2021年2月6日星期六

are hemorrhoids hard,Doctor Du has something to say (13)-Why is there a bag beside the anus?

    Patients and friends often consult about problems such as a long bag in the anus, purple lumps during defecation, and a small fleshy meat in the anus. Today, I will talk about some common lumps around the anus and rectum with everyone. I hope to be right. Solve the doubts in your mind.

    1. Hemorrhoids

    1. External hemorrhoids of connective tissue

    Due to the repeated stimulation of acute and chronic inflammation, connective tissue hyperplasia and hypertrophy occurred in the skin of the anal marginal fold, mainly including sentinel hemorrhoids (secondary to anal fissure, mostly located on the outer edge of the fissure), epidermal external hemorrhoids. It is the meat or skin patch described by most patients, and its main symptom is foreign body sensation in the anus.

    2. Varicose external hemorrhoids

    The soft mass on the edge of the anus is mostly an enlarged varicose vein plexus under the tooth line. It is manifested by the falling and rising of the anus, and the appearance is mostly dark red soft mass.

    3. Thrombotic external hemorrhoids

    A blood clot formed by rupture of the external hemorrhoid vein and blood accumulated under the skin. Visually, it was mostly a single dark purple mass with persistent severe pain.

    4. Severe internal hemorrhoids

    Internal hemorrhoids and hemorrhoids are enlarged and can protrude outside the anus during defecation. If it is not received in time, internal hemorrhoids can be incarcerated.

    2. Benign anorectal tumors

    1. Rectal polyps

    It is a common benign tumor of the rectum, a neoplasm on the mucous membrane. If the position is low or the polyp is large, it can come out of the anus during defecation. Polyps are generally pedicled.

    2. Anal papillary hypertrophy (anal papilloma)

    The location is near the anal sinus, the surface is smooth, grayish-white, there is no blood in the stool, and it can also prolapse outside the anus, often accompanied by anal fissures.

    3. Perianal infectious diseases

    1. Perianal abscess

    An infection that occurs in the space around the rectum. It is characterized by sudden onset, severe pain, obvious redness and swelling, which may be accompanied by symptoms such as high fever, and anal fistula after rupture.

    2. Anal fistula

    Masses caused by anal fistulas are mostly caused by fibrosis of the external mouth of chronic anal fistulas. Single or multiple bulging packets on the skin surface can be seen, and some patients often rupture and bleed pus and blood.

    3. Boils

    Acute purulent disease of the superficial area of ​​the perianal skin with a small area. The range is mostly less than 3cm, the color is red, burning, painful, easy to pus, easy to rupture, and easy to close the mouth.

    4. Sebaceous cysts are also called acneoma or lipoma. It is a disease of sebum secretion retention. It is more common among young people. The main manifestations are blackheads and cyst infections in the lesions, and occasionally cancerous changes occur.

    Four, perianal skin disease

    1. Condyloma acuminatum

    It is a benign neoplasm caused by human papillomavirus, and a few have the possibility of malignant transformation. Mainly through sexual transmission. Mainly manifested as the appearance of single or clustered light red or gray vegetations on the skin around the anus.

    2. Syphilis

    Papules or infiltrating erythema appear in the perianal period at the initial stage, and after a few weeks, they appear higher than the skin surface, with clear boundaries, and the surface is wet and rotten. The particles are densely packed like cauliflower and covered with flat condyloma with off-white film. It is mainly transmitted through unclean sexual intercourse, and occasionally indirectly through kissing, breastfeeding, or contact with contaminated clothing and blood transfusions. It can also be transmitted from mother to child.

    3. Perianal eczema

    The skin lesions are often symmetrical, primary and pleomorphic (often erythema, flushing, papules, papules, blisters, pustules, and scabs coexist), and the lesions are often flaky or diffuse. Due to improper treatment, chronic eczema and lichen-like changes can occur if the skin does not heal for a long time.

    4. Paget disease

    Also known as eczema-like carcinoma, it is an adenocarcinoma that occurs in the skin and is rare clinically. It can be divided into Paget disease of the breast and Paget disease outside the breast. Perianal Paget's disease (PPD) belongs to extramammary Paget's disease, which is more rare in clinical practice.

    Five, hemangioma

    Anorectal hemangioma has blood as the main symptom. It usually occurs in young people or children. Long-term bleeding can cause anemia. If it is a diffuse hemangioma, severe bleeding may occur. Patients with hemangioma are often accompanied by intussusception, volvulus, and intestinal obstruction.

    Six, anal malignant melanoma

    Malignant melanoma usually occurs in the skin and eyes, and the anus is the third most common site. Malignant melanoma of the anus is rare, accounting for 0.4% to 0.8% of colorectal malignant tumors, and 1.2% to 1.6% of anal malignant tumors. It mostly occurs in middle-aged and elderly people, and there is no significant difference in the incidence of men and women. 70% to 90% of the disease occurs in the anal canal of the dentate line, and the rest occurs in the perianal skin. It grows rapidly, has a high degree of malignancy, metastases early, and has a very poor prognosis. The transitional part of the anal canal is a 1cm wide circular area upwards from the dentate line, some under the dentate line, and some above the circular area. There are melanocytes and endocrine cells in the circular area. Therefore, malignant melanoma and carcinoid can occur. . Clinical symptoms such as prolapse and blood in the stool are often present.

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