Anal Abscess

An anorectal abscess originates from an infection arising in the cryptoglandular epithelium lining the anal canal

Anorectal abscesses are classified into:

  • Perinal (most common type)
  • Ischiorectal
  • Intersphincteric
  • Supralevator

Etiology:

  • Anal crypt gland infection (aerobic and anaerobic bacteria)

  • Others (10%):

    • Crohn disease,
    • Trauma,
    • Immunodeficiency (HIV infection, malignancy)
    • Tuberculosis,
    • Hidradenitis suppurativa,
    • Sexually transmitted diseases
    • Radiation therapy
    • Foreign bodies
    • Perforated diverticular disease,, or appendicitis

Symptoms:

  • Pain (Perianal)
  • Swelling
  • Discharge
  • Constipation
  • Inflammatory symptoms (Fever, Chills, malaise)
  • Inflammatory signs
  • Tender DRE

Diagnosis:

  • Clinically
  • Trans-perineal ultrasonography
  • Radiology (CT/MRI)
  • Others (Colonoscope)

Management:

  • I&D, packing, dressing
  • Antibiotics

Complications of anorectal abscesses:

  • Fistula formation (30-60%)
  • Bacteremia and sepsis
  • Fecal incontinence