Question 410

0

A 37-year-old woman presents to the clinic reporting pain in the anal area. She says that the pain is present for at least 30–60 minutes after every time after she completes a bowel movement. Physical examination finds no anal fissure and mild external hemorrhoids. Digital rectal exam reveals a tight anal sphincter and tenderness with traction on the puborectalis muscle. What is the most likely diagnosis?

There's more to see -- the rest of this topic is available only to subscribers.