Peer Reviewed

What's Your Diagnosis?

A Man With Throbbing, Severe Anal Pain



    Vy Mai, MD1 • Hossein Akhondi, MD2

    1Resident Physician, HCA Healthcare, Far West Division, Mountain View Hospital, Las Vegas, Nevada
    2Internal Medicine Department, HCA Healthcare, North Florida Division, West Florida Hospital, Pensacola, Florida

    Mai V, Akhondi H. A man with throbbing, severe anal pain. Consultant. 2022;62(10):e16-e17. doi:10.25270/con.2021.12.00010

    Received July 26, 2021. Accepted September 1, 2021. Published online December 23, 2021.

    The authors report no relevant financial relationships.

    This research was supported (in whole or part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.

    Hossein Akhondi, MD, West Florida Hospital, 8383 North Davis Highway, Pensacola, FL 32514 (


    A 50-year-old man with no significant medical history and no prior colonoscopy presented to our clinic with severe, constant, throbbing anal pain that had been worsening over the past 5 days. The pain was associated with bright red blood per rectum, described as red streaks on toilet paper. The patient denied weight loss, nausea, fever, or a family history of colon cancer.

    Physical examination findings revealed a tender, grape-sized, purple mass emerging from the anal verge (Figure). A rectal examination was not performed because of excruciating pain associated with palpation.

    Figure. A painful, protruding, purple, partitioned mass with surrounding inflamed skin tags.



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