Description

A perianal abscess is a collection of pus in the tissue surrounding the anus and rectum. It's typically caused by an infection of the anal glands, often due to blockage, and can be quite painful. Here's a comprehensive overview: --- 🔍 Causes Obstruction of anal glands (most common) Infection by bacteria, especially anaerobic bacteria or E. coli Conditions like: Crohn’s disease Diabetes Immunosuppression Trauma or surgery in the anal area --- ⚠️ Symptoms Severe pain in the anal or rectal area (worse with sitting, bowel movements) Swelling, redness, and warmth near the anus Fever, chills, and general malaise (if infection spreads) Pus drainage (if the abscess ruptures) A visible or palpable lump near the anus --- 🔬 Diagnosis Physical examination: Often sufficient, especially if the abscess is superficial Rectal exam: To detect deeper abscesses Imaging (if needed): Ultrasound, MRI, or CT scan for deep or complex cases --- 💉 Treatment 1. Incision and drainage (I&D) – Mainstay of treatment Usually performed under local anesthesia May be done in the ER, clinic, or operating room 2. Antibiotics Not always necessary after I&D unless: Immunocompromised Signs of systemic infection Extensive cellulitis Diabetic or other high-risk groups 3. Pain management NSAIDs or acetaminophen Sitz baths for comfort and hygiene --- ⚠️ Complications Fistula-in-ano: Occurs in up to 40–50% of cases An abnormal connection between the anal canal and the skin Recurrent abscess Spread of infection (e.g., sepsis, especially in immunocompromised) --- 📌 Follow-Up Monitor for signs of a fistula: Persistent drainage, recurrent infections Surgical intervention may be needed later if a fistula develops ---