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Hemorrhoids pp 461-470 | Cite as

Postoperative Complications Following Surgical Procedures for Hemorrhoids and Their Management

  • Steen Buntzen
Reference work entry
Part of the Coloproctology book series (COLOPROCT, volume 2)

Abstract

Minor complications following surgical procedures for hemorrhoidal disease are quite common and include pain, rectal bleeding, vasovagal reaction, micturition disturbances, anal fissures, and ulcers in the anal canal. Analgesics of the NSAID group and others are used to treat mild pain. Observation and/or surgical hemostasis are relevant in case of minor rectal bleeding. Micturition disturbances should be monitored with bladder scans and catheterization if necessary.

Massive rectal bleeding, severe pain, urinary retention, pelvic sepsis, and even death are considered as major complications. They are uncommon with an estimate between 1% and 2.5%.

Severe rectal bleeding is usually treated with surgical hemostasis and blood transfusions. The septic complication is the most feared complication with a significant risk of major morbidity and even of death. It may be in progress if a patient presents with unexpected severe perianal/abdominal pain in combination with urinary retention and fever. Objective findings may be sparse, and it is not uncommon that the patient has attended the hospital more than once before the condition is recognized. Cases presenting early with tissue edema and sepsis in the absence of necrosis may be treated only with antibiotics and supportive care. In the presence of necrosis, debridement should be undertaken urgently with or without laparotomy and fecal diversion in addition to antibiotics and supportive care.

Early recognition and immediate treatment of septic complications are crucial for a successful outcome.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Gastrointestinal Surgery, University Hospital of North Norway and The National Advisory Board of Incontinence and Pelvic Floor Health of NorwayThe Arctic University of NorwayTromsøNorway

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