Classification and Treatment of Anorectal Infections

Abstract

The classification of anorectal infections of cryptoglandular origin is outlined according to the anatomic location based on the cryptoglandular theory. Clinical evaluation emphasizes the concept that anatomy begets semiology, i.e., signs and symptoms. “Simple” abscesses are low-lying and confined to a single infralevator space. “Complex abscesses” can be supralevator or those involving multiple spaces. The variable anatomy of “horseshoe” abscesses is discussed. The principles of surgical drainage of simple and complex abscesses are described. Access and drainage of the post-anal spaces is discussed. The role of adjunctive imaging is also highlighted including its indications and clinical utility.