Sitting in Surgery — 35yo Man | General Surgery | SMLE Q#1187
SMLE Question #1187
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 35-year-old man has perianal pain and a lump that started 4 days ago after passing a very hard stool. Pain is now moderate and gradually improving but worsens with sitting. Examination shows a tense, bluish, exquisitely tender 1 × 1 cm perianal nodule under the perianal skin, separate from the anal canal. There is no active bleeding, discharge, fluctuance, or fever, and digital rectal examination is otherwise normal. What is the most appropriate management at this time?
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