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Clin Colon Rectal Surg
DOI: 10.1055/s-0043-1777451
Review Article

Anorectal Abscess

Anna Kata
1   Fairfax Colon and Rectal Surgery, PC. Fairfax, Virginia
,
Jonathan S. Abelson
2   Department of Colon and Rectal Surgery, Lahey Hospital and Medical Center, Burlington, Massachusetts
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Abstract

Anorectal abscesses are a common colorectal emergency. The hallmark of treatment is obtaining source control while avoiding injury to the underlying sphincter complex. Understanding the anatomy of an anorectal abscess is critical to planning the appropriate drainage strategy and decreasing the risk of complex fistula formation. Use of antibiotics should be reserved for those with extensive cellulitis, signs of systemic infection, or patients who are immunocompromised. Whether antibiotics prevent future fistula formation is an area of active research. Primary fistulotomy at time of the index drainage is controversial; however, there may be situations where it is appropriate. It is important to counsel patients that after effective drainage of an anorectal abscess, they have a 30 to 50% chance of developing an anal fistula that will then require further treatment.

Keywords

anorectal abscess - perianal abscess - anal fistula


Publication History

Article published online:
08 December 2023

© 2023. Thieme. All rights reserved.

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