SOLVED1394

67-year-old male presents for evaluation of chief complaint “small painful lump near anus” HPI Reports noticing small lump near his anus in the last week. States lump is tender to touch but area is not red or warm. Denies bleeding from lump or blood in his stool. Noted clear malodorous drainage from lump within the last 48 hours. Reports it is painful to sit and he has been unable to work as a school bus driver for the last 2 days. Pain is constant, reports taking acetaminophen 650mg approximately three times daily as needed for pain. Has also been taking sitz baths and warm showers to keep the area clean and reduce pain. Pain is not worse with defecation. No injury or trauma to the anus or rectum. No sensation of tearing or ripping. Having regular soft bowel movements with last reported bowel movement this morning. No change to diet and no recent abnormal strenuous activity. Endorses remote history of hemorrhoids for which he has used OTC preparation H but states this “does not feel like a hemorrhoid.”
SCIENCE
HEALTH SCIENCE
NURSING

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