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Perirectal abscess

Perianal Abscess, Anal Cellulitis

What is Perirectal abscess?

Perirectal abscess is a condition in which either the anal area or surrounding area has been infected with a microbial agent. This microbe then walls itself off, creating a fluid filled sac. Individuals who are at risk for this condition are those who are immunocompromised (bone marrow transplant, leukemia), and those with ulcerative colitis or diverticulitis.

How is it diagnosed?

History: Individuals generally give a history of tenderness, pain in the localized area, and/or fever.

Physical exam: Individuals will have tenderness upon rectal exam. A fistula may actually be visualized, or there may be localized swelling and redness around the anal area.

Tests include complete blood count (CBC) with differential, microbial culture of the involved site, and dye injection into the abscessed area to assess for sinus or fistula tract drainage.

How is it treated?

Most individuals are treated with incision and drainage of the abscess, followed by a combination of intravenous and oral antibiotics for two to four weeks.



What might complicate it?

Complications include bacteremia (spreading of the microbes into the blood stream) and sepsis (spreading of the microbial agents to the blood stream, followed by a bodily response, which initiates shock-like symptoms).

Predicted outcome

If the abscess is correctly treated, the predicted outcome is excellent. If the abscess is not treated, complications may result that may be life threatening.


Other possible diagnoses include diverticulitis, anal fistula, and rectocele.

Appropriate specialists

Colon surgeon.

Last updated 6 April 2018