Trauma to the anus can result in a painful hematoma formation.
Risk factors:
(1) blunt trauma to the anus while riding (horseback, bicycle, other)
(2) anal intercourse, including rape
(3) fall from height onto buttocks
(4) iatrogenic injury
(5) other trauma
Bleeding may be more marked if the patient has a significant coagulopathy, including anticoagulation.
In some cases the hematoma is limited to a portion of the external or internal hemorrhoidal plexus.
In other cases there may be hemorrhage into peri-anorectal soft tissue, which can be significant.
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Specialty: Gastroenterology
