22 yr old female pt. is come with complaining of sever pain at rectum after passing stool, pain persist for 1hr afterwards it resolves. this happens once in 2 to 3 months it's from 2yr now 1yr back she usg report is normal, but today's usg report is attached, other lab is normal and her mc is also regular, plz share your thoughts on it...

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Clinically history suggestive of Anal Fissure... However , USG report shows mucosal edema and wall thickening may be secondary to chronic constipation... I would suggest to do sigmoidoscopy to rule out inflammatory pathology like Ulcer, fissure, Hemmorhoids, diverticuli etc.

Looks like chronic constipation . She might be finger evacuating. . Can be SRUS or IBD . Needs colonoscopy

No H/o constipation
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It looks like proctitis, frequently associated with ulcerative colitis.. Colonoscopy and biopsy for diagnosis.. Rectum almost always involved in ulcerative colitis..

Mild mucosal as well as rectal thickening is the report. Patient should be evaluated by per rectal, proctoscopy,colonoscopy. Chronic fissure, solitary rectal ulcer, inflammatory bowel disease may be the differential diagnosis.

First of all DRE to be done Followed by Proctoscopy and colonoscopy to be done Put her on laxative and seitz bath

Pt . Needs proctoscopy or fib

Colonoscopy nd biopsy may give some clue

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