Q. I have a hard, tender and warm lump near my anus. What is it?

Answered by
Dr. Sumit Srivastava
and medically reviewed by iCliniq medical review team.
Published on Apr 02, 2016 and last reviewed on: Oct 03, 2019

Hi doctor,

I am in real pain for past 9 months and my doctor is clueless after several visits. After a period of 38.6 weeks in latent labor, I had a vacuum assisted vaginal delivery (first baby). No ultrasound was done the very day of admission. With crowning left medio-lateral episiotomy was given. Extension of 1.5 cm up to anal sphincter was given and sutured. I gave birth to 3.6 kg baby girl. After 2-3 days in hospital I kept complaining about excessive pain and burning in that suture compared to others. I was told that it was normal. After a month I could barely sit and feed my baby. In follow up doctor told me it was normal and healing. After 2 months it worsened again and I could feel a hard lump in left side below my vagina and near anus. It has been 9 months now after my delivery and every 4th day or once in a week I get the lump tender, warm and hardness in between my vagina and anus, along with discharge of pus or light color blood which is immensely painful. It keeps coming back always. I am getting weaker day by day. Mild fever, stiffness in legs, body ache, inability to move and sit when the pus forms until it discharges from a hole that has been there always. The same hole closes each time after discharge. Which doctor should I visit? Please help me urgently. What can this be?

Dr. Sumit Srivastava

General Medicine Internal Medicine
#

Hi,

Welcome to icliniq.com.

I have gone through your complaint.

  • It seems there is fistula (tunnel like passage) formation leading to recurrent perianal abscess in your anogenital area. But it needs to be examined to confirm the diagnosis.
  • I would suggest you to consult an experienced surgeon for further physical examination and have yourself examined.
  • After diagnosis is confirmed, surgical excision of the entire fistulous tract is the treatment of choice for the recurrent anal abscess.

The Probable causes:

Episiotomy.

Investigations to be done:

Fistulogram.

Differential diagnosis:

Abscess.

Probable diagnosis:

Fistula.

Treatment plan:

Fistulectomy with antibiotic coverage.

Regarding follow up:

Revert back after investigations to an internal medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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