Anorectal: perianal haematoma: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Anorectal: perianal haematoma

Sample item

A patient has sudden severe perianal pain with a tense, bluish, tender lump at the anal verge, seen within 24 hours of onset. What is the best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Evacuation of the clot under local anaesthesia

A thrombosed external pile (perianal haematoma) is a clot in the subcutaneous external plexus, usually after straining. Early excision or evacuation under local anaesthesia gives rapid relief, while late presenters improve with analgesia, stool softeners and sitz baths. Banding is applied only to internal piles.

Option by option

  • A. Total haemorrhoidectomy

    Formal haemorrhoidectomy is not needed.

  • B. Evacuation of the clot under local anaesthesia (correct)

    Correct. Early evacuation relieves the pain quickly.

  • C. High-dose antibiotics only

    Antibiotics do not treat a clot.

  • D. Rubber band ligation

    Banding treats internal haemorrhoids.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Evacuation of the clot under local anaesthesia. A thrombosed external pile (perianal haematoma) is a clot in the subcutaneous external plexus, usually after straining.

Why is "Total haemorrhoidectomy" not the answer?

Formal haemorrhoidectomy is not needed.

Why is "High-dose antibiotics only" not the answer?

Antibiotics do not treat a clot.

Why is "Rubber band ligation" not the answer?

Banding treats internal haemorrhoids.

What concept does this question test?

It tests Anorectal: perianal haematoma in General Surgery. Early excision or evacuation under local anaesthesia gives rapid relief, while late presenters improve with analgesia, stool softeners and sitz baths. Banding is applied only to internal piles.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Anorectal: perianal haematoma?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.