Differential Diagnosis for Swollen Perineum
- Single most likely diagnosis
- Hemorrhoids: This is a common condition that can cause swelling in the perineal area, especially if the hemorrhoids are thrombosed or prolapsed. The swelling is usually accompanied by pain, itching, and bleeding.
- Other Likely diagnoses
- Perineal abscess: An infection in the perineal area can cause swelling, pain, and redness. This condition often requires drainage of the abscess.
- Perineal hematoma: Trauma to the perineal area, such as from a fall or childbirth, can cause a collection of blood to form, leading to swelling and pain.
- Bartholin's cyst or abscess: A cyst or abscess of the Bartholin's gland, located on each side of the vaginal opening, can cause swelling and pain in the perineal area.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Necrotizing fasciitis: A severe infection that can cause rapid progression of swelling, pain, and necrosis of the tissue. This condition requires immediate medical attention.
- Fournier's gangrene: A rare but life-threatening condition characterized by necrotizing fasciitis of the genital and perineal area.
- Rectal cancer: Although less common, a tumor in the rectum can cause swelling in the perineal area, especially if it has spread to the surrounding tissues.
- Rare diagnoses
- Lymphogranuloma venereum (LGV): A sexually transmitted infection that can cause swelling and ulceration in the perineal area.
- Hiddenitis suppurativa: A chronic skin condition that can cause abscesses and swelling in the perineal area.
- Perineal sarcoma: A rare type of cancer that can cause swelling and a mass in the perineal area.