Approach to perianal problems Quiz: Ace Your Exams
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An 83-year-old woman presents to the emergency department with a rectal mass. She states that she feels a mass protruding from her rectum when she strains to use the bathroom. She has not had rectal pain, drainage, fevers, or chills, but she has been experiencing incomplete defecation and noticing streaks of blood on the toilet paper. She has four children, all born via spontaneous vaginal deliveries. She takes a stool softener for constipation. Temperature is 37.0 °C (98.6 °F), pulse is 84/min, blood pressure is 145/95 mmHg, and SpO2 is 100% on room air. Physical exam is notable for circumferential rings of soft rectal mucosa protruding from the rectum with Valsalva. Digital rectal exam is otherwise unremarkable. Which of the following is the most likely diagnosis?
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