Hemorrhoids and anal fissures hurt so much that my legs feel weak. The doctor's explanation is surprising.

A proctology operation a few days ago once again allowed everyone to appreciate the broad scope of knowledge covered by the Department of Anesthesiology.

Here's what happened: During an anorectal surgery that was originally unremarkable, Dr. Li, who was in charge of anesthesia, discovered something unusual. What surprised him most was that the patient did not walk into the operating room, but was pushed into the operating room on a flatbed cart. Normally, this type of minor surgery does not require a cart for transportation.

I asked the nurse who was in charge of receiving the patient, and the nurse said: The patient's legs are weak and he can't walk.

(The picture and text are unrelated)

Preoperative three-party verification

The photos are from the 4th "Renxin Cup Most Beautiful Angels in White Photo Collection Competition"

Photographer: Xiao Su, Gushi Hospital, Songyang County, Zhejiang Province

Hearing the words "can't walk anymore", Dr. Li immediately became alert. This is because if there is a problem with the movement or sensation of the lower limbs, spinal anesthesia should generally be avoided as much as possible. Once there is a dispute after the operation, it will be difficult to explain. Therefore, everyone will try not to walk by the river.

After the patient lay on the operating table, Dr. Li connected the patient to various monitoring devices while checking the patient's lower limbs. He mainly wanted to find out why the patient was weak.

When the patient heard Dr. Li asking him about his legs, he said with a painful look on his face: My legs are fine, I just feel weak and sore when I have hemorrhoids.

Looking at the occupation column in the medical record, it clearly says "driver", and he works for a bus company. With such an occupational background, it can basically completely rule out that he has problems with his legs and feet. In other words, what he said should be true: his legs become weak when he gets sick.

So the question is: where is the connection?

Hemorrhoids-legs, hemorrhoids-legs, Dr. Li's brain was rapidly searching for the answer.

Suddenly, he blurted out: I understand.

The anorectal doctor who was waiting for Dr. Li to change the anesthesia plan asked: Do we need to change to general anesthesia?

According to his experience, for patients with possible lower limb problems, the anesthesiology department will almost always directly change the anesthesia method.

Although they have their own thoughts about this approach, they can understand it. After all, medical work is tiring, and no one wants to get involved in things other than medical work, such as disputes. If they just switch to general anesthesia, they will not interfere with each other and there will be no suspicion at all.

Soon, Dr. Li turned the patient over and put him in a side-lying position.

Seeing that Dr. Li was about to give anesthesia, the anorectal doctor asked suspiciously: Is your leg okay? The implication was, aren't you afraid of getting into trouble?

Doctor Li knew what he meant and said briefly: We'll talk about it later. Let's give you anesthesia first.

Soon, the anesthesia was administered.

After the anorectal surgeon had completed the critical stage of the operation, he brought up the topic again: Teacher Li, can you tell us what the connection is here?

Dr. Li took out his cell phone and showed them a picture.

When everyone looked at it, they saw that it was a human anatomy diagram, mainly showing the distribution of nerve segments in the lower limbs.

When everyone was still confused, he pointed to "S2". It can be clearly seen that "S2" not only controls the back of the thigh and the heel, but also the perineum.

Dr. Li continued to explain: This picture can explain why he has "weak legs". If it is a simple internal hemorrhoid, its nerve distribution is not related to S2.

The anal canal is mainly innervated by the inferior hemorrhoidal nerve, anterior sphincter nerve, anococcygeal nerve and perineal branch of the first sacral nerve, which are branches of the pudendal nerve.

However, if it is an external hemorrhoid or anal fissure, it will directly touch the range of S2. Since S2 is also responsible for the sensation of the legs, the signal transmitted to the brain may be mistakenly interpreted as pain in the legs.

Especially when the pain is severe, you may feel soreness, swelling and weakness.

At this point, everyone suddenly understood and praised the anesthesiologist's anatomical skills.

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