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This year-old man presented with a very painful infection. There was a large abscess which was easily palpable with surrounding cellulitis. It clearly needed incision so he was admitted for this to be done under general anaesthetic. There was no obvious underlying cause, such as inflammatory bowel disease or diabetes. Following drainage, the abscess cavity required regular dressing but healed well. This man rather sheepishly requested help with the removal of this perianal lesion.
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Hemorrhoids and Anal Fissures: A Short Photo Essay

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Hemorrhoids and Anal Fissures: A Short Photo Essay | Patient Care Online

External hemorrhoids cause severe throbbing pain of sudden onset. Internal lesions are associated with bleeding, protrusion, fecal soiling, and pruritus. External hemorrhoids a single lesion is shown here are found below the dentate line the division between squamous epithelium distally and transitional columnar epithelium proximally and so are covered by skin. Patients experience significant pain when external hemorrhoids are dilated and thrombosed-conditions that stretch the overlying skin. Click here for the next image. If a patient's pain is severe at evaluation and there is ulceration, surgical excision pictured here can provide relief. Locally anesthetize the hemorrhoid, make an elliptical incision, and evacuate the clot or, preferably, excise the hemorrhoid.
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Clinical pictures: Perianal problems

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