Question
A tumor the size of an egg yolk has appeared inside a child’s anus, without significant symptoms, causing pain during bowel movements and difficulty in expelling the mass. It requires manual assistance to be reinserted.
Answer
Firstly, I have concerns about the doctor’s attitude at the provincial hospital. Based on your description, I have not seen a thorough exposure examination of the child’s anus, such as basic visual and rectal examinations, which raises questions about his diagnostic approach. Could you please tell me how large the mass is? Is it connected to the intestinal wall by a stalk, or is it a semiliquid mass that can only be seen outside the anus? If there is a stalk, it may be considered a neoplasm on the intestinal wall and requires surgical and pathological examination. If it appears spherical, while not entirely ruling out a neoplasm, it is more likely to be anal prolapse. The appearance of such a mass in a child at 4 years old reduces the possibility of congenital diseases. The likelihood of a child developing such a large polyp or tumor at 4 years old is also low, and the presence of the mass during bowel movements is related to increased abdominal pressure, so anal prolapse is initially considered. In children, anal prolapse is a self-limiting condition that usually resolves by age 5 to 6 as the child grows and develops. Therefore, non-surgical treatment is recommended, focusing on correcting constipation and establishing good bowel habits to improve symptoms. (Disclaimer: Online consultation does not constitute medical advice and does not carry any liability for any consequences.)