ANORECTAL ABSCESS

Question 1

MANAGEMENT

Answer 1

I & D in the Emergency Department

Question 2

DOCUMENTATION

Answer 2

SYMPTOMS
Perianal pain
Dyschezia
Fever/chills

SIGNS
Red, swollen, often fluctuant mass lateral to
the anus

Tender DRE

RELEVANT PMHx
Previous anorectal abscess

Extra-intestinal
manifestations of IBD.

Personal or family of Crohn’s or Ulcerative colitis

INVESTIGATIONS
CBC may show leukocytosis.

Imaging not
required for simple perianal abscesses.

consider U/S to define abscesses in the ischiorectal or intersphincteric spaces

COMPLICATIONS
Fistual in ano

Question 3

D/Dx

Answer 3

R/0 Fournier
Hemorrhoids
Fistula-in-ano
Fissures
pilonidal abscess
Anarectal Tumor

Question 4

Classifications

Answer 4

Perianal Abscess

Ischiorectal Abscess

Intersphincteric Abscess

Supralevator Abscess