RT Book, Section
A1 Marwan, Ahmed I.
A1 Chen, Mike K.
A2 Kline, Mark W.
SR Print(0)
ID 1182908777
T1 Other Anorectal Disorders
T2 Rudolph's Pediatrics, 23e
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259588594
LK accesspediatrics.mhmedical.com/content.aspx?aid=1182908777
RD 2024/04/20
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.