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Perirectal Abscess, Pediatric

Naamah Levy Zitomersky, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Abscess in the perirectal area

  • May be associated with fistula-in-ano

  • Classification of the abscess is based on the location in relation to the levator and sphincteric muscles of the pe...

DIAGNOSIS

Signs and symptoms 
  • General

    • Constant anal or perianal pain that often precedes local findings

    • Localized swelling, erythema, and fluctuance

    • Painful defecation or ambulation

    • Constitutional symptoms...

TREATMENT

GENERAL MEASURES

  • Lack of fluctuation should not delay treatment.

  • Abscess should be drained with placement of a seton or drainage catheter.

  • Abscess should be cultured at time of drainage to dire...

ONGOING CARE

  • If abscess recurs, consider other associated conditions (e.g., neutropenia, HIV, diabetes mellitus, Crohn disease, rectal duplication cyst).

  • Exploration for fistula-in-ano is recommended t...

ADDITIONAL READING

  • Caliste X, Nazir S, Goode T, et al. Sensitivity of computed tomography in detection of perirectal abscess. Am Surg.  2011;77(2):166–168. [View Abstract on OvidInsights]

  • Chang HK...

CODES

ICD9

  • 566 Abscess of anal and rectal regions

  • 565.1 Anal fistula

ICD10

  • K61.1 Rectal abscess

  • K60.3 Anal fistula

  • K61.3 Ischiorectal abscess

  • K61.4 Intrasphincteric abscess

SNOMED

  • 91669008 Perirectal abscess (...

FAQ

  • Q: What are complications of this problem?

  • A: Fistula formation is seen in up to 50% of patients, with a predilection for males.

  • Q: What are the most common organisms of the abscess?

  • A: Staphylococcu...

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