External peeling and internal ligation refers to stripping the varicose vein plexus beneath the skin of the mixed hemorrhoids and ligating the internal hemorrhoid portion from the very bottom with a silk thread, allowing the hemorrhoid nucleus to become necrotic and fall off due to lack of blood supply. The common causes of bleeding after 54 days of external peeling and internal ligation include hemorrhoidal core detachment, wound infection, anal stenosis, etc. 1. hemorrhoidal shedding: if the condition is more serious, hemorrhoidal nucleus is larger in size or the recovery ability is poor, the hemorrhoidal nucleus may be shed after 54 days of surgery, there will be slight bleeding, which can be manifested as bleeding after stool. 2. Wound infection: If after the external peeling and internal ligation surgery, there has been repeated chronic infection of the wound, resulting in even after 54 days the wound is still not completely healed, or even ulceration. After bowel movement, there will be dripping blood. 3. Anal stenosis: If there is scarring at the anus after 54 days of the procedure, which leads to anal stenosis, the stool will squeeze and rub the perianal area during defecation, resulting in bleeding after defecation. If you have bleeding after 54 days of exenteration, you should go to the hospital in time to find out the cause, so as to prevent serious consequences.