Anorectal Abscess Flashcards
Pertinent Anatomy
(1) Anus
(2) Rectum
Abscesses are frequently encountered in the _____ and ______ region
perianal and perirectal
Almost all Anorectal Abscess begin with involvement of an _______
anal crypt and its gland
What issue
Initially, the patient notices a dull, aching, or throbbing pain that becomes worse immediately before defecation, is lessened after defecation, but persists between bowel movements
Anorectal Abscess
Spaces which can become infected alone or in combination with each other are:
1) The perianal space
2) The intersphincteric space
3) The ischiorectal space
4) The deep postanal space
5) The supralevator or pelvirectal space
The ________ is most common and
the ______ occurs least often
perianal abscess Most
supralevator abscess Least
Differential Diagnosis
(1) Pilonidal Cyst
(2) Hemorrhoid
(3) Anorectal Fistula
Labs
None
RADs
Ultrasound for deep abscesses
True/ False
Treatment is surgical and should be performed as soon as the diagnosis is made, before the abscesses become fluctuant.
-Drainage should be both early and extensive
True
Isolated, simple, fluctuant perianal abscesses that are not associated with the presence of any deeper abscesses may be drained in the _____ using local anesthetics
ED or outpatient setting
True/False
If a simple, linear drainage incision is made, the abscess is less likely to recur because of premature closure of skin edges.
False
MORE LIKELY
To ensure adequate drainage, a _______ or ______ incision can be made over the fluctuant part of the abscess. Trimming the flaps of a cruciate incision is suggested to prevent _____.
cruciate or elliptical
closure
As a rule, antibiotics are not necessary after what?
an abscess has been adequately drained
Patients with fever, leukocytosis, valvular heart disease, or those with cellulitis should be given
broad- spectrum antibiotics
