A 31-year-old woman with Child's B liver cirrhosis with portal hypertension and splenomegaly presented with a one-month history of abdominal pain. A physical examination confirmed splenomegaly. A blood investigation revealed a low white blood cell (WBC) and platelet count. Computed tomography (CT) revealed a splenic artery aneurysm at the distal splenic artery measuring 3.4 x 3.4 x 4.3 cm (AP x W x CC) with thrombus and splenic infarction. A successful angiographic embolisation was performed without immediate complications. The abdominal pain symptoms resolved, leading to the patient's discharge from the ward on the third day post-embolisation. Follow-up at the surgical outpatient clinic indicated the patient remained asymptomatic, and repeated blood counts showed improvement in both WBC and platelet counts. Furthermore, follow-up CT scans demonstrated a reduction in spleen size, indicating positive outcomes and a favourable response to the intervention.
Internal hemorrhoids are a common issue in general surgery and are one of the leading causes of lower gastrointestinal bleeding globally. Numerous treatment options exist for managing this challenging condition. One relatively new treatment method is radiofrequency ablation for internal hemorrhoids (RAFAELO). According to the limited publications, this method is described as simple, quick, and safe. In this case series, we present five patients with internal hemorrhoids who were treated using the RAFAELO method and discuss their management and outcomes.