An unusual case of chronic anal pain--a pin in the bum?
We report the case of a 70-year-old woman who had previously undergone anterior resection in 2001 for a diverticular stricture. Bleeding from pelvic veins intra-operatively necessitated the use of two thumbtacks to aid haemostasis. Over the next 7 years, she presented repeatedly with anal pain, bleeding and mucus discharge per rectum. Multiple lower gastrointestinal endoscopies failed to make a definitive diagnosis until a single thumbtack was found eroding through the rectal mucosa. This was removed and she has been subsequently asymptomatic. This condition was clearly difficult to diagnose and requires a high index of suspicion in those patients who have previously undergone pelvic surgery.
Critchley
Adam Charles
AC
Department of General Surgery, Wansbeck General Hospital, Ashington, Northumberland, UK. adamcritchley@doctors.net.uk
Holtham
Stephen John
SJ
D000368:Aged; D001003:Anal Canal; D002908:Chronic Disease; D004241:Diverticulum, Colon / Q000601:surgery; D005260:Female; D005547:Foreign Bodies / Q000150:complications*; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006801:Humans; D017699:Pelvic Pain / Q000209:etiology*; D012007:Rectum; D012812:Sigmoidoscopy