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Date of last update: 8/19/2017.

Forum Name: Surgery Topics

Question: reopened perianal hematoma

 kirjavaa - Wed Dec 23, 2009 6:45 pm

I was struggling to pass a large bowel movement 4 days ago and when I was done noticed some bleeding. I didn't think of it at the time but a few days later I noticed a building pain in my anus. When I checked it in the mirror I found a pea sized dark blue spot on the edge of my anus. Looking online I was pretty sure that it was a perianal hematoma. After a few days the pain started to subside but I had been unable to pass another bowel movement so I began taking stool softners. Finally today I had a bowel movement and noticed more blood when I was finished. Upon inspection I noticed that the hematoma had a whole in it and was leaking blood. I am worried that the pain is going to become as bad as it was before if not worse. On some websites I found that if gotten to quickly enough a doctor can remove the blood before it clots avoiding the pain of a blood filled sac stretching my anus. Should I immediately try to have that done or is it going to continue healing on its own? Should I apply pressure to stop the bleeding?
 Dr.M.Aroon kamath - Sun Feb 07, 2010 11:38 pm

User avatar Hi,
Peri-anal hematomas are due to rupture of tiny veins that normally exist in the peri-anal region subcutaneously.These may rupture while straining at stool.They can be acutely painful if they are tense.In a few days time, they tend to become lax and the pain passes off.
In the acute phase, evacuation may be needed if the hematoma is very painful(tense).Hematomas that are not tense or painful may be managed conservatively (cold compresses, sitz baths & NSAIDs).

You need to be examined by a surgeon to
a) assess the hematoma and
b) to exclude any other co-existing cause for the bleeding.

Continued bleeding despite conservative management may even need surgical removal of the hematoma.
Good luck!

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