Anorectal Abscess pg 2164 Flashcards
what happens if there is an obstruction of the anal gland tht opens in the base of an anal crypt which normally drains into the anal canal?
anorectal abscess
where are anorectal abscess’ normally found? and what do they frequently involve?
encountered in the perianal and perirectal region and almost all begin with involvement of the anal crypt and its gland.
what are the potential spaces that can become infected resulting from a blocked anal gland orifice?
1- perianal gland
2- intersphincteric space
3- ischiorectal space
4- deep postanal space
5- supralevator or pelvirectal space
symptoms of anorectal abscess
initial dull, aching, or throbbing pain that becomes worse immediately before defecation, is lessened after defecation, but persists between bowel movements.
THE PAIN IS SIGNIFICANTLY INCREASED BY THE PRESSURE IN THE RECTUM, OCCURS JUST BEFORE DEFECATION.
are perianal abscesses usually accompanied by fever, leukocytosis, or sepsis with normally immunocompetent patients?
No
Which anal abscess may present with a patient appearing uncomfortable and may be febrile with possible leukocytosis?
all other anorectal abscesses. (e.g. ischiorectal, intersphincteric, supralevator…)
RAD for anorectal abscess?
ultrasound for deep abscesses
Treatment for perirectal and perianal abscess’
early and extensive drainage, before fluctuant.
perirectal in the OR
perianal with no complications may be drained in the ED or outpatient with local anesthetic (w finest gauge needle w systemic analgesia)
you must pack your drained anorectal abscess with strips of gauze for 24 hrs if you use which incision technique?
simple, linear drainage incision. do not let skin edges prematurely close or more abscess will occur
after cruciate or elliptical incisions of perirectal abscess, what are your follow up actions.
no packing, but if done, remove in 24 hrs.
cover with bulk dressing. sitz bath x3 a day.
consider antibiotics e.g. Keflex, doxy, clinda.
