TY - CHAP M1 - Book, Section TI - Chapter 416. Other Anorectal Disorders A1 - Sondheimer, Judith M. A2 - Rudolph, Colin D. A2 - Rudolph, Abraham M. A2 - Lister, George E. A2 - First, Lewis R. A2 - Gershon, Anne A. PY - 2011 T2 - Rudolph's Pediatrics, 22e AB - Internal hemorrhoids are masses of vascular tissue covered by rectal mucosa. They arise from the superior hemorrhoidal plexus and lie above the pectinate line (eFigs. 416.1 and 416.2). External hemorrhoids arise from the inferior hemorrhoidal veins lying below the pectinate line and are covered by skin (eFig. 416.3). Hemorrhoids are rare in children and are usually external, associated with chronic constipation.1 When engorged by straining, they appear as pearly gray or purple masses at the anal verge that occasionally bleed a small amount. They may become firm and painful when thrombosed or infected, conditions more common in adolescence than infancy. Hemorrhoids may be a sign of childhood sexual abuse. Symptoms from hemorrhoids usually improve with treatment of underlying constipation. Incision and evacuation of thrombosed or infected hemorrhoids may be necessary, but stool softeners, warm sitz baths, and antibiotics are often sufficient therapy. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=7038283 ER -