The perianal abscess is an infected cavity filled with pus around the anus or rectum (lower part of large bowel).
The perianal abscess is manifested with pain, fever and a swelling around anus. Sometimes the fever is absent and in deep abscesses the swelling is not detected. Their only manifestation is rectal pain and very painful digital examination.
The cause of perianal abscess
The origin of the infection is often an opening inside anal canal. From this opening, the inflamation spreads to the perianal skin and often appears as a painful swelling around anal orifice. Other causes of perianal abscess are hydradenitis suppurativa and simple furuncles (boils). Tuberculosis and amoebiasis are very rare causes of perianal abscess .
The proper treatment of the abscess is immediate and urgent surgical drainage, i.e. opening of the cavity and removal of pus. Treatment with antibiotics is a poor alternative because the abscess may be limited temporarily but not treated definitively. Their use is suggested only if the abscess cannot be localized because of poor diagnostic techniques. Endoanal ultrasound always detects the location of inflammation in difficult cases. If the pus is not drained, the inflammation can extend into the sphincters. In this case the treatment of the abscess is complicated and septicemia can occur.
The preoperative endoanal ultrasound delineates effectively the inflammation and the cause of anal abscess (anal opening). Surgical drainage is easier, more efficient and the incision is targeted and smaller. In some cases treat the cause of the fistula (anal orifice) can be simultaneously treated and no postoperative fistula occurs.
After removal of pus, fever and pain disappear and the wound heals quickly .
Postoperative perianal fistula
Often the communication with the anal canal (the anal orifice) persists after surgery, resulting in cycles of pain and discharge of pus from the wound from a small skin opening (perianal fistula). If the incision heals completely, the infection from the anal opening is entrapped inside perianal tissues and the abscess reappears.
PROCTOLOGY CLINIC- ATHENS GREECE