Bacteremia Following Proctoscopic Biopsy of a Rectal Polyp

Lal, Dheeraj

doi:10.1001/archinte.1972.03650010111022

Cited by 26 publications

(2 citation statements)

References 8 publications

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“…As Lal and Levitan have pointed out, hemorrhoidectomy may be followed by transitory bacteremia and low-grade fever as a result of the relatively constant release of bacteria into the bloodstream from a feeding focus. 23 LeFrock et al 24 also reported an 8.5% rate of bacteremia after the proctoscopic examination of patients with no evidence of lower-intestinal disease. Our patients all had thrombosis or gangrene of their prolapsed hemorrhoids, in which local inflammation is more severe than in common prolapsed hemorrhoids.…”

Section: Discussionmentioning

confidence: 96%

Stapled Hemorrhoidectomy versus Conventional Excision Hemorrhoidectomy for Acute Hemorrhoidal Crisis

Lai

Jao

et al. 2007

Journal of Gastrointestinal Surgery

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We compared the safety and clinical outcomes of stapled hemorrhoidectomy and conventional excision hemorrhoidectomy in the treatment of acute hemorrhoidal crisis, and analyzed various factors associated with complications in stapled hemorrhoidectomy. Forty patients underwent stapled hemorrhoidectomy and forty underwent conventional excision hemorrhoidectomy. All had the operation under local anesthesia with conscious sedation within 24 h of admission. The length of surgery, hospital stay, disability, postoperative pain, and the use of analgesics were significantly less for patients in the stapled hemorrhoidectomy group. Stapled hemorrhoidectomy did not significantly increase the rate of complications. Five patients in the stapled group (12.5%) required further surgical intervention: three with thrombosed hemorrhoids and two with recurrent prolapse. No serious complications were reported in either group. Patient satisfaction was similar in the two groups. Increased age was identified as a factor that significantly elevated the risk of complications in the stapled group (OR, 1.06; 95% CI, 1.01-1.13). Anemia and time between the onset of prolapsed hemorrhoids and hospital admission were also risk factors for complications, although they were not significant. Stapled hemorrhoidectomy is a feasible treatment for selected patients with an acute hemorrhoidal crisis and has a similar complication rate to that of conventional excision hemorrhoidectomy. Stapled hemorrhoidectomy is superior in less-postoperative pain, shorter operation time, shorter hospital stay, and earlier return to normal activity. However, we suggest that older patients with anemia or a prolonged hemorrhoidal crisis are unsuitable for stapled hemorrhoidectomy.

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Section: Discussionmentioning

confidence: 96%

Stapled Hemorrhoidectomy versus Conventional Excision Hemorrhoidectomy for Acute Hemorrhoidal Crisis

Lai

Jao

et al. 2007

Journal of Gastrointestinal Surgery

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“…However, transient low‐grade postoperative fever is observed occasionally in otherwise healthy patients undergoing elective haemorrhoidectomy, similar to that observed following oral, dental, urological and proctoscopic examinations. This is not surprising because haemorrhoidectomy exposes submucosal tissues and blood vessels in the anal area with its large resident bacterial population 12,13 . In one study, an incidence of 8.3% transient bacteremia was noted after haemorrhoidectomy 14 .…”

Section: Discussionmentioning

confidence: 99%