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Rectal Pain
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Available online at www.sciencedirect.com
Visual Journal of Emergency Medicine 1C (2015) 24–25 www.elsevier.com/locate/visj
Rectal Pain Laura Vearrier, MDn Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA
Keywords: abscess; rectum; anal canal
A 24-year-old female presents with a chief complaint of rectal pain. She reports that she had a bedside incision and drainage of a perianal abscess 5 days prior to presentation at another hospital. Since that time she has been taking oral ciprofloxacin and metronidazole as prescribed. She states that since that time she has had worsening pain and swelling in the left perineal area. She now has the sensation of feeling like the infection has spread to her bone. She denies fevers. She has had no drainage from the area. On physical examination she appears uncomfortable. Her vital signs are temperature 37.91C, heart rate of 94, blood pressure 120/76. On examination of the perianal area, at the 5 o'clock position there is 6-cm area of erythema, swelling, and tenderness. A 1-cm incision is visible medially with no active drainage. Even after intravenous hydromorphone, the patient refuses a digital rectal examination due to pain (Figs. 1 and 2).
Fig. 1. Coronal section of patient's computed tomography scan.
n
Correspondence to: 245 N 15th St., Mail Stop #1011, NCB Suite 2108, Philadelphia, PA 19102. E-mail address: [email protected]
http://dx.doi.org/10.1016/j.visj.2015.08.007 2405-4690/& 2015 Elsevier Inc. All rights reserved.
L. Vearrier / Visual Journal of Emergency Medicine 1C (2015) 24–25
Fig. 2. Axial section of patient's computed tomography scan.
Appendix. Supplementary Materials Supplementary material cited in this article is available online at http://dx.doi.org/10.1016/j.visj.2015.08.007. References [1] Marx J, Walls R, Hockberger R. Rosen's Emergency Medicine-Concepts and Clinical Practice. Elsevier Health Sciences; 2013. [2] Klein JW. Common anal problems. Med Clin North Am 2014;98(3):609–623.
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Available online at www.sciencedirect.com
Visual Journal of Emergency Medicine 1C (2015) 24–25 www.elsevier.com/locate/visj
Rectal Pain Laura Vearrier, MDn Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA
Keywords: abscess; rectum; anal canal
A 24-year-old female presents with a chief complaint of rectal pain. She reports that she had a bedside incision and drainage of a perianal abscess 5 days prior to presentation at another hospital. Since that time she has been taking oral ciprofloxacin and metronidazole as prescribed. She states that since that time she has had worsening pain and swelling in the left perineal area. She now has the sensation of feeling like the infection has spread to her bone. She denies fevers. She has had no drainage from the area. On physical examination she appears uncomfortable. Her vital signs are temperature 37.91C, heart rate of 94, blood pressure 120/76. On examination of the perianal area, at the 5 o'clock position there is 6-cm area of erythema, swelling, and tenderness. A 1-cm incision is visible medially with no active drainage. Even after intravenous hydromorphone, the patient refuses a digital rectal examination due to pain (Figs. 1 and 2).
Fig. 1. Coronal section of patient's computed tomography scan.
n
Correspondence to: 245 N 15th St., Mail Stop #1011, NCB Suite 2108, Philadelphia, PA 19102. E-mail address: [email protected]
http://dx.doi.org/10.1016/j.visj.2015.08.007 2405-4690/& 2015 Elsevier Inc. All rights reserved.
L. Vearrier / Visual Journal of Emergency Medicine 1C (2015) 24–25
Fig. 2. Axial section of patient's computed tomography scan.
Appendix. Supplementary Materials Supplementary material cited in this article is available online at http://dx.doi.org/10.1016/j.visj.2015.08.007. References [1] Marx J, Walls R, Hockberger R. Rosen's Emergency Medicine-Concepts and Clinical Practice. Elsevier Health Sciences; 2013. [2] Klein JW. Common anal problems. Med Clin North Am 2014;98(3):609–623.
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