Good end of the buttocks, suddenly swelled up a bag, pain intense, not embarrassed just stuck in the “chrysanthemum” side, from time to time overflow point of blood. This scene in the hemorrhoid patients, especially external hemorrhoid patients often occur, this round or oval lump, is thrombosed external hemorrhoid. Thrombosed external hemorrhoids those things 1, hemorrhoids family hemorrhoids are divided into internal hemorrhoids, external hemorrhoids, mixed hemorrhoids, which we say external hemorrhoids are located below the dentate line, the subcutaneous veins of the subrectal veins of the subcutaneous branch of the rectal vein pathologically dilated, thrombosed or fibrotic hemorrhoids. It is also divided into varicose external hemorrhoids, connective tissue external hemorrhoids, inflammatory external hemorrhoids and thrombosed external hemorrhoids. 2, the story of thrombosed external hemorrhoids thrombosed external hemorrhoids is the emergency of hemorrhoids, often due to eating irritating food, forced defecation leads to perianal subcutaneous venous lining inflammation, destruction or even rupture, blood in the blood vessels into a block or due to the collapse of blood vessels silt in the subcutaneous and formed, can cause swelling and severe pain, or with bleeding. Exactly how painful it is depends on how large the clot is or whether there is inflammation. Thrombosed external hemorrhoids appear as a pea-shaped, dark purple bump, and within 72 hours of onset, the patient is in significant pain, usually requiring hemorrhoidectomy. If the onset has been more than 72 hours or there is local inflammation, conservative treatment is recommended. Thrombosed external hemorrhoid attack, this treatment is “on the road” 1, hemorrhoidectomy Thrombosed external hemorrhoidectomy refers to the external hemorrhoid thrombus with varicose external hemorrhoidal venous plexus together with stripping excision, remove the swelling as well as the root cause of thrombosis again surgery. Conservative non-surgical treatment is often ineffective when the pain is severe in the short term after the onset of the disease, and the resection is usually performed under local anesthesia or lumbar anesthesia. The procedure is not complicated, but there is some risk of postoperative complications, such as bleeding and infection. In this regard, petroleum jelly gauze can be applied, and then gauze pressure bandage, in the case of heavy bleeding need to be sutured to stop bleeding, while keeping the local clean and clean, warm water sitz bath can also accelerate the healing of the wound. For the specific choice of surgical methods for thrombosed external hemorrhoidectomy, relevant clinical studies have also been conducted to compare. A prospective RCT (randomized controlled trial) that included 35 patients with acute thrombosed prolapsed hemorrhoids found that anastomotic hemorrhoidectomy was feasible for the treatment of acute thrombosed prolapsed hemorrhoids, with lower pain scores and faster symptomatic relief at 2 weeks postoperatively compared with conventional hemorrhoidectomy. Meanwhile, an RCT of 41 cases also confirmed that there was no statistically significant difference between anastomotic hemorrhoidectomy and conventional hemorrhoidectomy in terms of length of hospital stay, complication rate, and voiding function. However, the pain level in the first postoperative week of anastomotic hemorrhoidectomy was significantly lower than that of the hemorrhoidectomy group, and the patients recovered faster from the operation, with better overall symptomatic improvement and higher patient satisfaction. It is therefore evident that anastomotic hemorrhoidectomy is a safe and effective surgical resection method for the treatment of acute thrombosed prolapsed hemorrhoids. But anemia, long-term hemorrhoidal risk factors of elderly patients are not suitable for. 2.Conservative treatment For patients with thrombosed prolapsed hemorrhoids episodes lasting more than 72 hours, conservative treatment can be prioritized, including lifestyle modification, stool softening, and oral or local use of analgesic drugs. Patients’ symptoms such as pain, bleeding and lumps are usually relieved in about 24 days. (1) Lifestyle adjustment Increase dietary fiber intake as appropriate, develop good defecation habits, keep the perianal area clean, and take a sitz bath appropriately. Secondly, prolonged standing or sitting is not conducive to local blood flow, so prolonged sitting or standing still should be avoided. (2) Stool softening If the stool is dry and hard and defecation is difficult, in addition to drinking more water and eating more fruits and vegetables, stool softeners, such as glycerin and liquid paraffin, can be applied under the guidance of the doctor. (3) Use of drugs When the patient’s pain is more obvious, he can also follow the doctor’s instructions to take oral or local use of drugs to relieve pain, such as oral flavonoids Diosmin, Troxerutin, as well as external use of local anesthesia drugs nifedipine ointment, Lidocaine ointment, this kind of drugs have a more significant effect on relieving pain. Thrombosed hemorrhoids, once generated, the patient’s daily life will inevitably bring a lot of inconvenience, in order to avoid this situation, should actively start from the root cause, do the corresponding preventive measures, to prevent the problem before it occurs. References [1] Zhao Yupei. Chinese medical encyclopedia. General Surgery [M]. Beijing:Published by Peking Union Medical College Press,2017:440-478. [2]Chinese Society of Integrative Medicine Professional Committee of Colorectal and Anal Diseases. Chinese hemorrhoid diagnosis and treatment guidelines (2020)[J]. Colorectal and anal surgery,2020,527.