title: Emergency transanal haemorrhoidal Doppler guided dearterialization for acute and persistent haemorrhoidal bleeding.
abstract: OBJECTIVE
  The effectiveness of Doppler guided transanal haemorrhoidal dearterialization (THD) for arresting persistent haemorrhoidal bleeding in patients admitted as an emergency was studied.
  
  
  METHODS
  Eleven patients with severe anal bleeding underwent emergency THD as definitive treatment for haemorrhoids. In the majority of patients antiplatelet or anticoagulant therapy was ongoing and severe anaemia was present in six patients.
  
  
  RESULTS
  The mean operative time was 39.7 min. Six to nine feeding arteries were ligated. Intra-operative blood loss was nil. Bleeding was well controlled in all patients. No blood transfusion was required. Mean pain score per verbal numeric scale was 3.6 and 1.4 on day 1 and day 3 respectively. The mean time to resumption of normal activities was 8 days. No major complications were experienced. Six months follow-up demonstrated good control of haemorrhoidal disease.
  
  
  CONCLUSIONS
  THD is effective in controlling acute haemorrhoidal bleeding with a low incidence of postoperative complications.
authors.affiliation: Department of Surgery, University of Perugia, Perugia, Italy. emanuelcavazzoni@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Cavazzoni
authors.forename: W
authors.initials: W
authors.lastname: Bugiantella
authors.forename: L
authors.initials: L
authors.lastname: Graziosi
authors.forename: M
authors.initials: M
authors.lastname: Silvia Franceschini
authors.forename: F
authors.initials: F
authors.lastname: Cantarella
authors.forename: E
authors.initials: E
authors.lastname: Rosati
authors.forename: A
authors.initials: A
authors.lastname: Donini
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D000925:Anticoagulants / Q000008:administration & dosage; D001158:Arteries / Q000000981:diagnostic imaging / Q000601:surgery; D003107:Colorectal Surgery / Q000379:methods*; D004638:Emergency Treatment; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000601:surgery*; D006484:Hemorrhoids / Q000000981:diagnostic imaging / Q000601:surgery*; D006489:Hemostatic Techniques; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D012007:Rectum / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors