History of Present Illness:
A 70-ish-year-old female with a history of HTN presents to the ED for 8 hours of rectal pain, mass and bleeding. She said she had the lump about two weeks ago but it was smaller and resolved on its own within an hour. This time it is getting worse rather than better.
Vital Signs & Physical Exam:
Vital signs are normal. Physical exam is normal except for a red anal mass shown below
Relevant Test Results:
- Labs: reassuring
What is the most likely cause of the pain?
- A) Internal hemorrhoid
- B) external hemorrhoid
- C) Rectal prolapse
- D) Uterine prolapse
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ANSWER: What is the most likely cause of the pain?
- A) Internal hemorrhoid
- B) external hemorrhoid
- C) Rectal prolapse – CORRECT
- D) Uterine prolapse
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CASE CONCLUSION: Could not reduce. Surgery called in and was able to reduce in frog-leg position. Patient sent home and referred to G-surg. Called back next day and still doing well.