NMS. Casos Clínicos

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Chapter 8 ♦ Lower Gastrointestinal Disorders

Figure 8-20: Internal versus external hemorrhoids. Position of the hemorrhoids relative to the dentate line (sinusoidal line) classifies them as internal (proximal to the dentate line) or external (distal to the dentate line). (From Albo D. Operative Techniques in Colon and Rectal Surgery . Wolters Kluwer Health; 2015, Fig. 45-1.)

Figure 8-21: Rubber band application to internal hemorrhoid. A, B: The forceps grab the protruding internal hemorrhoid as broadly as possible. C: The ligator is pushed directly down onto the hemorrhoid until the base of the hemorrhoid is reached. D: The ligator fires the rubber band around the base of the hemorrhoid. It is of the utmost importance that the ligation is performed definitively proximally to the dentate line (dotted arrow). (From Albo D. Operative Techniques in Colon and Rectal Surgery . Wolters Kluwer Health; 2015, Fig. 45-11.) SAMPLE