Concluded Case

6 yrs F constipation since 1 yr pt told parents about pain during defecation but they ignore it since 1 yr seen before 5 days Plz Dx n Rx

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Concluded answer

Classical presentation of a sentinel pile , indicative of a scar tissue of a chronic fissure in ano presenting as external anal swelling, mostly seen in patients with chronic constipation as in this case . There must be a hypertrophied anal papilla just adjoining sentinel pile inside anal canal . Chronic fissure is difficult to treat. Treatment- Antibiotics- Amoxyclav 375 mg B.D for 7 days Laxative- polyethylene glycol 2 tsf O.D for 1 month. A high fibre diet . Sentinel pile cannot be treated conservatively. It can be only excised. but generally it is not required. Sitz bath over prolonged period can help.

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Sentinel pile.

Sentinel pile Fissures are usually caused by trauma to the inner lining of the anus. ... Chronic fissures may be more difficult to treat and may also have an external lump associated with the tear, called a sentinel pile or skin tag, as well as extra tissue just inside the anal canal, referred to as a hypertrophied papilla.

A skin tag over a chronic fissure. The child has to be treated for constipation.
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@agenesis of anorectal.tract

External pile/ sentinal tag. Rectal examination to look Analfissure or infected piles

Anal tag seems to be infected Anal fissure

Sentinel pile

ANAL FISSURE INFECTED ANAL TAG

Sentinel pile

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