I. See Also

II. Epidemiology

  1. More common in men

III. Pathophysiology

  1. Infection of anal glands
    1. Occurs at mucocutaneous junction (Dentate Line)
  2. Contiguous spread of infection in to ischiorectal space
  3. Causative organisms: Mixed infection with fecal flora
    1. Bacteroides fragilis (most common in adults)
    2. Escherichia coli (most common in children)

IV. Types

  1. Perianal Abscess (60%)
    1. Local Perianal Abscess
    2. Immediately adjacent to anal verge
  2. Ischiorectal Abscess (25%)
    1. Inferior to levator ani
    2. Two to 3 cm from anal verge
  3. Pelvirectal Abscess
    1. Superior to levator ani
    2. Pelvic or intraabdominal source
  4. Intersphincteric Abscess

V. Predisposing Factors

VI. Symptoms

  1. Constant, throbbing perianal pain

VII. Signs: General

  1. Palpable, tender mass in perianal area or in Rectum
  2. Drainage may be seen via perianal skin tract
    1. See Fistula-in-ano

VIII. Management

  1. Surgical drainage is critical
    1. See types above for specific approach
  2. General Measures
    1. Stool Softeners (e.g. Colace)
    2. Sitz baths
    3. Frequent dressing changes
  3. Antibiotics usually not indicated
    1. Special Indications
      1. Systemic signs of infection
      2. Valvular heart disease
      3. Immunocompromised patient
    2. Antibiotic coverage (Anaerobes, Gram Negatives)
      1. Ciprofloxacin 500 mg PO bid and
      2. Metronidazole 500 mg PO tid

IX. References

  1. Goroll (2000) Primary Care Medicine, Lippincott, p. 426
  2. Marx (2002) Rosen's Emergency Medicine, p. 1951
  3. Roberts (1998) Procedures, Saunders, p. 649-51
  4. Surrell in Pfenninger (1994) Procedures, Mosby, p. 969

Images: Related links to external sites (from Google)

Ontology: Perirectal abscess (C0267566)

Concepts Acquired Abnormality (T020) , Disease or Syndrome(T047)
ICD10 K61.1
SnomedCT 91669008
English PERIRECTAL ABSCESS, Perirectal abscesses, perirectal abscess (diagnosis), rectal abscess perirectal, perirectal abscess (physical finding), perirectal abscess, peri-rectal abscess, abscesses perirectal, abscess perirectal, peri rectal abscess, Perirectal abscess, Perirectal abscess (disorder), abscess; perirectal, pararectal; abscess, perirectal; abscess
Italian Ascesso perirettale
Japanese 直腸周囲膿瘍, チョクチョウシュウイノウヨウ
Czech Perirektální absces
Hungarian perirectalis tályog
Dutch abces; perirectaal, pararectaal; abces, perirectaal; abces, perirectaal abces
Spanish absceso perirrectal (trastorno), absceso perirrectal, Absceso perirrectal
Portuguese Abcesso perirrectal
French Abcès périrectal
German perirektaler Abszess

Ontology: Anorectal abscess (C0267567)

Concepts Pathologic Function (T046)
ICD9 566
ICD10 K61 , K61.2
SnomedCT 155793007, 197167001, 75236001, 197160004, 155796004, 266530003
Dutch anorectaal abces, abces anorectaal, abces van anorectale streken, abces; anorectaal, anorectaal; abces, Anorectaal abces, Abces van anaal en rectaal gebied
French Abcès anorectal, Abcès des régions anale et rectale
German Abszess anorektal, anorektaler Abszess, Abszess in der Anal- und Rektalregion, Anorektalabszess, Abszess des analen und rektalen Bereichs
Italian Ascesso anorettale, Ascesso anale e rettale
Portuguese Abcesso anorrectal, Abcesso das regiões anal e rectal
Spanish Absceso anorrectal, Anal/rectal abscess, Anorectal abscess, Anal/rectal abscess NOS, Abscess - anal/rectal, Absceso de las regiones anal y rectal, absceso anorrectal (trastorno), absceso anorrectal, SAI (trastorno), absceso anorrectal, SAI, absceso anorrectal
Japanese 肛門直腸膿瘍, コウモンチョクチョウノウヨウ
English Anorectal abscess NOS, Abscess anorectal, Anal & rectal abscess, Anorectal abscess NOS (disorder), abscess of anal and rectal regions, Abscess;anorectal, abscesses anorectal, abscess anorectal, Anorectal abscess, Anorectal abscess (disorder), abscess; anorectal, anorectal; abscess, Abscess - anal/rectal, Anal/rectal abscess NOS, Anal/rectal abscess, Abscess of anal and rectal regions, anorectal abscess
Czech Anorektální absces, Absces řitní a konečníkové krajiny
Korean 항문 및 직장부의 고름집(농양), 항문직장 고름집(농양)
Hungarian Analis és rectalis régió abscessusa, anorectalis tályog, anorectalis abscessus