32 year old female is brought in by her family with several months history of anal pain, pruritus and difficulty passing stool. Comorbid HIV infection receiving treatment. What would your concerns be? Treatment options?

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Prolapse rectum with inflammation and perianal pruritis Pt is compermised it looks to be habitual of anal sex hence condylomata accuminata should also be considered With full protection attend the pt Replace prolapsed rectum Treat perianal pruritis Rx oral antibiotics like azithromycin500mg Tab Levocetrizine5mg Locally fucibact oint Anometerogyl oint for internal applicaion Laxatives for constipation or tenusmus Once infection resolved do proctoscopy and assess anorectal pathology and guide further accordingly In addition continue ART

Thanx dr Sunita kude
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Rectal prolapse seen. Peruritus may be due to Trichuris trichura or pruritus Ani from hemorrhoids due to sever constipation. De worming may be done. Provide plenty of water and vegetable for soft stool to come out

? FISSURE IN ANO ..AND.. ? CONDYLOMA ACCUMINATUM.. R/O..MALIGNANCY.. NEED'S..ANORECTAL EXAMINATION AND ..EXPERTS OPINION..

Tnx Dr Amitabha Dasgupta
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It's case of anal fissure wd Infected 3oclock piles...is it naevus? Rule out properly by finger Dx any and sigmoid scopy or colonoscopy for assessing any int. Piles or any growth. Tt. Anal dilation Paritial sphincterectomy Hemorroidectomy Wd necessary investigation... For eg.. Cd4count. Aft surgical procedure Need daily dressing by topical antibiotic, anti fungal ointment. Oral antibiotics Oral anti-inflammatory Oral antibiotics.

Codyloma with anal fissure

Thanx sir
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SUGGESTIVE Of.. ..RECTAL PROLAPSE AND PERIANAL PRURITUS INFLAMMATION

PROLAPSE RECTUM WITH INFLAMMATION AND PERIANAL PRURITIS.

Thanks Dr kute Ankush
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Its a case of rectal prolapse.Pruritus may be due haemmorrids.post anorectal examination treatment can be decided.

Gangrene ous swelling mostly piles operate send for HP because of HIV chances of malignancy

DD Acute fissure in ano , .ca rectum Malignant melanoma Condyloma acuminata

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