Enfermedad Hemorroidal Hemorroides Internas - Clasificación

Presentación del tema: "Enfermedad Hemorroidal Hemorroides Internas - Clasificación"— Transcripción de la presentación:

1 Enfermedad Hemorroidal Hemorroides Internas - Clasificación
Grade I: No prolapsadas Grade II: Espontáneamente reducidas Grade III: Reducidas manualmente Grade IV: Irreductible

2 Enfermedad Hemorroidal Hemorroides Int. - Indicaciones para tratamiento
Fallas de las medidas conservadoras Dieta alta en fibra Abundantes líquidos Suplemento de fibra Ablandadores Continuación de los síntomas Sangrado Prolapso Prurito/irritación Dolor Incontinencia Difícil higiene First line therapy is conservative, non-surgical management. This includes a high fiber diet, increased oral fluid intake, fiber supplementation, stool lubricants and softeners, and sitz bathes. When this line of therapy fails and symptoms persist, further therapy may be indicated.

3 Enfermedad Hemorroidal Complicaciones.
Trombosis hemorroidal. Sangramiento hemorroidal. Estrangulamiento hemorroidal. Necrosis hemorroidal. Infección necrotizante. First line therapy is conservative, non-surgical management. This includes a high fiber diet, increased oral fluid intake, fiber supplementation, stool lubricants and softeners, and sitz bathes. When this line of therapy fails and symptoms persist, further therapy may be indicated.

4 Enfermedad Hemorroidal Diagnostico diferencial.
Carcinomas anales y rectales. Pólipos anales y rectales Prolapso rectal. Abscesos perianales. Papilitis hipertrofias. Endometriosis perianales. First line therapy is conservative, non-surgical management. This includes a high fiber diet, increased oral fluid intake, fiber supplementation, stool lubricants and softeners, and sitz bathes. When this line of therapy fails and symptoms persist, further therapy may be indicated.

5 Enfermedad Hemorroidal Hemorroides Internas - Manejo
Procedimientos Qx: Hemorroidectomía convencional o láser Anopexia con grapado circular (PPH) Consultorio Ligadura con banda elástica (RBL) Escleroterapia Fotocoagulación Grade 1-3 hemorrhoids may be managed with office based therapy, of which there are multiple options. Surgical therapy is usually reserved for grade 4 hemorrhoids or in patients who have failed office therapy. Sphincterotomy and anal stretch are mentioned for historical perspectives only and probably have no or an extremely limited role in hemorrhoidal therapy

6 Enfermedad Hemorroidal Hemorroides Internas.
Foto coagulación Escleroterapia Crioterapia

7 Enfermedad Hemorroidal Hemorroides Int. - Ligadura con banda (RBL)
RBL is useful for grade 1-3 internal hemorrhoids

8 Enfermedad Hemorroidal Hemorroides Internas - Ligadura con banda
The hemorrhoid to be banded is grasped through an anoscope and banded.