Anorectal Abscess › Patient Education › Services

A A A
Print
Share
Like any abscess, an anorectal abscess should be treated promptly so it doesn't progress into a serious infection. Fortunately, the majority of anorectal abscesses are easily treated. Some, however, are in hard-to-reach locations and take more complicated forms, making treatment more challenging.  

How easily an anorectal abscess can be diagnosed depends largely on its location. The experts at Colorectal Physicians & Surgeons of PA have the experience and tools to accurately locate and recognize anal abscesses and to rule out other disorders that can have similar symptoms. An anorectal abscess is a collection of pus, surrounded by inflammation, in the area of the anus or rectum. The infection originates in an anal gland and may contain bacteria from either feces or skin. A throbbing or dull aching pain in the anal region is usually the main symptom of an anorectal abscess. Walking, straining, coughing or sneezing may aggravate the pain. A patient may or may not also feel a swollen mass, depending on its location. Additional symptoms may include: 
  • Fever
  • Urinary retention
  • Discharge of pus 

An anorectal abscess can often lead to an anorectal fistula — a tiny tunnel in the body with one opening in the anal canal and the other opening in the skin near the anus. Untreated, an abscess can progress into a necrotizing (tissue-killing) and life-threatening systemic infection.

Superficial abscesses, located around the anus or in the space between the anus and ischium (part of the hip bone) can usually be detected with a visual and digital (gloved finger) examination. Abscesses deeper inside the body can cause severe pain and a patient may be given general anesthesia for the examination. Abscesses located up the anal canal, nearer the abdominal cavity, can be difficult to diagnose because they can mimic abscesses caused by diverticulitis or Crohn's disease. In these cases, doctors might use an ultrasound, MRI (magnetic resonance imaging) or CT (computed tomography) scan.

After the abscess has been drained, doctors might use other tools to check for other disorders: 

  • Proctoscopy to examine the anal canal, rectum and lower portion of the colon
  • Flexible sigmoidoscopy a thin tube with a lighted camera inside the tip to view the lining of the rectum and sigmoid colon

The main treatment for an anorectal abscess is to drain it. At Colorectal Physicians & Surgeons of PA, this procedure is done by a colon and rectal surgeon. Where the abscess is located usually determines how the surgeon drains it. After the abscess has been drained, patients with conditions that make them more susceptible to infection are usually prescribed antibiotics.  

Draining Approaches

  • Perianal Abscess (in the area surrounding the anus): The surgeon removes the most prominent part of the abscess with a crisscross cut. The resulting flaps of skin are then trimmed, and the abscess is thoroughly scraped and flushed out. The surgery is usually performed as an outpatient procedure using local anesthesia.
  • Ischioanal Abscess (between the ischium and anus or rectum): If the abscess is small, the surgeon treats it similarly to a perianal abscess. If the abscess is large and has spread to one or both sides — called a horseshoe abscess — it must be drained in the operating room, with the patient under regional or general anesthesia.
  • Intersphincteric Abscess (between the internal and external anal sphincter muscles): The surgeon makes an incision into the anal canal lining and down through the internal sphincter muscle to reach and drain the abscess. The surgery is usually performed in an operating room with the patient under regional or general anesthesia.
  • Supralevator Abscess (above the levator ani muscle): Surgery to drain a supralevator abscess will depend on the origin of the abscess. If the abscess is an intersphincteric abscess that has extended upward, the surgeon will drain it into the rectum. If the abscess is an ischioanal abscess that has extended upward, the surgeon will drain it through the ischioanal fossa (hollow area between the anus and the ischium bone) and out through the skin. If the abscess is due to an intra-abdominal disorder such as Crohn's disease or diverticulitis, the abscess will likely be drained during surgery to treat the other disorder.

To make an appointment with a doctor from Colorectal Physicians & Surgeons of PA, please call (814) 453- 2777.