Neonatal Hemorrhoid

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.