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What is Anal Abscess / Perianal Abscess?
Anal abscess is also called perianal abscess. It is a common acute bacterial infection-associated disease. The perianal gland becomes infected, and a pus collection (abscess) forms around the anus. Anal abscesses rarely rupture on their own and often require surgical incision and pus drainage. It may be associated with anal fistula.
With appropriate and prompt surgical incision and drainage, morbidity and mortality from a perirectal abscess are very low.
Delaying surgical treatment of an anal abscess, or in immunocompromised patients (e.g., those with diabetes, Crohn's disease, or patients taking steroids), the abscess may progress to a potentially deadly condition such as necrotizing fasciitis or Fournier's gangrene. Necrotizing fasciitis or Fournier's gangrene may lead to other serious complications, such as bacteremia, sepsis, septic shock, and death.
Causes
Anal abscess occurs more frequently in men. The anal gland inside the anus is infected by fecal bacteria(e). With the accumulation of pus, an abscess is formed eventually.
Symptoms
- Painful lump around the anus with local increase in temperature and redness
- Pain/tenderness around the anus upon touching/sitting
- Pus leakage/blood-stained discharge
- Fever
- General malaise
Diagnosis
Experienced surgeons can confirm the perianal abscess diagnosis upon bedside examination. Rarely, it may require needle aspiration of pus bedside, ultrasound scan, CT scan or MRI scan to confirm the diagnosis. Surgeons need to rule out other causes of anal abscess.
Treatment
The gold standard of abscess treatment is surgical incision and drainage.
Medicines
Medicines are used to control the disease and relieve the symptoms of the anal abscess. Commonly used medicines are:
- Antibiotics
- Analgesics
- Laxatives
- Local anaesthetic agents
Surgical Treatment
Surgical incision and pus drainage of an anal abscess are performed by experienced surgeons under local anesthesia, spinal anesthesia, or general anesthesia.
Post-Surgery Care
After surgery, patients need to have wound cleansing, wound gauze packing, and wound dressing after bowel movements or showers. Most wounds will heal with daily cleansing and dressing within one to two months after surgery. Some wounds shrink but do not heal and have intermittent pus-like or blood-stained turbid discharge. If your wound does not heal within one to two months after incision and drainage of an anal abscess, you should seek advice from an experienced surgeon to rule out an anal fistula.
FAQs
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