A rectal sub-mucosal hematoma, imperfectly called a thrombosed external pile or external hemorrhoid, is a collection of blood within the skin around the anus, occurring due to a ruptured blood vessel within the sub-mucosa usually caused by some minor trauma such as hard stool or due to severe constipation. Present case is a six year old girl child came into view with large mass coming out from anus with red dark- purple collection, pain and discomfort. She was unable to walk or sit. On examination no significant history of trauma except constipation, there was no history of per rectal bleeding. Suddenly a swelling appeared after defecation. She was hospitalized for surgical excision. After hospitalization this swelling burst and reduced with discharge of clotted blood.

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Corresponding author
Kiran Khandare, Mahatma Gandhi Ayurved College Hospital and Research Center, Salod (H), Wardha, Maharashtra, India (kbkhandare@gmail.com)