ANORECTAL ABSCESS

There are four types of abscesses:

  1. submucosal
  2. subcutaneous (perianal)
  3. ischiorectel
  4. high intermuscular.

Usually there is no apparent cause, but certain underlying diseases such as Crohn’s disease, ulcerative colitis, rectal
cancer, HIV disease, diabetes mellitus, and active tuberculosis may be present.

Clinical Features

Presents as acute painful swelling with fluctuation not always obvious and there is pain on defecation and blood-stained purulent anal discharge.

Complications

  • Fistula formation
  • Recurrence of the abscess
  • Sinus formation.

Management

  • Give tabs diclofenac 50mg 8 hourly or ibuprofen 400mg 8 hourly for the appropriate duration.
  • Incise and drain under general anaesthesia (de-roof by making a cruciate incision and excising the four triangles of skin).
  • Take a pus swab for culture and sensitivity.
  • Advise saline sitz bath and stool softeners.