A 28yrs old female pt having lesson like this in anal canal , associated with pain while passing stools and difficulty in siting, also complaint of constipation since 10days ..plz dx and rx ,

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A case of thrombosed external pile mass - may have developed while straining as patient is having constipation . Another possibility is Acute fissure in Ano with sentinel pile Treatment remains similar A laxative Sitz,bath Ornidazole 500mg + cefuroxime 250 mh B.D for 5 days Tab Aceclofenac + serratiopeptidase B.D for 7 days. Topical Xylocaine + nifedipene ointment In rare cases- surgery may be required

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Prolapsed hemorrhoids with likely a/w anal fissure Replace prolapsed piles with xylocaine gelly and assess fissural status Rx bulk laxatives Locally seatz bath with lukewarm water and betadine lotion Anometerogyl oint twice daily Smuth oint twice daily Xylocaine gelly for instant relief frequently Once settled down proceed with proctoscopy and adv elective surgery Conservative Tab cefixime+ofloxacin 1bd Tab pilon 1bd Antiinflamatory and antispasmodics

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This is called as external thrombosed piles It is basically a clot in subcutaneous region It many times resolve spontaneously However, healing can be hastened with medication Adv C. ESoz D 40 mg once daily T. Ecosprin 75 mg one tablet in morning T. Cilostazole 50 mg one tablet twice a day Lactulose syrup 10 ml at night time Vitamin B 12 capsule once daily

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External thrombosed piles with anal fissure, due to constipation there is friction injury of anal margin leading to slight bleeding ang collected along the external piles and gets thrombosed usually paniful or may be infected causing more discomfort. Sietz bath Antibiotic may be helpful Laxative stool softner Lignocaine jelley to apply locally.

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? SENTINEL PILES.. ? PERIANAL ABSCESS.. ? PERIANAL HEMATOMA.. MANAGEMENT.. PROCTOSCOPY.. SURGEONS OPINION.. SYMPTOMATIC T/T..WITH CLINICAL CORRELATION..

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thrombosed piles -Jaluokavacharan internal medicine Trifala guggulu 3-3-3 tabs chandrakala 2-2-2-2 phalatrikadi guggulu 2-2 Arshkuthar 3-3-3 gairik+praval+musta etc. anupan Audumbaravleh Avagah swed Panchvalkal patra+trifala+haridra after 1 week Kankayan gutika 2-2-2 stopped chandrakala. after 1-1 1/2 months patient is ok with medicine no swelling no pain

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Perianal hematoma Dd Fissure 99% present Behind sentinel piles Rx Metrogyl 400 bd Akilos sp bd Rbson bd Anoblis oint Stool softner night with warm water Advice- exercise Avoid spicy food, fried food With homoeopathy Silicea 200 tds Sulph + ratania 200 tds Syphilinum 1m stat

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Fissure in ano with sentil pile Tab.O2 bd Tab enzoflam tds Tab chymoral foerte tds Cap omez 2omg bd Syp creamfin 20ml hs Lignocain gelly before motion Sitz bath Diltigesic ointment after motion Proctoscopy examination needed

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Prolapsed piles Sy cremaffin 10 ml hs Oint proctosedyl bd bd Increase roughage in diet Daflon1000 tds Chew nuxvomica30 Sulphur 30 Alumina30 Life style modifications

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? Perianal abscess.. ? Piles... Rx tab O2 bd Tab flexon bd Tab rantac 150 mg bd Syp duphalac 20 mg od Kmno4 sitz bath bd Anobliss cream bd Soft diet Increase water intake Avoid staining.. General surgeon opinion sos

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