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Perianal Disease

Michael J Eiswerth, Doctor of Osteopathic Medicine and Tyler D Sharpe, MD Reviewed 06/2021
 


BASICS

DESCRIPTION

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

  • 60% are perianal; the remainder are intrasphincteric or supralevator.

  • On clinical con...

DIAGNOSIS

HISTORY

  • Perirectal pain, particularly with sitting or defecation

  • Constipation

  • Fever, chills

  • Spontaneous foul-smelling drainage

PHYSICAL EXAM

  • Fever (20%)

  • Perirectal swelling (superficial abscesses)

  • P...

TREATMENT

GENERAL MEASURES

  • Incision and drainage with packing is the primary treatment of choice for perianal abscesses (3)[B].

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

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Postoperative care

    • Sitz baths every 2 to 4 hours

      • Sit in bathtub with warm water, with or without additives such as Epsom salts.

    • Heating pad or warm compress as neede...

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. [View Abstract on Ovi...

ADDITIONAL READING

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

SNOMED

  • 75236001 anorectal abscess (disorder)

  • 36046008 Ischiorectal abscess...

CLINICAL PEARLS

  • Anorectal abscess must be treated promptly.

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

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