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    External hemorrhoids cause severe throbbing pain of sudden onset. Internal lesions are associated with bleeding, protrusion, fecal soiling, and pruritus. External hemorrhoids a single lesion is shown here are found below the dentate line the division between squamous epithelium distally and transitional columnar epithelium proximally and so are covered by skin. Patients experience significant pain when external hemorrhoids are dilated and thrombosed-conditions that stretch the overlying skin. Click here for the next image.
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    Clinical pictures: Perianal problems

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    Hemorrhoids and Anal Fissures: A Short Photo Essay

    This year-old man presented with a very painful infection. There was a large abscess which was easily palpable with surrounding cellulitis. It clearly needed incision so he was admitted for this to be done under general anaesthetic. There was no obvious underlying cause, such as inflammatory bowel disease or diabetes. Following drainage, the abscess cavity required regular dressing but healed well. This man rather sheepishly requested help with the removal of this perianal lesion. It had been present for some years, but his new partner did not like it, making him seek help.
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    Hemorrhoids and Anal Fissures: A Short Photo Essay

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