WordNet

purely outward or superficial; "external composure"; "an external concern for reputation"- A.R.Gurney,Jr.
outward features; "he enjoyed the solemn externals of religion"
coming from the outside; "extraneous light in the camera spoiled the photograph"; "relying upon an extraneous income"; "disdaining outside pressure groups" (同)extraneous, outside
from or between other countries; "external commerce"; "international trade"; "developing nations need outside help" (同)international, outside
happening or arising or located outside or beyond some limits or especially surface; "the external auditory canal"; "external pressures"
a nonresident doctor or medical student; connected with a hospital but not living there (同)medical extern
pain caused by venous swelling at or inside the anal sphincter (同)haemorrhoid, piles

PrepTutorEJDIC

『外側の』,外部の / (作用・動作などが)『外側からの』,外部からの / 表面上の,見せかけの / 体外の;体外用の / 外国の(foreign) / (…の)外観,外形《+『of』+『名』》
痔(じ)(piles)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/07 17:03:39」(JST)

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Perianal hematoma

Perianal hematoma, perianal thrombosis, anal vein thrombosis, or external hemorroidal thrombosis^[1] is a type of hematoma located in, or on the border of the anus.^[2] It is sometimes inappropriately referred to as an external hemorrhoid.^[1]

Signs and symptoms

A thrombosed external hemorrhoid

A perianal hematoma, identified by the typical blue tinge under the skin (to the left in the above image)

The symptoms of a perianal hematoma can present over a short period of time. Pain, varying from mild to severe,^[3] will occur as the skin surrounding the rupture expands due to pressure. This pain will usually last even after the blood has clotted, and may continue for two to four days.

Causes

Perianal hematoma are caused by the rupture of a small vein that drains blood from the anus.^[4] This rupture may be the result of forceful or strained bowel movement or caused by heavy lifting, coughing or straining. Once the rupture has formed, blood quickly pools within a few hours and, if left untreated, forms a clot.

Management

If diagnosed within the first few hours of presentation, the pooling blood may be evacuated using a syringe. Once the blood has clotted, removal by this method is no longer possible and the clot can be removed via an incision over the lump under local anesthetic. The incision is not stitched, but will heal very well. Care needs to be taken in regard to bleeding from the wound and possible infection with fecal bacteria. If left alone it will usually heal within a few days or weeks.^[5] The topical application of a cream containing a Heparinoid is often advised to clear the clot .^[6]

References

^ ^a ^b Stein, Ernst (2003). Anorectal and colon diseases : textbook and color atlas of proctology (1st English ed.). Berlin: Springer-Verlag. p. 80. ISBN 9783540430391.
^ Australian Doctor Patient information sheet - Author: Professor John Murtagh
^ Anatomy by Regions - Richard S. Snell (Google Books)
^ MerckSource - Site Improvements In Progress
^ Perianal hematoma - Medbroadcast
^ [1]

UpToDate Contents

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1. 痔核の治療 treatment of hemorrhoids
2. 痔疾患の外科的治療 surgical treatment of hemorrhoidal disease
3. 痔核：臨床症状および診断 hemorrhoids clinical manifestations and diagnosis
4. 肛門そう痒症患者へのアプローチ approach to the patient with anal pruritus
5. クローン病の肛門合併症 perianal complications of crohn disease

English Journal

Anal Health Care Basics.

Chang J1, Mclemore E2, Tejirian T3.
The Permanente journal.Perm J.2016 Oct 10;20(4). doi: 10.7812/TPP/15-222. [Epub ahead of print]
Despite the fact that countless patients suffer from anal problems, there tends to be a lack of understanding of anal health care. Unfortunately, this leads to incorrect diagnoses and treatments. When treating a patient with an anal complaint, the primary goals are to first diagnose the etiology of
PMID 27723447

Thrombosed external hemorrhoids in pregnancy: a retrospective review of outcomes.

Mirhaidari SJ1,2,3, Porter JA4,5, Slezak FA4,5.
International journal of colorectal disease.Int J Colorectal Dis.2016 Aug;31(8):1557-9. doi: 10.1007/s00384-016-2565-y. Epub 2016 Mar 31.
PMID 27029798

Anorectal emergencies.

Lohsiriwat V1.
World journal of gastroenterology.World J Gastroenterol.2016 Jul 14;22(26):5867-78. doi: 10.3748/wjg.v22.i26.5867.
Anorectal emergencies refer to anorectal disorders presenting with some alarming symptoms such as acute anal pain and bleeding which might require an immediate management. This article deals with the diagnosis and management of common anorectal emergencies such as acutely thrombosed external hemorrh
PMID 27468181

Japanese Journal

内外痔核に対するEA法の有用性

鉢呂芳一,安部達也,國本正雄,菱山豊平,海老澤良昭,阿部清秀
日本大腸肛門病学会雑誌 66(8), 601-604, 2013
目的：痔核治療において，同一痔核の外痔核部位を切除し内痔核部位にaluminum potassium sulfate and tannic acid（以下ALTA）療法を行うEA法について，治療成績を中心に報告する．対象：症例は2011年2月より2013年1月までに，EA法を1主痔核以上に施行した296例を対象とした．EA法以外の部位はALTA療法による単独治療を施行した．術前のGoligher分 …
NAID 130003369879

肛門専門病院における新患5,447人の分析―特に3大肛門疾患と裂肛症例の分析―

辻順行,家田浩男
日本大腸肛門病学会雑誌 66(7), 479-491, 2013
平成22年1月から6月までに肛門疾患で家田病院の外来を受診した新患5,447例とその中の裂肛1,355例を対象に分析し，以下の結果を得た．<BR>1）新患5,447例の疾患別頻度（％）は，内外痔核が62.8，裂肛が24.9，痔瘻が6.5の順で，3大疾患で94.2％を占めた（重複あり）．2）新患5,447例の性差を3大疾患に分けて調べると（％），内外痔核では男性が55.6，女性が44.4 …
NAID 130003369868

外痔核に対する外用薬により薬物性肝障害を惹起した1例

森澤嘉彦,田中篤,三浦亮 [他],深水雅子,後藤英晃,根來真一郎,三神昌樹,塙直子,相磯光彦,福里利夫,滝川一
肝臓 = ACTA HEPATOLOGICA JAPONICA 49(8), 362-367, 2008-08-25
症例は63歳男性．2006年2月に直腸癌と診断され同年3月に手術目的で当院外科に入院したが，肝機能異常を認めたため手術を延期し退院した．退院時には肝機能異常は改善していたものの，その後再度肝機能異常が増悪したため精査目的にて当科紹介入院となった．各種ウイルスマーカーや自己抗体は陰性であり，アルコール摂取や自然食品も含めた内服薬服用はなかった．しかし肝機能異常発現前の2006年2月から，外痔核に対し …
NAID 10021939356