May 23rd, 2009 Perianal Hematoma
What is perianal hematoma?
Perianal hematoma is a small lump of blood, usually the size and the color of a blueberry, that develops on the border of the anus. It arises due to rupture of a small vein adjacent to the edge of the anus, usually triggered by such activities as heavy lifting, coughing, and straining at the toilet. It should not be confused with external hemorrhoid, which is an internal pile that is protruding through the anus.
Perianal hematoma is quite common in all age groups from teenagers onward but prevalence is higher in people who like to lift weights at the gym or whose job requires them to lift (movers, etc.) or to sit for long periods (truck drivers, etc.), those who are chronically constipated and pregnant women.
Signs and symptoms of perianal hematoma
Common symptoms include:
- Severe pain that can last for up to four days, after which it gradually subsides. The pain is constant without short jabs and worsens on sitting, walking and upon opening the bowels. Due to the sensitivity of the area affected, the pain seems out of proportion to such a small lump.
- Feeling of a lump at the anus.
- Flecks of blood from the anus, which you may notice on toilet paper, coating the stool or in the toilet after you have opened your bowels
Treatment of perianal hematoma
Generally, a small-sized perianal hematoma can be left alone to resolve in a few days. You only need to take oral analgesics such as paracetamol and aspirin for the pain. Topical soothing conditions such as Anusol, Anacal and Anugesic may give you some relief but are generally not effective to shrink the lump.
If the lump is larger or the pain becomes intolerable, urgent medical intervention may be called for. Through a small surgical procedure under local anesthesia, the doctor cuts of the hematoma with a pair of scissors, causing immediate relief.