Approach to hematochezia Quiz: Ace Your Exams

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A 30-year-old woman presents to the emergency department with a 2-day history of severe pain with defecation. She has also noticed bright red blood in her stool. The pain lasts for a few hours after she has a bowel movement. Prior to the onset of the pain and blood in the stool, she had experienced increased straining to pass bowel movements and noticed that her stools were hard. She does not have abdominal pain or fever. She has no significant medical history. Temperature is 99.0°F; pulse is 92/min, and blood pressure is 132/84 mmHg. Peri-anal examination reveals a painful lesion that can be seen below. Which of the following is the most likely diagnosis?

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Hemorrhoids

Perianal abscess

Anal fissure

Solitary rectal ulcer syndrome

Anal cancer