Clin Colon Rectal Surg 2007; 20(2): 077-085
DOI: 10.1055/s-2007-977485
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.


Amy Halverson1
  • 1Division of Surgical Oncology, Northwestern Medical Faculty Foundation, Chicago, Illinois
Further Information

Publication History

Publication Date:
09 May 2007 (online)


Hemorrhoids are normal vascular structures underlying the distal rectal mucosa and anoderm. Symptomatic hemorrhoidal tissues located above the dentate line are referred to as internal hemorrhoids and produce bleeding and prolapse. Thrombosis in external hemorrhoids results in painful swelling. Symptomatic internal hemorrhoids that fail bowel management programs may be amenable to in-office treatment with rubber band ligation or infrared coagulation. Internal hemorrhoids that fail to respond to these measures or complex internal and external hemorrhoidal disease may require a surgical hemorrhoidectomy, either open or closed. A stapled hemorrhoidopexy treats symptomatic internal hemorrhoids and should be employed with care and only after thorough training of the surgeon because of the risk of rare, severe complications. The choice of procedure should be based on the patient's symptoms, the extent of the hemorrhoidal disease, and the experience of the surgeon.


Amy HalversonM.D. 

Division of Surgical Oncology, Northwestern Medical Faculty Foundation

201 E. Huron St., Galter 10-105, Chicago, IL 60611