As I did my rounds, I came across an elderly lady who presented to us with fresh per rectal bleed(bleeding fresh blood from her anus). The medical officer who saw her after taking the history, proceeded to do a digital examination of the anus. She felt some soft bulge for which she assumed that it was haemorrhoids. As it was not bleeding anymore, she admitted the frail lady, for observation.

Suspicious, I decided to examine this cachetic lady myself and to my horror she had a mass in the rectum. I ordered for an urgent colonoscopy and this was the image I saw.

That was cancer of the lower rectum.

Didn’t the famous Norman Browse(editor of a famous surgical textbook) say that you cannot diagnose haemorrhoids with digital examination.

The dangers of assumption!!