Tuesday, March 23, 2010

Gangrenous Hemorrhoids

I'll let that title sink in for a minute. Think about it. I was shocked, when I read it on the specimen source sheet yesterday. I have seen a lot of hemorrhoids under the scope. Not as bad to look at as you might think - dilated, blood filled vessels underneath colonic and transitional (anal) mucosa. But gangrenous? That's a new dimension of hemorrhoid.

I've seen gangrenous limbs and extremities - fingers, toes, knee stumps, etc. The thought of gangrenous hemorrhoids elicited an olfactory sensation that was both curious and revolting. The combination of the scent of gangrene mixed with the anal extrusion of grape-like clusters of swollen blood vessels.

Then I thought of the neglect involved that would lead to gangrenous hemorrhoids. Was this person mentally stable? In a long term care facility with shady staff members that let their clients sit in wheelchairs in the corner of the room for days on end? What type of situation would generate gangrenous hemorrhoids?

I mentally prepared myself for the sight of gangrene superimposed onto hemorrhoids under the scope. Gangrene is not as ugly as you might think - an eosinophilic, basophilic (purple-y pink) smudge of necrotic cells infiltrated by neutrophils (purulence). Microscopic neutrophils are a lot cuter than gross pus. Tiny multi-lobed globes.

I searched for the tell-tale signs of gangrene, but they weren't there. Flipped to high power, and hunted around. Where was the gangrene? There was a little ulceration, but no gangrenous necrosis. I guess if someone looked at ulcerated hemorrhoids they might think they were gangrenous, and describe them as such. But there is a big difference between ulceration and gangrene.

So I've yet to see gangrenous hemorrhoids. A bit of a relief. But I enjoyed thinking about them, and wonder if they really exist. I decided it would make a great derogatory term for your worst enemy. The low-ball. The verbal gut-punch. "You are a gangrenous hemorrhoid."


rlbates said...

lq2m over this one.

Jabulani said...

sq2m. I'm going to borrow that verbal gut-punch ;)

John Hornor said...

Oy. That's balmy.

Speaking of hemorrhoids, what exactly, is witch hazel?

Steve Weddle said...


The domain gangrenoushemorrhoid.com is available!!

Gizabeth Shyder said...

I don't know what lq2m and sq2m mean.

I don't know what witch hazel is.

I leave that domain open for someone else.

Robin said...

LQ2M - Laugh quietly to myself
SQ2M - Smile "" ""

Don't know what the third (witch hazel) would be.


jillian said...

Witch hazel is the name of a plant, and also the astringent extract of said plant.

Gizabeth Shyder said...

And I assume it has something to do with hemorrhoids?

Unknown said...

Witch hazel tends to soothe and lessen the irritation of hemorrhoids. Available over-the-counter as Tucks' wipes.

Jonathon Dentler said...

Witch hazel herbal plant helps to cure hemorrhoids. It can make your life better if you have hemorrhoids. I also recommend to check out this site: Get Rid Of Hemorrhoids

Burt said...

Hemorrhoids are pain in the ass :-) But serriously, witch hazel helps to cure them.