Anorectal abscess

Question 1

What is an anorectal abscess?

Answer 1

Collection of pus in the anal or rectal region

Question 2

What causes an anorectal abscess?

Answer 2

Plugging of the anal ducts that drain the anal gland in the anal wall, which usually eases passage of faecal matter through mucus section, this causes fluid stasis and infection

Question 3

What are the common causative organisms of anorectal abscesses?

Answer 3

E coli, bacteriodes spp, enterococcus spp

Question 4

Where are anal glands located?

Answer 4

interspincteric space between the internal and external anal sphincter

Question 5

What are the 4 types of anorectal abscess?

Answer 5

perianal, ischioretal, interspincteric, supralevator

Question 6

What are the clinical features of anorectal abscesses?

Answer 6

pain in the perianal region thats worse when you sit down, swelling, itching, discharge, systemic features e.g. fever and rigors, malaise and sepsis

Question 7

On examination how would an anorectal abscess present?

Answer 7

Erythematous, fluctuant, tender perianal mass, dishrag or have cellulitis

Question 8

What is the management for anorectal abscesses?

Answer 8

IV antibiotics and analgesia, incision and drainage, proctoscopy to check there is no fistula