2020年10月21日星期三

hemorrhoids or anal cancer,Severe pain of anal protrusion, marginal bone inserted into the anus

    Upon entering the consultation room, Uncle Liao’s family said to me, “Director Chen, I don’t know why, my father has a sudden pain in the anus recently. Please check it in detail”. I looked up and saw Uncle Liao frowned, his face pale and painful. I carefully checked the patient. The patient's abdomen was flat and soft, no abnormal mass was palpable, and no tenderness and rebound pain. When inspecting the anus, the patient's anus was abnormally smooth, there was no sign of recurrence of hemorrhoids, and there was no redness or inflammation around the anus. However, during the digital anus examination, the patient's anus tends to become tense and tender, and he refuses further examination. Irresistible, with the consent of the patient and his family, I first disinfected the patient's anus, and then injected some anesthetics around the anus. Soon the patient's anus loosened and the pain disappeared. Then I used my finger to penetrate the anus and found a flat and sharp foreign body 3cm above the anal opening was inserted under the anal canal. After being removed by clamps, it was discovered that the original culprit that caused Uncle Liao's anal pain in the past few days, and the trouble sleeping and eating turned out to be a triangular fish bone about 1.5cmx2.5cm in size. Uncle Liao remembered that he did eat a meal of carp (grass carp) 5 days ago. It may be that the person is old and has lost his teeth. The food was not sufficiently chewed when eating. The fish bone clip attached to the food and entered the stomach and intestines. The anus, due to the role of the anal sphincter, usually forms like a tight bottleneck. After the feces with fish bones reach the anus, due to excessive force, the fish bones exposed outside the feces are inserted into the perianal like a knife, causing pain Unbearable. After Old Uncle Liao took out the fish bones and used some antibacterial and anti-inflammatory drugs appropriately, the pain did not recur.

    Food foreign body punctures the anus. The main symptom is sudden strong pain during defecation. If the bone is directly inserted into the perianal tissue, there is generally no obvious bleeding. The bone punctures the anus, which not only leads to abnormal pain in the anus, but also severe It can cause infection and perianal abscess, and the problem is even more serious. Therefore, when eating fish, poultry, animals, bones and other foods in normal times, especially the elderly, you should swallow slowly. If you feel an obvious foreign body sensation, do not swallow it forcibly. If the patient has acute anal pain and has recently eaten fish, poultry, animals, bones and other foods, first consider the possibility of anal foreign body stabbing, and go to the hospital for examination and treatment in time to prevent aggravation of the condition.

    Note: No coincidence. Just in the afternoon of Zuotian (2012, July, 27). I also performed an emergency anal fishbone removal for the old man Ren who came from Anhui Province thousands of miles to Zhongshan City to visit his son.

    Mr. Ren is 61 years old this year. After eating a fish-meat food for 3 days, the anus suddenly seemed to be pricked by an awl during defecation the day before yesterday (July 25) and sustained severe pain, difficulty in movement, and restlessness. As the saying goes: nails in the eyes, thorns in the flesh, not to mention the insertion of fish bones into the most sensitive anal tissue of the human body, it is painful and painful. Because the patient is really intolerable. Mr. Ren had to go to the anorectal department of our hospital yesterday (7, 27) morning with his family. During the engraving examination, the patient saw a painful face, pale, bent over and back, unable to sit. Check the patient’s anus for swelling and swelling throughout the entire circumference. Finger examination of the anus touched a thin strip of curved fishbone foreign body, one end was inserted into the patient’s posterior anal canal and could not be removed. diagnosis. 1. Anal foreign body stabbed the anus, 2. Perianal infection 3. Ring-shaped hemorrhoids complicated by infection. In order to relieve the patient’s pain in time and prevent the infection from further aggravating, I am concerned about the patient’s urgency. After obtaining the consent of the patient and his family, I immediately decided that the patient should be admitted to the hospital immediately and do the relevant preoperative examination and preoperative emergency surgery. Ready to work. In the afternoon, emergency anal foreign body removal and mixed hemorrhoids external resection and internal radical resection are planned. 4 o'clock in the afternoon. The patient was successfully anesthetized in the operating room. Routine disinfection and draping took only more than half an hour to successfully complete the anal fishbone removal for the patient (a curved fishbone about 3 to 5 cm long was removed during the operation). During the operation, it was found that the fishbone was as sharp as a blade. When the patient was forced to defecate, he even cut a large longitudinal slit in a large internal hemorrhoid at 6 o'clock and was infected with suppuration. After careful removal of the perianal infection tissue and external resection and internal ligation of circular mixed hemorrhoids, the operation was successfully completed. The anal pain that had plagued Ren's old man for many days also disappeared immediately.

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