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Perianal Abscess

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Practices of Anorectal Surgery

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Abstract

Inflammation from the anal gland infection is the primary focus, and an abscess is formed from the spread of inflammation to the surrounding spaces. Anorectal abscess is classified by the surrounding area of anal sphincter as perianal, intersphincteric, ischioanal, and supralevator abscess. MRI is useful for complex abscess or recurrent abscess and gives a surgeon more precise information of the range of abscess and anatomical relation compared to the CT or ultrasound. One of the most controversial in anal abscess treatment is whether to perform only simple incision and drainage or perform curative surgery on the anal fistula. If there is concern of anal dysfunction due to incision and drainage and fistulotomy, then seton application can be an alternative treatment.

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References

  1. Abcarian H. Anorectal infection: abscess-fistula. Clin Colon Rectal Surg. 2011;24:14–21.

    Article  Google Scholar 

  2. Sneider EB, Maykel JA. Anal abscess and fistula. Gastroenterol Clin N Am. 2013;42:773–84.

    Article  Google Scholar 

  3. Eisenhammer S. The internal anal sphincter and the anorectal abscess. Surg Gynecol Obstet. 1956;103:501–6.

    CAS  PubMed  Google Scholar 

  4. Parks AG, Gordon PH, Hardcastle JD. A classification of fistula-in-ano. Br J Surg. 1976;63:1–12.

    Article  CAS  Google Scholar 

  5. Schwartz DA, Loftus EV Jr, Tremaine WJ, Panaccione R, Harmsen WS, Zinsmeister AR, Sandborn WJ. The natural history of fistulizing Crohn’s disease in Olmsted County, Minnesota. Gastroenterology. 2002;122:875–80.

    Article  Google Scholar 

  6. Harper PH, Fazio VW, Lavery IC, Jagelman DG, Weakley FL, Farmer RG, Easley KA. The long-term outcome in Crohn’s disease. Dis Colon Rectum. 1987;30:174–9.

    Article  CAS  Google Scholar 

  7. Wiese DM, Schwartz DA. Managing Perianal Crohn’s Disease. Curr Gastroenterol Rep. 2012;14:153–61.

    Article  Google Scholar 

  8. Sordo-Mejia R, Gaertner WB. Multidisciplinary and evidence-based management of fistulizing perianal Crohn’s disease. World J Gastrointest Pathophysiol. 2014;5:239–51.

    Article  Google Scholar 

  9. Read DR, Abcarian H. A prospective survey of 474 patients with anorectal abscess. Dis Colon Rectum. 1979;22:566–8.

    Article  CAS  Google Scholar 

  10. McElwain JW, MacLean MD, Alexander RM, Hoexter B. Guthrie Anorectal problems: experience with primary fistulectomy for anorectal abscess, a report of 1,000 cases. Dis Colon Rectum. 1975;18:646–9.

    Article  CAS  Google Scholar 

  11. Visscher AP, Felt-Bersma RJ. Endoanal ultrasound in perianal fistulae and abscesses. Ultrasound Q. 2015;31:130–7.

    Article  Google Scholar 

  12. Plaikner M, Loizides A, Peer S, Aigner F, Pecival D, Zbar A, Kremser C, Gruber H. Transperineal ultrasonography as a complementary diagnostic tool in identifying acute perianal sepsis. Tech Coloproctol. 2014;18:165–71.

    Article  CAS  Google Scholar 

  13. Khati NJ, Sondel Lewis N, Frazier AA, Obias V, Zeman RK, Hill MC. CT of acute perianal abscesses and infected fistulae: a pictorial essay. Emerg Radiol. 2015;22:329–35.

    Article  Google Scholar 

  14. Garcia-Granero A, Granero-Castro P, Frasson M, Flor-Lorente B, Carreño O, Espí A, Puchades I, Garcia-Granero E. Management of cryptoglandular supralevator abscesses in the magnetic resonance imaging era: a case series. Int J Color Dis. 2014;29:1557–64.

    Article  Google Scholar 

  15. Steele SR, Kumar R, Feingold DL, Rafferty JL, Buie WD, Standards Practice Task Force of the American Society of Colon and Rectal Surgeons. Practice parameters for the management of perianal abscess and fistula-in-ano. Dis Colon Rectum. 2011;54:1465–74.

    Article  Google Scholar 

  16. Sözener U, Gedik E, Kessaf Aslar A, Ergun H, Halil Elhan A, Memikoğlu O, Bulent Erkek A, Ayhan Kuzu M. Does adjuvant antibiotic treatment after drainage of anorectal abscess prevent development of anal fistulas? A randomized, placebo-controlled, double-blind, multicenter study. Dis Colon Rectum. 2011;54:923–9.

    Article  Google Scholar 

  17. Tan KK, Koh DC, Tsang CB. Managing deep postanal space sepsis via an intersphincteric approach: our early experience. Ann Coloproctol. 2013;29:55–9.

    Article  Google Scholar 

  18. Schouten WR, van Vroonhoven TJ. Treatment of anorectal abscess with or without primary fistulectomy. Results of a prospective randomized trial. Dis Colon Rectum. 1991;34:60–3.

    Article  CAS  Google Scholar 

  19. Ho YH, Tan M, Chui CH, Leong A, Eu KW, Seow-Choen F. Randomized controlled trial of primary fistulotomy with drainage alone for perianal abscesses. Dis Colon Rectum. 1997;40:1435–8.

    Article  CAS  Google Scholar 

  20. Quah HM, Tang CL, Eu KW, Chan SY, Samuel M. Meta-analysis of randomized clinical trials comparing drainage alone vs primary sphincter-cutting procedures for anorectal abscess-fistula. Int J Color Dis. 2006;21:602–9.

    Article  CAS  Google Scholar 

  21. Oliver I, Lacueva FJ, Pérez Vicente F, Arroyo A, Ferrer R, Cansado P, Candela F, Calpena R. Randomized clinical trial comparing simple drainage of anorectal abscess with and without fistula track treatment. Int J Color Dis. 2003;18:107–10.

    CAS  Google Scholar 

  22. Malik AI, Nelson RL, Tou S. Incision and drainage of perianal abscess with or without treatment of anal fistula. Cochrane Database Syst Rev. 2010;(7):CD006827.

    Google Scholar 

  23. Hanley PH, Ray JE, Pennington EE, Grablowsky OM. Fistula-in-ano: a ten-year follow-up study of horseshoe-abscess fistula-in-ano. Dis Colon Rectum. 1976;19:507–15.

    Article  CAS  Google Scholar 

  24. Browder LK, Sweet S, Kaiser AM. Modified Hanley procedure for management of complex horseshoe fistulae. Tech Coloproctol. 2009;13:301–6.

    Article  CAS  Google Scholar 

  25. Ustynoski K, Rosen L, Stasik J, Riether R, Sheets J, Khubchandani IT. Horseshoe abscess fistula. Seton treatment. Dis Colon Rectum. 1990;33:602–5.

    Article  CAS  Google Scholar 

  26. Rosen SA, Colquhoun P, Efron J, Vernava AM 3rd, Nogueras JJ, Wexner SD, Weiss EG. Horseshoe abscesses and fistulas: how are we doing? Surg Innov. 2006;13:17–21.

    Article  Google Scholar 

  27. Hamadani A, Haigh PI, Liu IL, Abbas MA. Who is at risk for developing chronic anal fistula or recurrent anal sepsis after initial perianal abscess? Dis Colon Rectum. 2009;52:217–21.

    Article  Google Scholar 

  28. Buchan R, Grace RH. Anorectal suppuration: the results of treatment and the factors influencing the recurrence rate. Br J Surg. 1973;60:537–40.

    Article  CAS  Google Scholar 

  29. Vasilevsky CA, Gordon PH. The incidence of recurrent abscesses or fistula-in-ano following anorectal suppuration. Dis Colon Rectum. 1984;27:126–30.

    Article  CAS  Google Scholar 

  30. Serour F, Somekh E, Gorenstein A. Perianal abscess and fistula-in-ano in infants: a different entity? Dis Colon Rectum. 2005;48:359–64.

    Article  Google Scholar 

  31. Orkin BA, Smith LE. Perineal manifestations of HIV infection. Dis Colon Rectum. 1992;35:310–4.

    Article  CAS  Google Scholar 

  32. Vanhueverzwyn R, Delannoy A, Michaux JL, Dive C. Anal lesions in hematologic diseases. Dis Colon Rectum. 1980;23:310–2.

    Article  CAS  Google Scholar 

  33. Baker B, Al-Salman M, Daoud F. Management of acute perianal sepsis in neutropenic patients with hematological malignancy. Tech Coloproctol. 2014;18:327–33.

    Article  CAS  Google Scholar 

  34. Laor E, Palmer LS, Tolia BM, Reid RE, Winter HI. Outcome prediction in patients with Fournier’s gangrene. J Urol. 1995;154:89–92.

    Article  CAS  Google Scholar 

  35. Anaya DA, Dellinger EP. Necrotizing soft-tissue infection: diagnosis and management. Clin Infect Dis. 2007;44:705–10.

    Article  CAS  Google Scholar 

  36. Yang BL, Lin Q, Chen HJ, Gu YF, Zhu P, Sun XL, Shao WJ. Perianal necrotizing fasciitis treated with a loose-seton technique. Color Dis. 2012;14:e422–4.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Colorectal Division, Department of Surgery, Hansol Hospital, Seoul, South Korea

    Seung Han Kim

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  1. Seung Han Kim
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Editors and Affiliations

  1. Hansol Hospital, Seoul, Korea (Republic of)

    Dong Keun Lee

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Kim, S.H. (2019). Perianal Abscess. In: Lee, D. (eds) Practices of Anorectal Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-13-1447-6_8

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  • DOI: https://doi.org/10.1007/978-981-13-1447-6_8

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-1446-9

  • Online ISBN: 978-981-13-1447-6

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