Thrombosed external hemorrhoids and perianal abscesses are essentially different: first, the causes are different: thrombosed external hemorrhoids are caused by varicose veins around the anus, mainly related to unhealthy diet and living habits, while perianal abscesses are formed mainly due to acute purulent lesions at the end of the rectum, causing infection of the anal glands and spreading to the skin around the anus. Secondly, the symptoms are different between the two. Thrombosed external hemorrhoids usually cause anal pain and itching, and also cause blood in the stool, while perianal abscesses cause itching and redness, swelling and pain in the skin around the anus, and also lead to yellow pus around the anus. Finally, the treatment methods for both are different. Thrombosed external hemorrhoids can be treated by conservative methods such as topical ointment, while perianal abscesses require surgical incision and drainage.