Concluded Case

50/male, manual labourer, pain and discharge from the lesion since 1 day. Not obese, does not smoke, drinks beer occasionally. No h/o trauma/TB/IBD. What are the differentials and the most likely diagnosis?

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It is prolapsed piles There is no other differential diagnosis Give Glycerine mixed with magnesium sulfate powder dressing, put Glycerine and Mgso4 mixture in gauze piece and apply it in swelling After 4 - 5 hours swelling will reduce in size and pain will go away Swelling can then be easily reduced Once reduced - how to prevent recurrence 1) Avoid constipation - straining while passing stools is most important cause of prolapse, beer with non veg food causes severe constipation and prolapse - that can be important mechanism in this patient 2) Piles banding with piles banding instrument would help prevent recurrence

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@Lohitaksh Makasare ITS RECTAL PROLAPSE SENTINEL HEMORRHOIDS

Haemorrhoids

I think its a 4th degree bleeding piles In differetials we can think about rectal prolapse Constipation is a major Nidana so 1st avoid it And Avgah swed in nirgundi patra kwath to reduce swelling Haritaki 4 tab at night to avoid constipation Sunarin or pilex ointment for LA after taking sweda And avoid heavy diet

Good one Dr Hanif.
1

4th degree prolapsed haemorrhoids. Use Xylocaine jelly ,and reduce the prolapsed pile mass . Once it is reduced definitive treatment for haemorrhoids is indicated. Haemorrhoidectomy is indicated

IT'S A..CASE OF.. ? HEMORRHOIDS.. ? PROLAPSE HEMORRHOIDS..

Rectal prolapse need surgical intervention

Prolapsed piles.Sitz bath.Antibiotic coverage. Pain killers.Lactulose for comfortable bowels.

It is prolapsed piles There is no other differential diagnosis Give Glycerine mixed with magnesium sulfate powder dressing, put Glycerine and Mgso4 mixture in gauze piece and apply it in swelling After 4 - 5 hours swelling will reduce in size and pain will go away Swelling can then be easily reduced Once reduced - how to prevent recurrence 1) Avoid constipation - straining while passing stools is most important cause of prolapse, beer with non veg food causes severe constipation and prolapse - that can be important mechanism in this patient 2) Piles banding with piles banding instrument would help prevent recurrence

Rectal prolapse.. A condition that occurs when part of the large intestine slips outside the anus. Rectal prolapse typically occurs in older women, but it can occur in men and women of any age. Risk factors include multiple births and vaginal delivery. Rectal prolapse is caused by weakening of the ligaments and muscles that hold the rectum in place. In most people with a prolapsed rectum, the anal sphincter muscle is weak. The exact cause of this weakening is unknown; however, risk factors usually are associated with the following health conditions. Same answer i have replied in previous case presented today.

Prolapsed Piles d/d prolapsed rectum

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