Perianal Abscess
A collection of pus near the anus causing severe pain and swelling.
Overview
A perianal abscess is a collection of pus near the anus, resulting from infection of the anal glands. It's extremely painful and requires urgent surgical drainage. About 30-50% of perianal abscesses develop into anal fistulas, so follow-up is important.
Causes
- Infection of anal glands (cryptoglandular theory)
- Blocked anal gland duct
- Crohn's disease
- Immunosuppression
- Diabetes
- Trauma
- Foreign body
Risk Factors
- Diabetes
- Crohn's disease
- Immunosuppression
- HIV
- Previous abscess
- Smoking
- Anal fissure
Symptoms
Diagnosis
- Clinical examination (visible swelling, fluctuance)
- No imaging usually needed for superficial abscesses
- MRI pelvis for deep/recurrent/complex abscesses
- CT scan if systemic sepsis
- Examination under anesthesia (EUA)
Treatment Options
Surgical Treatment
Incision and drainage under local or general anesthesia is the definitive treatment. The abscess is opened, pus drained, and the cavity left open to heal from inside out. Dr. Bhagat performs primary drainage with assessment for fistula tract — if a simple fistula is identified, primary fistulotomy can be done simultaneously to prevent recurrence.
Recovery
Same-day procedure. Pain relief is immediate after drainage. Wound care with daily sitz baths for 2-4 weeks until healed. Follow-up at 6-8 weeks to check for fistula formation.
Prevention
- Good perianal hygiene
- Treat constipation promptly
- Control diabetes
- Seek early treatment for anal pain/swelling
- Don't attempt to squeeze or drain at home
Frequently Asked Questions
Can I treat a perianal abscess with antibiotics alone?
Will the abscess come back?
Expert Consultation Available
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