A painful package on the buttocks is first considered to be a perianal abscess if the package is located under the skin around the anus. A perianal abscess is a purulent inflammation of the perianal rectum caused by an infection of the anal glands in the rectum. Since perianal abscesses have an internal opening, they should be treated surgically. Surgery can be performed either as a one-time radical perianal abscess surgery or as a perianal abscess excision and drainage, followed by anal fistula surgery after the second stage of formation. If the mass is higher than the skin surface, accompanied by pain and a purple-black local color, it is considered thrombosed external hemorrhoids. The thrombosed external hemorrhoid is also clinically considered for surgical treatment first, and can be treated by thrombectomy or thrombosed external hemorrhoidectomy. Some small thrombosed external hemorrhoids can also be treated conservatively by taking 2 oral Diosmin tablets 3 times/day, or 4 tablets of Destructor 3 times/day, and using topical Ma Yinglong hemorrhoid cream.