (not veins or arteries).

  • Blood inflow to hemorrhoids is from the superior hemorrhoidal artery with some contribution from middle hemorrhoidal artery, and most distally from inferior hemorrhoidal artery. pH analysis of hemorrhoidal bleeding confirms that it is arterial blood.

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Authors and Affiliations

  1. Section of Colon and Rectal Surgery, Department of Surgery, NorthShore University Health System, 2650 Ridge Ave Ste 2507, Evanston, IL, 60201, USA

    Marc A. Singer MD

Authors
  1. Marc A. Singer MD
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Correspondence to Marc A. Singer MD .

Editor information

Editors and Affiliations

  1. Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA

    David E. Beck

  2. Department of Colorectal Surgery Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA

    Steven D. Wexner

  3. Department of Colorectal Surgery, The Cleveland Clinic Foundation Digestive Disease Institute, Cleveland, Ohio, USA

    Tracy L. Hull

  4. Department of Colon and Rectal Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA

    Patricia L. Roberts

  5. Division of Colon and Rectal Surgery, Loyola University Medical Center Professor of Surgery, Head, Maywood, Illinois, USA

    Theodore J. Saclarides

  6. Chairman, Surgical Disciplines, Central Michigan University School of Medicine, Mount Pleasant, Michigan, USA

    Anthony J. Senagore

  7. Department of Surgery John E. Connolly Chair, University of California, Irvine School of Medicine, Irvine, California, USA

    Michael J. Stamos

  8. University of Washington Department of Surgery, Madigan Army Medical Center Department of Colon & Rectal Surgery, Fort Lewis, Washington, USA

    Scott R. Steele

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© 2014 Springer Science+Business Media New York

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Singer, M.A. (2014). Hemorrhoids. In: Beck, D., et al. The ASCRS Manual of Colon and Rectal Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8450-9_11

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  • DOI: https://doi.org/10.1007/978-1-4614-8450-9_11

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8449-3

  • Online ISBN: 978-1-4614-8450-9

  • eBook Packages: MedicineMedicine (R0)

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