Anorectal Abcess Flashcards
What is the pertinent anatomy and physiology of anorectal abcess?
Located in the anus and rectum.
Occurs from obstruction of anal gland.
Opens in the base of an anal crypt
normally drains int o the anal canal
glrand orifice is blocked with may result in infeciton and abcess formation
What do anorectal disorders range from?
simple to complex, may be varied and multiple, and at times can manifest signs and symptoms of underlying serious llocal or sytemic disorders that may be life threatening
What is the pathophysiology of anorectal abcess?
abcesses are frequently encountered in the perianal and prerectal region, almost all begin with involvement of an anal crypt and its gland. From there the infeciton can progress to involve any of the potential spaces that are normally filled with fatty tissue and have little inherent resistance to the progression of infection.
Spaces which can become infected are
perianal
intersphincteric
ischiorectal
deep postanal
supralevator or pelvic rectal spaces
What abcess is most and least common?
Perianal abcess is most common
Supralevator abcess is least common
What can develop as a common chronic sequela of anorectal abcess?
Fistula formation
What are the symptoms of anorectal abcesses?
Most common in young middle-aged males
initially the patient notices a dull, aching, or throbbing pain that becomes worse immediatelybefore defecation, is lessened after defecation, but persisits between bowel movmenets
What is the treatment for anorectal abcess?
surgical and should be performed as soonas the diagnosis is made
All perirectal abcesses should be drained in the operating room
isolated simple perianal abcesses can be drained in outpatient setting or ED
What type of incision should be made during drainage?
elliptical
What antibiotic should be used if indicated for an anorectal abcess?
Keflex(Cephalexin) 250mg PO four times a day
Doxycycline 100mg BID for 7 days
Clindamycin 300 mg PO every 6 hrs for 7 days
Dicloxacillin 125-500mg po every 6 hrs
