患者女,68岁,因“排便费力4 d,便血1 d”之主诉入院。入院前4 d无明显诱因排便时费力,自觉不畅,需自行挤压肛门周围,方可排出少量黄色干结大便。入院当天清晨排大量暗红色血液,感肛门处疼痛,憋胀,下坠感明显,门诊肛诊:距肛门口约3 cm 3点位可触及局部黏膜表面颗粒样,欠光滑,与周围黏膜界线欠清,远端无法触及,指套血染,以“直肠 Female patient, 68 years old, due to ”defecation effort 4 d, blood in the stool 1 d “ the main complaint was admitted. 4 d before admission no obvious incentive for defecation effort, consciously poor, need to squeeze around the anus, before discharge a small amount of yellow dry knot stool. Early on the day of admission a large number of dark red blood row, feeling anal pain, bloating, obvious sense of falling, outpatient anal diagnosis: about 3 cm 3 away from the anus can touch the local mucosal surface of granular, less smooth, and the surrounding mucosal line Clear, remote can not touch, refers to blood stained sleeve, with ”rectum