Perianal abscess
| Anorectal abscess | |
|---|---|
![This is a modified version of the original by Armin Kübelbeck [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons, https://commons.wikimedia.org/wiki/File%3APiles_diffdiag_01.svgSpecifically, it was made abscess-specific by removing fistula labels.](https://en.wikipedia.org/wiki/File:Abscess_diag_02.svg) |
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| Anorectal abscess types and locations | |
| Classification and external resources | |
| Specialty | gastroenterology |
| ICD-10 | K61.0 |
| ICD-9-CM | 566 |
| DiseasesDB | 32048 |
| MedlinePlus | 001519 |
| eMedicine | med/2733 emerg/494 |
Anorectal abscess (also known as an anal/rectal abscess, or perianal/perirectal abscess) is an abscess adjacent to the anus. It arises from an infection at one of the anal sinuses which leads to inflammation and abscess formation. Most cases of perianal abscesses are sporadic, though there are certain situations which elevate the risk for developing the disease, such as diabetes mellitus, Crohn's disease, chronic steroid treatment and others. Ischiorectal, inter- and intrasphincteric abscesses have been described.
There are four types of anorectal abscesses: perianal, ischiorectal, intersphincteric, and supralevator.
Pain in the perianal area is the most common symptom of an anorectal abscess. The pain may be dull, aching, or throbbing. It is worst when the person sits down and right before a bowel movement. After the individual has a bowel movement, the pain usually lessens. Other signs and symptoms of anorectal abscess include constipation, drainage from the rectum, fever and chills, or a palpable mass near the anus. The condition invariably becomes extremely painful, and usually worsens over the course of just a few days. The pain may be limited and sporadic at first, but invariably worsens to a constant pain which can become very severe when body position is changed (e.g., when standing up, rolling over, and so forth). Depending upon the exact location of the abscess, there can also be excruciating pain during bowel movements, though this is not always the case. This condition may occur in isolation, but is frequently indicative of another underlying disorder, such as Crohn's disease.
This condition is often misdiagnosed initially by the patient as a bad case of hemorrhoids, since this is almost always the cause of any sudden anal discomfort. The presence of the abscess, however, is to be suspected when the pain quickly worsens over one or two days and the usual hemorrhoid treatments are ineffective in bringing relief. Furthermore, any serious abscess will eventually begin to cause signs and symptoms of general infection, including fever and nighttime chills.
A physician can rule out a hemorrhoid with a simple visual inspection, and usually appreciate an abscess by touch.
Abscesses are caused by a high-density infection of (usually) common bacteria which collect in one place or another for any variety of reasons. Anal abscesses, without treatment, are likely to spread and affect other parts of the body, particularly the groin and rectal lumen. All abscesses can progress to serious generalized infections requiring lengthy hospitalizations if not treated.
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