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Painfulanal
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Dear Editor, A 27-year-old male presents with severe anal pain for the past 2 days.

He complains of a mass around his anus.

His bowel movements have been generally normal, but recently, they have been very painful.

Even sitting causes significant discomfort.

He denies any fevers, rectal bleeding, or any trauma to the area including anal sex.

His past medical, surgical, and social histories are otherwise unremarkable.

Examination shows a tender 4.5.5 cm lesion with some bluish spots at 9 oclock which partially obstructs the external anal canal.

After achieving local anesthesia with lidocaine 1, using.

11 scalpel, multiple relatively large thrombi removed.

Patient immediately felt better after procedure.

A painful atraumatic external anal lesion is a relatively uncommon condition.
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