Neonatal Hemorrhoid

September 14, 2005
Robert P. Blereau, MD

An excrescence at the 6 o'clock position at the anal verge is evident on this 8-day-old girl's anus. A hemorrhoid needs to be considered in the differential diagnosis of rectal bleeding in all age groups, since the condition can be present in neonates as well as adults.

An excrescence at the 6 o'clock position at the anal verge is evident on this 8-day-old girl's anus. The grandmother had noted bright blood with the infant's bowel movements and believed the baby had a hemorrhoid.

The grandmother was correct. The patient was given a local anesthetic, and the lesion was excised in the physician's office. The base was cauterized with silver nitrate. Antibiotic ointment was applied to the area; healing was uneventful, with no apparent significant discomfort.

Microscopic examination of excised material revealed that the lesion was covered with squamous mucosa and had a core-like center showing numerous small venules within an intervening fibrous-like background with a fresh blood clot at its tip. A hemorrhoid needs to be considered in the differential diagnosis of rectal bleeding in all age groups, since the condition can be present in neonates as well as adults.

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