Fatal clostridial infection following hemorrhoidal banding

OʼHara, Vincent S.

doi:10.1007/bf02988999

Cited by 91 publications

(35 citation statements)

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“…While band ligation is marked by a large number of complications of an inflammatory character (26,27), no such incidence has been reported with IRC (28).…”

Section: Discussionmentioning

confidence: 99%

Infrared coagulation versus rubber band ligation in early stage hemorrhoids

Gupta

2003

Braz J Med Biol Res

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The ideal therapy for early stages of hemorrhoids is always debated. Some are more effective but are more painful, others are less painful but their efficacy is also lower. Thus, comfort or efficacy is a major concern. In the present randomized study, a comparison is made between infrared coagulation and rubber band ligation in terms of effectiveness and discomfort. One hundred patients with second degree bleeding piles were randomized prospectively to either rubber band ligation (N = 54) or infrared coagulation (N = 46). Parameters measured included postoperative discomfort and pain, time to return to work, relief in incidence of bleeding, and recurrence rate. The mean age was 38 years (range 19-68 years). The mean duration of disease was 17.5 months (range 12 to 34 months). The number of male patients was double that of females. Postoperative pain during the first week was more intense in the band ligation group (2-5 vs 0-3 on a visual analogue scale). Post-defecation pain was more intense with band ligation and so was rectal tenesmus (P = 0.0059). The patients in the infrared coagulation group resumed their duties earlier (2 vs 4 days, P = 0.03), but also had a higher recurrence or failure rate (P = 0.03). Thus, we conclude that band ligation, although more effective in controlling symptoms and obliterating hemorrhoids, is associated with more pain and discomfort to the patient. As infrared coagulation can be conveniently repeated in case of recurrence, it could be considered to be a suitable alternative office procedure for the treatment of early stage hemorrhoids.

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“…While band ligation is marked by a large number of complications of an inflammatory character (26,27), no such incidence has been reported with IRC (28).…”

Section: Discussionmentioning

confidence: 99%

Infrared coagulation versus rubber band ligation in early stage hemorrhoids

Gupta

2003

Braz J Med Biol Res

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“…The hospital readmission rates are put at between 1.2 and 2.5% [23]. With occasional reports of life-threatening bleeding or pelvic sepsis [34], the relative merits of banding as a non-operative treatment must be set against the higher potential complication rate. …”

Section: Outpatient Treatmentsmentioning

confidence: 99%

The Surgical Management of Haemorrhoids – A Review

Hardy¹,

Chan²,

Cohen³

2005

Dig Surg

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A number of new surgical treatments have led to a reappraisal of haemorrhoid disease over the last few decades. Despite a range of treatment modalities, the options are limited in their effectiveness and can lead to a number of complications. An inadequate classification system based on appearance rather than symptoms makes the choice of appropriate therapy difficult. More recent techniques have led to a move away from surgical excision. However, further research is required to establish their precise indications and long-term efficacy.

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“…This method gives good results in 69–94% of cases. Although it is not associated with the problems that follow the typical surgical treatment of hemorrhoids [3, 4, 5, 6], the method is not free of complications and even deaths have been reported to occur in immunosuppressed patients [7, 8]. In this prospective study we analyze the results of the treatment of symptomatic hemorrhoids in 500 patients, using the RBL method.…”

Section: Introductionmentioning

confidence: 99%

Rubber Band Ligation of Symptomatic Internal Hemorrhoids: Results of 500 Cases

2000

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Background/Aim: In this prospective study the results of rubber band ligation (RBL) of symptomatic hemorrhoids in 500 consecutive patients with 2nd (255 cases), 3rd (218 cases) and 4th degree (27 cases) hemorrhoids are presented. Methods: The patients’ symptoms were hemorrhage in 142 cases (28.4%), prolapse in 33 cases (6.6%) and both hemorrhage and prolapse in 325 cases (65%). Sixteen patients with hemorrhoids had liver cirrhosis and portal hypertension. RBL was performed using the St Marks’ applicator (Seward) on an outpatient basis. Multiple ligations in two (259 cases) or three (190 cases) sessions were undertaken in 449 patients (89.8%), while a single ligation was done in 51 cases (10.2%). Results: Successful results were achieved in 440 cases (88%) in a 24-month follow-up. A total of 94 patients (18.8%) had complications which required no hospitalization. Pain and hemorrhage were the most frequent complications. RBL proved to be safe in 16 patients with coagulation disorders due to liver cirrhosis. Two years after RBL, symptomatic recurrence was 11.9% (53/445) with repeat RBL or surgery in 9.2% (41/445). Conclusions: RBL is a useful, safe and successful method for treating symptomatic 2nd and 3rd degree hemorrhoids, which can be applied successfully in selected cases with 4th degree hemorrhoids, but with an increased rate of recurrence and additional treatment requirements. Also, RBL seems to be safe in patients with liver cirrhosis and portal hypertension.

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Fatal clostridial infection following hemorrhoidal banding

Abstract: A case is described in which death followed banding of hemorrhoids. The clinical course was suggestive of overwhelming toxemia due to clostridia.

Cited by 91 publications

References 1 publication

Infrared coagulation versus rubber band ligation in early stage hemorrhoids

Infrared coagulation versus rubber band ligation in early stage hemorrhoids

The Surgical Management of Haemorrhoids – A Review

Rubber Band Ligation of Symptomatic Internal Hemorrhoids: Results of 500 Cases

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