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What Is a Perirectal Abscess?

The rectum is the last part of the large intestine, where stools (bowel movements) are stored before leaving the body through the anal canal and anus. When the rectal space (the perirectal space) and glands in the rectum that make mucus are infected by bacteria, small hollow cavities or holes that fill with pus form. These collections of pus-filled cavities in this area are called perirectal abscesses. Abscesses can also form around the anus and are called perianal abscesses.

Anyone can have a perirectal abscess, but men get them more often than women.

What Causes a Perirectal Abscess?

The most common cause is a bacterial infection from the anal canal into one of the perirectal spaces. All these bacteria are normally found in the bowel (large intestine) and on skin outside the anal canal.

What Are the Symptoms of a Perirectal Abscess?

Symptoms include rectal pain that is lasting, throbbing, and often made worse with movement or straining. Others are fever, constipation, and trouble urinating. Sometimes, a rectal mass can be felt that is red, hot, tender, and swollen.

How Is a Perirectal Abscess Diagnosed?

The health care provider makes a diagnosis from symptoms and doing a physical examination. Blood tests and urine tests may also be done.

How Is a Perirectal Abscess Treated?

The main treatment is surgery. People with surface abscesses can be treated as an outpatient with local anesthesia. Deeper abscesses usually need hospitalization. A general surgeon or surgeon who specializes in diseases of the colon and rectum does the operation.

Antibiotics are often given but don’t substitute for prompt surgery and draining the abscess. Pain after surgery is usually treated by sitting in warm water (called sitz baths) three or four times daily. Medicines can also help relieve pain.

Stool softeners are used to prevent getting constipated and stop straining with bowel movements.

Complications that can occur after surgery include incomplete healing, having the abscess come back, and formation of a fistula. A fistula is a tunnel connecting the skin with the anal gland that the abscess started from. A fistula usually occurs 4 to 6 weeks after abscess drainage and needs surgery to fix it.

DOs and DON’Ts in Managing a Perirectal Abscess:

  • DO get treatment. Untreated perirectal abscesses can spread into other tissues and make the problem worse.
  • DO call your health care provider if you have rectal pain and high temperature.
  • DO call your health care provider if you notice a mass in your rectum or drainage of pus from your anus.
  • DO call your health care provider if you have lasting drainage from your incision, fever, or pain after surgery.
  • DON’T ignore symptoms. The earlier surgery is done, the less the chances for complications (such as the abscess spreading to nearby tissues).
  • DON’T miss follow-up health care provider appointments. The surgical wound should be checked frequently to make sure that it heals properly.

Contact the following source:

  • American College of Surgeons
    Tel: (312) 202-5000, (800) 621-4111

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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