Concluded Case

45 years female with severe pain anal region and bleeding P/R . History of similar episodes in the past . Patient has been repeatedly on the lines of acute anal fissure. Further opinions welcomed

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Concluded answer

It is a case of chronic fissure in ano with sentinel pile with associated haemorrhoids. Patient responded to conservative treatment

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Present picture shows prolapsed and thrombosed hemorrhoids gr 4 May be also associated with anal fissure On physical examination if possible reduce them and hemorrhoidectomy is final approach.

Thanx dr Devendra Kanjoliya
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External Haemorrhoid with Skin tag Need Surgery for properly managment

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This is a patient of acute on chronic fissure with thrombosed external pile , it is an extremely painful condition, As the pt having bleeding may have internal piles also. Now aim should be to get the patient pain free Conservative treatment may be done like Sitz bath Laxative Lignocine jelly locally But I think to get pt immediate pain free to think to put an incision of the bulged external thrombosed pile and to remove the blood. It will be helpful then follow the coservstive treatment.

Prolapsed thrombosed piles, with fissure in ano Sitz bath, antibiotics, metronidazole, chymoral forte, PILON, Thrombophob oint , stool softener After acute stage is over, hemorrhoidectomy, and fissurectomy

Thrombosedand infectedexternal pilesmay be associated internal piles. PR examination can help indiagnosis for associated etiology. Maybe fistula/ Fissure..

SUGGESTIVE. OF HAEMORRHOIDS... THROMBOSED WITH SKIN. TAG

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It is a case of chronic fissure in ano with sentinel pile with associated haemorrhoids. Patient responded to conservative treatment

Prolapsed piles local phenol injection may help stool softner daflon 500 tds oint proctosedyl bd

Prolapsed hemorrhoids

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Thrombosis piles. Seitz bath.dobesil ointt.antibioti.brufen

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