Perirectal abscess fistula

Perirectal Abscess and Fistula - Causes, Symptoms and Treatments. A perirectal abscess is a localized collection of pus caused by inflammation of the soft tissue outside the anal verge. Such inflammation may produce an anal fistula -an abnormal opening in the anal skin-that may communicate with the rectum. Sometimes an abscess will return if a fistula , or tube like connection, forms between the inside of the anus and the skin.

Once a fistula forms, bacteria from the intestine becomes trapped and causes the infection to return.

This is called a perirectal fistula. Perianal and perirectal abscesses are common anorectal problems. The infection originates most often from an obstructed anal crypt glan with the resultant pus collecting in the subcutaneous tissue, intersphincteric plane, or beyond (ischiorectal space or supralevator space) where various types of anorectal abscesses form. It can cause a lot of pain and will most likely require medical attention. Here, a colorectal surgeon your questions.

An abscess is a pocket of infection creating pus. Chronic fistula may present with discharge on the buttocks and pruritis, and the pain is usually less prominent. A fistula -in-ano represents the chronic phase of ongoing perirectal sepsis.

A previous history of perirectal abscess , drained either spontaneously or surgically, can usually be elicited. Patients often report a cyclical pattern of pain, swelling, and drainage. Moisture can cause skin irritation, excoriation, and pruritus. The extrasphincteric fistula is uncommon and only seen in patients who had multiple operations.

In these cases the connection with the original fistula tract to the bowel is lost. A superficial fistula is a fistula that has no relation to the sphincter or the perianal glands and is not part of the Parks classification. WHAT IS AN ANAL ABSCESS OR FISTULA ? This may be combined with hydrogen peroxide injection into the fistula. Bleier and Husein Moloo Introduction Cryptoglandular infection and abscess is a common problem encountered by general and colorectal surgeons.

Development of abscesses is anatomically related to infection of the anal glands. Given the variability in location and severity of the abscess , it is important to consider the presence of fistulas or tracts which may contribute to the spread of the infection. Anorectal infection: abscess - fistula. Epidemiology Incidence is estimated at ~1:1000.

It forms part of the broader group of anorectal abscesses. They are often associated with perianal fistulae and are components of grades and fistulae of the St James’ University Hospital classification 2. Infection and anal gland drainage obstruction from the perianal fistula may.

MR Imaging Classification of Perianal Fistulas and Its Implications for Patient Management. Trans-sphincteric Fistula with Abscess or Secondary Track within the Ischiorectal Fossa. Clinical Experience with the Classification and Its Implications for Patient Management.

He had no systemic symptoms such as fever, nausea, or malaise, and his vital signs were within normal limits. A perirectal (pair-e-rek-tull) abscess (ab-sess) is a pocket of pus in the tissues around the rectum. The rectum is the last part of the bowel (intestine) that ends at the anus. Bacteria may enter the skin through a tear in the skin. Anal abscesses are the acute manifestation of a purulent infection in the perirectal area, while anal fistulas are the chronic manifestation of such infections.

An anal abscess is a pus-filled cavity that most commonly develops from an infected anal crypt gland following obstruction and bacterial overgrowth. Less common causes for the formation of anorectal abscesses are inflammatory bowel. Approximately of perirectal abscesses are thought not to be due to infected anal glands. In the majority of cases, caused by infection of the anal glan surgical treatment is usually required. The aim of treatment is to maximize the healing rate and minimize the risk of incontinence.

A recent Swedish cohort study estimated the incidence at 16. The true incidence may be higher, since many patients are treated with antibiotics in the community and some abscesses spontaneously. Setons may also be used as temporary initial intervention in the management of a fistula.

A seton is a nonabsorbable nylon or silk suture that is guided through the fistula tract and tied.