A 28-year-old man presents with sudden onset severe anal pain and a tender, bluish lump at the anal verge that appeared after heavy lifting. The most appropriate management within the first 48 hours is:
- A Incision and evacuation of the thrombus ✓
- B Warm sitz baths and analgesics
- C Rubber band ligation
- D Hemorrhoidectomy
Correct answer: A. Incision and evacuation of the thrombus
Explanation
Thrombosed external hemorrhoids cause intense pain due to clot formation in a subcutaneous vein. Incision and clot evacuation within 48-72 hours provides rapid relief. Conservative measures are used beyond this window. Rubber band ligation is for internal hemorrhoids, and hemorrhoidectomy is reserved for prolapsed strangulated hemorrhoids.
Reference: Sabiston Textbook of Surgery, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.