Question

A man complained of recurrent discharge and pain due to lesions around the anus for 3 years. What is the diagnosis?

• A. Pilonidal sinus
• B. Carbuncle
• C. Boil
• D. Fistula in ano

Answer 1

The Correct Option is D

The patient presents with recurrent discharge and pain due to lesions around the anus for a duration of three years. The key indicators to consider in this scenario are:

• Recurrent discharge: This symptom suggests a chronic condition that involves a pathway for fluid escape.
• Pain and lesion location: The lesions are localized around the anus, which helps narrow down the differential diagnosis.

Given these symptoms, let's evaluate the options:

• Pilonidal Sinus: This condition typically occurs near the coccyx at the top of the buttocks rather than around the anus. It involves a sinus tract and can cause discharge but is less likely given the location specificity in this case.
• Carbuncle: This is a cluster of boils caused by a bacterial infection that can cause pus formation. It is less likely to be recurrent for several years and primarily occurs on hairy areas with many follicles, not localized to the anal region.
• Boil: Also known as a furuncle, it is a skin infection that involves a hair follicle. Boils can cause pain and discharge but usually resolve after treatment and do not typically recur in the same area for years.
• Fistula in ano: This is an abnormal connection between the epithelialized surface of the anal canal and the perianal skin. It often presents with chronic discharge and pain around the anus, aligning perfectly with the patient's symptoms.

Based on the recurrent discharge and pain specifically located around the anus, the most plausible diagnosis is Fistula in ano, which matches the clinical presentation provided.