Perianal Abscess: Definition, Causes, Symptoms, Diagnosis, Treatment, Complications and Prevention

It refers to the accumulation of fluids and pus under the skin around the anus or rectum.

The gland in the anal canal becomes infected with a bacterial infection and exudes mucus that builds up to cause a pus-filled cavity.

The abscess commonly presents as a visible, painful swelling on the outer aspect of the buttock. Occasionally, the infection will continue above the elevator harness, causing pain and a palpable mass on rectal exam.

Drainage of a perirectal abscess often results in a chronic anal fistula, a communication from inside the anorectum to the skin outside.

Perianal abscess or rectal abscess occurs when a cavity in the anus fills with pus. It causes extreme pain, fatigue, rectal discharge, and fever. In some cases, anal abscesses can lead to painful anal fistulas.

This occurs when the abscess does not heal and breaks open on the surface of the skin. If an anal abscess doesn’t heal, it can cause a lot of pain and may require surgery.

How common is a perianal abscess?

In general, abscesses that occur in the deeper tissues are rare and less visible as well. If the infection becomes more severe, the easiest alternative is to have surgery. However, this is not enough, as it does not reduce the risk of a relapse.

Causes of perianal abscess

They can be caused by:

  • A blocked anal gland.
  • A sexually transmitted infection.
  • An infected anal fissure.
  • Inflammatory bowel diseases that cause the immune system to attack healthy tissues.
  • Diabetes (high blood sugar levels in the body).
  • A weak immune system due to autoimmune diseases such as HIV or AIDS.
  • Anal sex.
  • Recent chemotherapy.
  • Untreated constipation.

Symptoms of perianal abscess

  • Constant pain that feels like a knife is scratching inside the anus is one of the most noticeable symptoms of a perianal abscess.
  • The pain is accompanied by internal anal swelling and area pain and throbbing during bowel movements.

Pain is common to all abscesses, but in the case of perianal abscesses, there are other signs that make it more obvious of this type.

The signs are:

  • Untreated and aggravated constipation.
  • Rectal bleeding.
  • Sensitivity of the skin around the anus and internally as well.
  • Higher levels of fatigue.
  • Tenderness and swelling in the rectum.
  • Itching in the affected area.
  • An outward-hanging lump of skin looks inflamed, located on the edge of the anus.
  • Fever as a result of infection.
  • Pain and burning sensation when urinating.

 Diagnosis of perianal abscess

Anal abscess can usually be diagnosed by a surgeon through an examination of the area and a digital rectal exam. Sometimes the doctor may order an ultrasound, CT scan, or MRI to determine the extent of the abscess.

In certain situations where the condition is extremely painful, the doctor may examine you under anesthesia.

Treatment for perianal abscess

Treatment is incision and drainage under local anesthesia that is done as a daycare procedure. Surgical drainage of large or deeper abscesses may require hospitalization. Antibiotic therapy may be necessary.

Postoperative recovery

  • Postoperative pain and discomfort can be relieved with pain relievers.
  • Sitz bath three or four times a day is recommended.
  • Stool softeners are recommended to relieve pain during bowel movements.
  • Gauze or mini pad can be used to prevent clothing from getting dirty from the drain.
  • A person can expect to return to work or school within a few days of the procedure.

Drainage from an abscess is rarely associated with complications, and if there are, they are minimal.

Complications of untreated perianal abscess

Anal fistulas ( fistula in anus ), which are small tunnels, like abnormal connections between the abscess site and the skin, can develop in about half of the patients with perianal abscess.

The fistula can continuously discharge pus. Sometimes the patient presents with a fistula with an underlying perianal abscess.

Surgery is necessary to cure anal fistulas, as in some cases, if the external opening of the fistula closes spontaneously and the tract persists, it can lead to recurrent infection and recurrent perianal abscess.

Prevention

  • Treat chronic constipation.
  • Treat anal fissures promptly
  • Maintain high levels of personal hygiene.
  • Using condoms during anal intercourse is important.
  • Frequent diaper changes in babies and young children.
  • Proper cleaning during diaper changes for babies and young children.
  • Control of diabetes.