Thrombosed Haemorrhoid (Anal Haematoma)
A 74-year-old male had a few days' history of a painful lump in the anus. A thrombosed haemorrhoid or anal haematoma has bluish colouration. The pain subsides spontaneously in about one week and the haemorrhoid starts to decrease in size. Pain can be alleviated and healing accelerated by incision and evacuation of the thrombus. The skin is first anaesthetized superficially using a thin needle. A sufficiently deep incision is made by scalpel tangentially (and not radially) to the anus. Entrapped dark blood and thrombus burst out immediately. Because the haemorrhoid often contains multiple separate closts, squeezing between fingers facilitates evacuation of them all. Insert one finger in the anus to accomplish this.
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