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Anorectal Abscess

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Localized induration, inflammation, and infection of the cryptoglandular tissues of the anal canal

  • 80% are perianal; the remainder are intrasphincteric or supralevator.

  • System(s) affec...

DIAGNOSIS

HISTORY

  • Perirectal pain, particularly on defecation or with sitting

  • Constipation

  • Fever, chills

  • Spontaneous foul-smelling drainage

PHYSICAL EXAM

  • Fever (20%)

  • Perirectal swelling (superficial abscesse...

TREATMENT

GENERAL MEASURES

  • Incision and drainage with packing is the primary treatment of choice for perianal abscesses (2)[B].

  • Simple abscesses can be treated in office or ED under local anesthesia. Mo...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Postoperative care

    • Sitz baths every 2 to 4 hours

      • Simplest method is to sit in bathtub with warm water, with or without additives such as Epsom salts.

    • Heating pad or ...

REFERENCES

1
Rizzo JA, Naig AL, Johnson EK. Anorectal abscess and fistula-in-ano: evidence-based management. Surg Clin North Am.  2010;90(1):45–68. {L-End} [View Abstract on OvidMedline]
2
Malik AI...

ADDITIONAL READING

  • Abcarian H. Anorectal infection: abscess-fistula. Clin Colon Rectal Surg.  2011;24(1):14–21.

  • Afşarlar CE, Karaman A, Tanir G, et al. Perianal abscess and fistula-in-ano in child...

SEE ALSO

Anorectal Fistula 

CODES

ICD10

  • K61.2 Anorectal abscess

  • K61.3 Ischiorectal abscess

  • K61.4 Intrasphincteric abscess

  • K61.1 Rectal abscess

  • K61.0 Anal abscess

ICD9

566 Abscess of anal and rectal regions 

SNOMED

  • 75236001 anorectal absc...

CLINICAL PEARLS

  • Anorectal abscess should be treated immediately.

  • Patients with systemic signs of infection or who are suspected of having complex abscesses require hospital admission and surgical consu...

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