Anal Polyp vs. Hemorrhoid Node
Left picture: The diagnosis is a polyp of the anal channel. Right picture: This boy has a node due to a thrombus of hemorrhoids. In this case, a cause of the hemorrhoids must be looked for because the patient is too young for simple hemorrhoids, for instance a portal hypertension.
In both toddlers with lower gastrointestinal bleeding a local finding was seen at the anus on examination. Left picture: In the 4-year-old boy loss of blood by the anus was in the forefront of the history. Right picture: This 3-year-old boy complained of spontaneous pain during defecation. Right picture: The mass is part of the transition to the anal channel; it is tense and painful to touch. Left picture: The mass shows some bleeding - notice the perianal region -, is smooth, and continues in a stalk which is adherent to the wall of the anal channel.