perirectal abscess

Etiology

risk factors

• diabetes
• inflammatory bowel disease
• immunocompromised patients

Clinical manifestations

• painful induration in perianal area
• erythematous, palpable mass, with drainage
• fever
• may or may not worsen with bowel movements

Differential diagnosis

• anal fissures
  • pain worsens with bowel movements
  • may be visible as a small tear in the anus distal to the dentate line
• thrombosed hemorrhoid
  • persistent rectal or perianal pain
  • may worsen with bowel movements
  • hard, purple lump at the anal verge
  • no purulent drainage
  • fever uncommon
• pilonidal abscess
  • occur in the gluteal cleft above the anus, near the coccyx
• hydradenitis suppurativa
  • intertriginoud areas such as axilla, groin, perianal area, inframammary region
  • comedones, sinus tracts, scarring, inflammatory nodules

Management

• incision & drainage
• gram negative antibiotic coverage (except Crohn's disease)
• see Crohn's disease for treatment of perirectal fistula & & perirectal abscess in oatients with Crohn's disease

More general terms

• abscess
• anorectal disease