Akut tromboze hemoroidal hastalığın gelişiminde pıhtılaşma mekanizmasının rolü

Yıl 2023, Cilt: 16 Sayı: 2, 216 - 221, 05.04.2023

Selman Alkan Murat Çakır Alper Varman Mustafa Sentürk Omer Kisi Ahmet Topal

https://doi.org/10.31362/patd.1181190

Öz

Amaç: Hemoroidal hastalık sık görülen benign anorektal bölge hastalığıdır. Hemoroidal hastalığın seyri sırasında oluşan akut tromboz ağrılı bir komplikasyondur. Etyopatogenezinde etkili etmenler tam bilinmiyor. Çalışmamızdaki amacımız hastalığın gelişiminde pıhtılaşmaya yatkınlığı değerlendirmektir.
Gereç ve yöntem: Akut tromboze hemoroidal hastalığı olan 30 hasta ile hemoroidal hastalığı olan ancak tromboz gelişmeyen 30 hasta çalışmaya dahil edildi. Bu hastalardan alınan numuneler tromboelastografi cihazında incelendi. Demografik verileri ile kıyaslandı.
Bulgular: Akut tromboze hemoroidal hastalığı olan hastalarda alfa açısının daha küçük olduğunu tespit ettik.
Sonuç: Akut tromboze hemoroidal hastalığı olan hastalarda hiperkoagülabilite durumu oluşmamaktadır. Ancak kanamaya yatkınlık gelişmektedir.

Anahtar Kelimeler

Hiperkoagülabilite, tromboze hemoroid, tromboelastografi, Hypercoagulability, thrombosed hemorrhoid, thromboelastography

The role of coagulation mechanism in the development of acute thrombosed hemorrhoidal disease

Öz

Purpose: Hemorrhoidal disease is a common benign anorectal disease. Acute thrombosis that occurs during the course of hemorrhoidal disease is a painful complication. Factors affecting its etiopathogenesis are not known definitively. The aim of this study, therefore, was to assess predisposition to coagulation during the development of the disease.
Material and methods: 30 patients with acute thrombosed hemorrhoidal disease and 30 other patients with hemorrhoidal disease but no thromboses were included in the study. Samples collected from
these patients were analyzed with thromboelastography machines. The results were compared with patients’ demographic data.
Results: No statistically significant difference was found between the groups as per age, sex, diarrhea, history of a similar attack, history of surgical treatment, spicy food consumption, fibrous food consumption, and regular exercise. The results of our study revealed that the alpha angle was smaller in patients with acute
thrombosed hemorrhoidal disease.
Conclusion Hypercoagulability does not occur in patients with acute thrombosed hemorrhoidal disease.

Anahtar Kelimeler

Hypercoagulability, thrombosed hemorrhoid, thromboelastography

Kaynakça

• 1. Riss S, Weiser FA, Schwameis K, Riss T, Mittlböck M, Steiner G, Stift A. The prevalence of hemorrhoids in adults. Int J ColorectalDis. 2012 Feb;27(2):215-20. Epub 2011 Sep 20.
• 2. Selvaggi L, Sciaudone G, Canonico S, Selvaggi F, Pellino G. The Management of Acute Hemorrhoidal Disease. Rev Recent Clin Trials. 2020 Mar 30. doi: 10.2174/1574887115666200330162537. [Epubahead of print]
• 3. Ibrahim AM, Hackford AW, Lee YM, Cave DR. Hemorrhoids can be a source of obscure gastrointestinal bleeding that requires transfusion: report of fivepatients. DisColonRectum. 2008 Aug. 51(8):1292-4. [Medline].
• 4. Grucela A, Salinas H, Khaitov S, Steinhagen RM, Gorfine SR, Chessin DB. Prospective analysis of clinician accuracy in the diagnosis of benign anal pathology: comparison across specialties and years of experience. Dis Colon Rectum. 2010 Jan. 53(1):47-52. [Medline].
• 5. Rivadeneira DE, Steele SR, Ternent C, et al. Practice parameters for the management of hemorrhoids (revised 2010). DisColonRectum. 2011 Sep. 54(9):1059-64.
• 6. El Nakeeb AM, Fikry AA, Omar WH, et al. Rubber band ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases. World J Gastroenterol. 2008 Nov 14. 14(42):6525-30
• 7. Geçim E. Hemorrhoidal Disease. Turk J ColorectalDis 2011; 21: 145-159
• 8. Ng L, Monagle K, Monagle P, Newall F, Ignjatovic V (2015) Topicaluse of antithrombotics: review of literature. ThrombRes 135:575–581
• 9. Mentefl BB, Görgül A, Tatlicio¤lu E, Ayo¤lu F, Unal S. Efficacy of calciumdobesilate in treating acute attacks of hemorrhoidal disease. DisColonRectum 2001;44:1489-95.