Diagnosis
The diagnosis of perianal vein thrombosis is usually very easy to make. The examining doctor can usually determine what it is by simply inspecting the anal region. Due to the painfulness of the nodules, the examination of the rectal region with the finger (digital-rectal examination) is usually not necessary.
Important differential diagnoses that the physician must rule out include hemorrhoidal disease, abscess and malignant disease of the anal region (anal carcinoma). Since many patients are ashamed to let the doctor examine the painful anal region, they often resort to self-medication. This should be avoided if possible. It makes more sense to let the doctor make the diagnosis, since other, more dangerous causes can also be hidden behind the complaints.
History
Very large perianal vein thromboses can lead to bleeding due to the strong stretching of the skin, which can cause the thrombosis to empty itself. As a rule, however, the nodules recede of their own accord without complications. Nevertheless, almost half of the patients must expect a recurrence of perianal vein thrombosis.
Therapy
In most cases, perianal vein thrombosis resolves itself. This can last from a few days to several weeks. If the symptoms are more severe, the patient can be given painkillers such as ibuprofen or diclofenac.
Anti-inflammatory and analgesic ointments or suppositories can also have a soothing effect. Many patients are also helped by cooling the anal region. In the case of very pronounced findings and severe pain, spontaneous healing sometimes cannot be delayed.
In these cases, surgical removal of the perianal vein thrombosis can be performed. However, opening is usually only recommended if the perianal vein thrombosis does not persist for longer than three days, since spontaneous healing without opening is usually less complicated and faster.In addition, the older blood clots grow together with the vein wall and cannot be removed so easily. During the surgical procedure, a small skin incision about 5 mm long is made under local anesthesia at the level of the blood clot.
The coagulated blood can then be removed through this incision. Patients usually feel great relief immediately after the procedure. The small wound usually heals easily and quickly. In order to support the uncomplicated healing, warm sitz baths with chamomile are recommended after the procedure.
