Purulent Discharge in Surgery — 42yo Man | General Surgery | SMLE Q#7424
SMLE Question #7424
Surgery
General Surgery
Objective: OBJ-TRACH-EMERG-01
Last updated: February 2026
A 42-year-old man has 4 days of severe, constant throbbing anal pain with purulent discharge, worse with sitting and defecation. Perianal inspection shows no external swelling, erythema, or visible opening. Digital rectal examination reveals a very tender, fluctuant mass confined to the anal canal, without extension to the perianal skin. Which of the following is the most likely diagnosis?
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