Patient history : A 28-year-old man presents to the emergency department complaining of anal and lower back pain for the previous 36 hours. He has tried taking simple analgesics with no pain relief. The pain progressively worsened, and he is now finding it uncomfortable to walk or sit down. He is otherwise fit and well and smokes ten cigarettes a day. Physical examination : Inspection of the anus reveals a 3 cm × 3 cm swelling at the anal margin.
The swelling is warm, exquisitely tender, and fluctuant. There is no other obvious abnormality. What is your diagnosis for this patient and how would you treat him? (Answer is posted in the comment section below!) * The Case Challenge is from the Editorial Team of Docplexus and is meant for educational purposes only.
