This gentleman presented with bleeding via his anus and felt like there was some swelling protruding out of his anus everytime he opens his bowels. Initial examination revealed this:

Picture 1

Then on further investigations, we found this:

Picture 2.1

Picture 2.2

Care to guess what picture 1 and picture 2 is about? Picture 1 is a common occurrence which many take for granted when one presents with bleeding from the anus. True enough apart from losing blood, this condition is almost never a threat for life. However, assumptions can be lethal as a significant number of them with Picture 1 might have an associated problem or pathology as for example in this patient in Picture 2.

The take home message – never assume that all is fine.