Tactics of management of patients with single-node thrombosis of external hemorrhoids

Uninodular thrombosis of external hemorrhoidal nodes (UTHN) was identified in 81.4% of all forms of thrombosis. Objective. To develop treatment algorithms for patients with UTHN. Material and methods. An analysis of data from 362 outpatient patients with UTHN showed that 81.5% sought help from a proctologist more than 3 days after the onset of thrombosis. In 81.3% of cases, anal pain was absent or mild/moderate in nature. First-degree UTHN (UTHN-1) was found in 91.7% of patients, while second-degree UTHN (UTHN-2) was present in 8.3%. In 305 (84.3%) patients, UTHN was visualized on unchanged anoderm. Constipation was noted in 14.4% of patients. The characteristics of inflammation in patients with UTHN-2 included: 1 — necrosis size up to 5 mm; 2 — slight discharge of pus or blood. Results. Conservative treatment is the primary method for managing patients with UTHN. The use of a conservative treatment algorithm allowed for the recovery of 340 (93.9%) patients within a timeframe of 7 to 19 days. Twenty-two (6.1%) patients with UTHN-1 and UTHN-2 underwent surgery after inflammation subsided. In 45 (9.7%) patients, despite refusing surgery, recovery also occurred. Limitations on performing surgeries in outpatient settings include: 1 — the success rate of conservative treatment; 2 — lack of facilities for performing surgeries in outpatient clinics; 3 — frequent refusals by patients for surgery. The period of disability during the postoperative period averaged 12 ± 1 days. Conclusion. Treatment algorithms for patients with UTHN allow for a balanced use of conservative or surgical treatment methods.