Pathophysiological Estimation of Hemorrhoidal Bleeding in Patients

Abstract

The mechanism of hemorrhoidal bleeding was estimated by measuring platelets, the coagulation system, and fibrinolysis, as well as by observing hemorrhoidal tissues, in patients with hemorrhoidal bleeding. Compared with normal volunteers, high fibrinolytic activity and a high titer of platelet derived growth factor (PDGF) were noticed ; however, the coagulation system was not significantly different in patients with hemorrhoidal bleeding. In resected hemorrhoidal tissues, thrombi were separated from the vessel wall and were floating in the blood stream. A large number of dilated vessels were present above the lamina muscularis around the Herrmann line. It is presumed that hemorrhoidal bleeding occurs in injured angiogenetic dilated vessels denuded in the anorectum under stimulation by PDGF, and that it reoccurs by enhanced fibrinolysis.