Excision and clot evacuation of a thrombosed hemorrhoid

This figure depicts the procedure for an excision of a thrombosed hemorrhoid and evacuation of the clot.
Figure A: Injection of local anesthetic at the base of the thrombosed hemorrhoid.
Figure B: Excision of an ellipse of skin with iris scissors. Do not excise deep into the anal sphincter.
Figure C: Excised skin ellipse and clot evacuated.
Figure D: Hemorrhoid excised, clot evacuated, wound left open to heal. Note underlying anal sphincter.