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Blood and puss coming from hole above butt hole. Have hurting lump on back. How to get cured?

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hi I am a 24 year male I have had this issue for about 2 1/2 years. I have a hole roughly and inch above my butt hole the bleeds and pusses. It started after a day or two of bad diarrhea I had a lump back there that hurt like hell eventually I popped it and a lot of puss came out since then I have had to pop it a couple of time. there is what feels like to me a large vain under the hole and from what I can tell it leads into the anus. I had a doctor look at it about a year ago in a physical. he said it was hemorrhoid related a varicose vain or something. any way I have just gone through appendix surgery and have had a lot of lose stools needless to say Im getting quite sore back there. however the hole is really causing me a lot of issues. when i started having bms after the surgery there was a lot of blood coming out of it more then any other time before. about a week later my butt hole was so sore it was hard to figure out that the pain was coming from the hole or rather the mass under it. it was causing so much pian that I had to try to pop it, when i did not much puss came out but it feel a lot better back there. 2 days later the pain was back I poped it again and alot of puss came out. now i thought that this was the end but no now daily this thing is getting painful and is now pussing on its own without me even touching it. please help and info much a appreciated
Posted Mon, 6 Aug 2012 in Skin Hair and Nails
 
 
Answered by Dr. Indranil Ghosh 4 hours later
Hi
Thanks for writing in.

I understand your concern. That hole is obviously bothering you because of the pain, bleeding and pus discharge.

From what you have described there are two possibilities-
1. It is a pilonidal sinus-something related to hair getting inside and forming a blind channel which accumulates pus repeatedly. If a vein is inside then it may bleed also.
2. If it really extends into the rectum or anal canal, then it has to be a perianal fistula, which forms after an infection which ruptures both inside and outside.

In both of these cases, as it is bothering you, it is prudent to repair it by surgery. It is not a major surgery and sometimes possible under local anesthesia. If pus is present now, then a course of antibiotics before the surgery will be required.

Hope I have answered your query. I will be happy to answer any follow-up queries.
Best Wishes,
Above answer was peer-reviewed by
 
Follow-up: Blood and puss coming from hole above butt hole. Have hurting lump on back. How to get cured? 16 hours later
is there any chance the there could be a not operable situation? or are we talking no issues same day surgery? like I said I just got my appendix done I would really hate to have to go through something like that back to back.
 
 
Answered by Dr. Indranil Ghosh 9 hours later
Hi

I am afraid that with the kind of symptoms you are having, it appears that surgery will be required. However, as you have said correctly it is a day care surgery and you won't have most of the problems associated with the surgery you just had.
Above answer was peer-reviewed by
 
Follow-up: Blood and puss coming from hole above butt hole. Have hurting lump on back. How to get cured? 39 hours later
ok so my surgeon that did my appendix confirmed that it is a fistula yesterday however, I am slightly concerned because the way that he explained the procedure to me is that he was going to turn the tube into a valley which sort of makes sense, my issue is that this has been going so long how does he know what he's cutting into without prior imaging. all he did was feel around back there.
 
 
Answered by Dr. Indranil Ghosh 8 hours later
Your surgeon is absolutely right in the fact that the tube has to be converted to a valley so that pus does not accumulate.

Usually for perianal fistula no imaging is required unless the surgeon suspects anything else after the physical examination.

Best wishes.
Above answer was peer-reviewed by
 
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