Anorectal Abscess

Definition:
It an abscess (a large packet of infection) adjacent to the anus. It is often known as anal abscess, renal abscess, peri-rectal abscess and perianal abscess. The condition in variably becomes extremly painful and usually worsens over the course of just a few days. Pain may be limited and sporadic at last but invariably worsen to a constant pain which can become very severe when body position is changed (i.e. standing up rolling over and so forts).

Anorectal Abscess is caused by obstruction of an anal gland resulting in retrograde infection.

Cause:

• caused by high density of infection
• common bacteria
• staphylococcus
• methicillin resistant staphylococcus aureus

|| Note:: Bacteria which collect in one place or another for any variety of reason. Anal abscesses which out Rx, are likely to spread and affect other parts of body, particularly the groin and rectal lumen. All abscesses can progress to serous generalized infections requiring lengthy hospitalization if not treated.||

Clinical Features:

• swelling, redness, tenderness (if superficial)
• pain --> initial limited and sporadic, later-severe pain, excoriating pain during bowel movement.
• fever
• night time chills.
• bleeding
• diarrhea, mucopurulent discharge, foul smelling pus
• crampy abdominal pain
• visual inspection - haemorrhoids on touch

Diagnosis

• History taking
• Physical examination
• P/R examination --> Abscess feel
• Sigmoidoscopy --> identify portions of anorectal
• Rectal swab for c/s text - identify the pathogens

Management

• Medical Management
• Surgical Management
• Nursing Management

Medical Management:

• sitz bath
• analgesic
• antibiotics

|| Note: Anal abscess unfortunately, cannot be treated by a simple course of antibiotics or other medications. Even small abscess will need the attention of a surgeon immediately.||

Surgery:

• Deep incision and drainage performed (to the root of the abscess)
• Allow the abscess to drain its exudate.
• Exudate sent for microbiological analysis to determine the type of infection.
• Incision not closed, as the damaged tissue must heat from the inside towards the skin over a period of time. The wound may be packed with gauze and allowed to heat by granulation.