An anorectal abscess is a pus-filled infection in the anal or rectal region, often caused by anal fissures, STIs, or blocked glands. The condition presents with symptoms such as painful swelling, discharge, and fever, with prompt treatment leading to good recovery outcomes. Common types include perianal, ischiorectal, and intersphincteric abscesses, requiring diagnosis via digital examination and possibly imaging, with treatment typically involving surgical drainage.

1. ANORECTAL ABSCESS
Mr. ANILKUMAR B R , M.s.c Nursing
Assit Professor
Medical –surgical Nursing

2. Anorectal abscess
• An anorectal abscess is a
collection of pus in the anal or
rectal region.
• It may be caused by infection
of an anal fissure, sexually
transmitted infections or
blocked anal glands.

3. What is Anorectal abscess?
• An anorectal abscess is a
collection of pus that builds
up in the rectum and anus.
• With prompt treatment,
client with this condition
usually recover very well.
• Complications tend occur
when treatment is delayed.

4. Types of anorectal abscess
1. Perianal abscess: the most common (60%).
2. Ischiorectal abscess: (20%)
3. Intersphincteric abscess: (5%)
4. Supralevator abscess: (4%)

5. Epidemiology
• High-risk groups include those with diabetes, immune
compromised patients, people who engage in receptive anal
sex and patients with inflammatory bowel disease.
• Deep rectal abscesses may be caused by intestinal disorders
such as Crohn's disease or diverticulitis.
• Studies suggest that most patients are between the ages of 20
to 60 with a mean age of 40. The male-to-female ratio is 2:1.

6. Etiological factors for anorectal abscess
1. A blocked gland
2. An infection of an anal fissures ( a tear or ulcer in the
lining of the anal canal)
3. A sexually transmitted disease (STI)
4. People with inflammatory bowel disease
5. People with DM
6. People with a weakened immune system.

7. SIGNS & SYMPTOMS
1. Painful, hardened tissue around the anus
2. Discharge of the pus from rectum
3. A lump or nodule at the edge of anus
4. Tenderness at the edge of anus
5. Fever
6. Constipation
7. Pain associated with bowel movements
8. Pain is usually constant, throbbing and worse when sitting
down and Fatigue

8. Assessment and diagnostic
1. A digital rectal examination is usually sufficient for the diagnosis
and the treatment planning of anal abscesses and fistulae.
2. Initial investigation will depend on presentation but may include a
screen for sexually transmitted diseases and/or investigation for
inflammatory bowel disease, diverticular disease or lower
gastrointestinal tract malignancy.
3. Proctosigmoidoscopy may be performed to exclude associated
diseases.

9. Assessment and diagnostic
4. MRI scan: allows the assessment of:
a) Location of any fistular tracts.
b) Location of the internal and external opening(s) of any
fistula.
c) Location of deep abscesses.
d) The state of the anorectal wall and the perirectal spaces.
e) Any damage to the anal sphincter.
5. Transperineal ultrasound may be a useful adjunct.

10. Medical Management
• Prompt surgical drainage.
• Medication for pain relief.
• Antibiotics are usually not necessary unless there is
associated diabetes or immunosuppression.
• Stool softeners may be used.

11. Surgery to drain the abscess which may be done under LA or GA
depending on the extent & location of the abscess.
• Low fistulae: lay open with either fistulotomy or
fistulectomy.
• High fistulae: may require a defunctioning proximal
colostomy; there is also a risk of postoperative faecal
incontinence.