Hemorrhoid Teknik

2. • Anal cushion adalah daerah antara mukosa dengan sphincter
internal anal berisi vascular cushion, treitz elastic fiber dan
colaggen connective tissue
• Jadi hemorrhoid adalah vascular cuschion yang mengalami
prolapse, kongesti dan membesar serta berdarah
• Fungsi anal cushion untuk memastikan kontinense dengan cara
menutup anal canal saat defekasi (fig 3.3)
• The three main cushions are located at left lateral (3 o’clock),
right anterior (11 o’clock), and right posterior (7
• o’clock) in the anal canal
• Therefore, according to Thomson, anal cushion and
hemorrhoidal tissue are synonyms.
• The tissues in the cushion are fixed to the internal sphincter
and the conjoined longitudinal muscle with collagen
connective tissue and become weak and loose with age.
Especially with repeated straining by defecation, the anal
cushion becomes engorged and prolapsed, which disrupts
Treitz’s muscle and eventually anal cushion prolapses

4. • Anal cushion menonjol secara fisiologis pada saat
straining sehingga akan membuka anal canal dan
membentuk lip of the anus  saat setelah defekasi
kembali ke posisi semula  kegagalan kembali ke posisi
semula disebutlah hemorrhoid

5. • It is the basic form of protruding piles on the direction of
4, 7, and 11 o’clock which needs incision and resection as
shown in the figure (Figs. 7.26 and 7.27)