Perianal (around the anus) hematoma (swelling filled with blood) or hemorrhoid, Can You Tell The Difference?

(Last Updated On: April 23, 2017)

Perianal (around the anus) hematoma (swelling filled with blood) or hemorrhoid?

The perianal hematoma is a swelling blood vessel around the anus identified by it’s typical blue color just under the skin.
Caused by a small rupturing vein that bleeds from the anus area, this rupture can be caused by heavy exercise, bicycling, heavy lifting, coughing, straining during bowel movements, large stool plus other reasons. Once a rupture has occurred, blood will quickly pool under the skin and if left unchecked will form a clot within hours.

Hemorrhoids or piles are inflamed and swollen veins in the rectum and anus. The term “hemorrhoids” in principle refers to cushions of tissue filled with blood vessels in the rectum and anus area. However, the term is interchangeably used to refer to varicosities of the hemorrhoid tissue.
The difference being hemorrhoids fill with blood while Perianal Hematoma rupture and clot.


A burst perianal blood vessel sometimes misdiagnosed as an external hemorrhoid or pile will likely cause pain, varying from mild to severe.
The pain is generally the result of the skin surrounding the rupture expanding due to the pressure caused by the blood. This pain will usually last even after the blood has clotted, and may continue for two to four days.


If you are lucky enough to figure out what has happened within the first few hours of rupture, the pooling blood may be evacuated using a syringe. Once the blood clots, the clot can be removed by your doctor making an incision just over the lump. The incision is not usually stitched, but should heal very well. Keep in mind that this bleeding wound is in an area with fecal bacteria and infection is possible.

Once you have hemorrhoids, it is best to seek out the origin of the hemorrhoids and why it is happening. After that, you can change specific parts of your lifestyle, such as your food intake to help avoid the hemorrhoids from being an incessant nuisance.

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