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患者男,65岁。因肛门突出物2年,10个月前因肛门瘙痒就诊,诊断为痔,行手术切除,术后伤口一直未愈,排便困难逐渐加重,肛门疼痛。5个月前再次行手术治疗,病理示良性病变。术后症状未缓解,肛门疼痛剧烈,坠胀,大便排出十分困难,仅排稀水样便。体检:截石位3、5、7、11点位置肛缘隆起突出,8、7、4点位置见3处较大溃疡,长2~3 cm,隆起物及肛周5 cm范围扪及质硬包块,活动度差,有触痛,肛管、直肠仅能勉强通过小指,直肠下段扪及半环形质硬肿块,不能探及上缘。腹股沟扪及多个肿大淋巴结,活动度差。盆
Male patient, 65 years old. Due to anus over 2 years, 10 months ago due to anal itching treatment, diagnosis of hemorrhoids, surgical resection, the wound has not healed, defecation difficulty gradually increased, anal pain. 5 months ago again surgery, pathology showed benign lesions. Postoperative symptoms did not alleviate, severe anal pain, bulge, stool discharge is very difficult, only a row of dilute watery stools. Physical examination: position 3,5,7,11 for the lithotomy position prominent prominence of the anal edge, 8,7,4 point position to see the three large ulcers, long 2 ~ 3 cm, bump and perianal 5 cm palpable mass range Hard mass, poor activity, tenderness, anal canal, rectum only barely through the little finger, lower rectum palpable semi-circular hard mass, can not explore and the edge. The groin palpable multiple enlarged lymph nodes, poor activity. Pots