TY - CHAP M1 - Book, Section TI - Other Anorectal Disorders A1 - Marwan, Ahmed I. A1 - Chen, Mike K. A2 - Kline, Mark W. Y1 - 2018 N1 - T2 - Rudolph's Pediatrics, 23e AB - Hemorrhoids are rare in children and are divided into internal and external hemorrhoids. Internal hemorrhoids are masses of vascular tissue covered by rectal mucosa. They arise from the superior hemorrhoidal plexus and lie above the pectinate line (Figs. 411-1 and 411-2). External hemorrhoids are covered by skin and lie below the pectinate line. They arise from the inferior hemorrhoidal veins (Fig. 411-3). Most hemorrhoids in children are associated with chronic constipation and are of the external type. They appear as pearly gray or purple masses at the anal verge that may occasionally bleed. They may become firm and painful when thrombosed or infected. Incision and evacuation of thrombosed or infected hemorrhoids may be necessary, but stool softeners, warm sitz baths, and antibiotics are often sufficient therapy. Symptoms from hemorrhoids usually improve with treatment of underlying constipation. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/11 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1182908777 ER -