What are the absolute contraindications to emergent excision of thrombosed external hemorrhoids?

Updated: Aug 17, 2018
  • Author: Brett Wallace Lorber, MD, MPH, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Absolute contraindications to thrombosed external hemorrhoid excision in the emergency department (ED) include the following:

  • Any concern that the lesion may be something other than a thrombosed external hemorrhoid, such as a painless rectal mass (thrombosed external hemorrhoids are always painful)
  • A grade IV internal hemorrhoid associated with a thrombosed external hemorrhoid
  • Known severe coagulopathy
  • Hemodynamic instability

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