Perianal Abscess

Perianal Abscess:

An anal abscess (also known as an anal/rectal abscess, peri-rectal/peri-anal abscess, or ano-rectal abscess) is an abscess (a large pocket of infection) adjacent to the anus.An abscess is a collection of pus within the body. A perianal abscess refers to an abscess in the area around the anus. There are numerous different names given to these abscesses, depending on their actual location. Those in the skin adjacent to the anus are perianal abscess. Those that are deep seated and lie next to the muscles are called ischiorectal abscess. Some uncommon abscess that lies between the 2 layers of the sphincter muscles are called intersphincteric abscess.

Symptoms:

The condition invariably becomes extremely painful, and usually worsens over the course of just a few days. The pain may be limited and sporadic at first, but invariably worsens to a constant pain which can become very severe when body position is changed (e.g., when standing up, rolling over, and so forth). Depending upon the exact location of the abscess there can also be excruciating pain during bowel movements, though this is not always the case. This condition may occur in isolation, but is frequently indicative of another underlying disorder, such as Crohn’s disease.Pain is usually the most obvious symptom. The more superficial abscess may also start as a swelling that is painful when touched. The area may also feel warm to touch. This pain is persistent and may be worse when passing motion.
Some patients are so fearful of the pain that they avoid passing motion when they have an abscess. For some of the deep abscesses, pain may be the only symptom. Although an abscess is due to an infection, fever may not always be present. Some of the abscesses are very deep seated and pain may be the only symptom.
In some cases, the skin over the abscess may break and pus (and sometimes a bit of blood) may discharge. The pain and swelling would usually improve after the pus is discharged, but you should still see your doctor to ensure that all the pus is cleaned out. If the pus is not properly cleared, the abscess can recur in the near future.
Some people confuse the swelling with hemorrhoids (piles).

Causes:

Abscesses are caused by a high density infection of (usually) common bacteria which collect in one place or another for any variety of reasons. All abscesses can progress to serious generalized infections requiring lengthy hospitalizations if not treated. Historically, many rectal abscesses are caused by bacteria common in the digestive system, such as E. coli.

Diagnosis:

Most of the time, it is fairly easy to diagnose an abscess, just by looking at it and touching it.
In some of the rare deep abscesses, it might require either ultrasound, C.T scan or even M.R.I for an accurate diagnosis.

Treatment:

Some of the very small and early abscesses may be treated with antibiotics and use of a needle and syringe to suck out most of the pus.
Most abscesses require incision and drainage. This is a minor surgery in which the skin over the abscess is cut open and the pus is washed out. The skin cut is not stitched back, and the open wound requires daily cleaning to ensure that no remnant pus stays behind.

Pilonidal Sinus D 1