The patient reported that in 2015 and early 2016, he had experienced swelling and discomfort in the anus twice, and the swelling and discomfort in the anus disappeared after he was infused with antibiotics.
Seven days ago, he was on a business trip to the southern provinces. Due to the spicy diet and exhausted travel, anal swelling and discomfort reappeared. This time, he did not inject antibiotics, but took anti-inflammatory drugs. As a result, the inflammation could not be controlled and the anal swelling and discomfort became worse. And I felt that the swollen part of the "bulge" went to the anal opening this time. During the examination, there was a surgical scar on the right back of the anus. The skin flushed and swelled at the scar at the anal opening. I inserted the index finger of my left hand into the anus, and the thumb was outside the anus. The two fingers were palpated together, and the size of a quail egg was palpable. The patient’s pain was not severe when palpated (lidocaine glue was injected locally). Give the patient an urgent blood test, four items of coagulation, and electrocardiogram. The result is normal. Therefore, the perianal abscess was incised and drained under local anesthesia in the outpatient clinic. After incision at the most obvious swelling, there was not much bleeding, and a drop of pus was not seen when it was opened with vascular forceps. After further separation, a sludge-like thing the size of soybeans came out of the incision, which was packed with oil gauze.
The cut out foreign body is not hard and easily breaks. As shown in the photo, the patient's analysis may be that the hemorrhoid plug he plugged was not melted and embedded in the tissue.
After 40 days or even months and years after hemorrhoid surgery, a small blister will bulge in the scar of the operation. The patient has no obvious pain, but a little discomfort. Will come out. The patient’s foreign body was relatively large, the local appearance was a lump, and the skin was red. If he reacted more severely, he was mistaken for recurrence of anal fistula. I have seen foreign body embedding thread, gauze strip edge, medicine slag, and rubber band tied with thread. This case has allowed me to increase the types of foreign body embedding.