2. ANORECTAL ABSCESS
•MC organism – E.COLI
•Commonly occurs due to infection of anal glands
in relation to crypts-CRYPTOGLANDULAR
DISEASE (95%)
•Common in diabetics & immunocompromised
•Other causes-
o injury to anorectum
o Cutaneous infection ( boil)
o Blood born infections
3. PATHOPHYSIOLOGY
Originates from an infection arising in the
crypto glandular epithelium lining the anal
canal
The internal anal sphincter normally serves
as a barrier to infection passing from the gut
lumen to the deep perirectal tissues.
This barrier can be breached through the
crypts of Morgagni, which can penetrate
through the internal sphincter into the
intersphincteric space
4. PATHOPHYSIOLOGY
Once infection gains access to the
intersphincteric space, it has easy
access to the adjacent perirectal
spaces
Extension of the infection can
involve the intersphincteric
space 2–5%, ischiorectal space
20-25% , or even the
supralevator space 2.5%.
12. PERIANAL ABSCESS (60%)
•Lies in region of subcutaneous
portion of EXTERNAL SPINCTER
•Usually results from suppuration of
anal gland or thrombosed ext pile or
any infected perianal condition
16. ISCHIORECTAL FOSSA
•PYRAMIDAL IN SHAPE
•5CM DEPTH,2 CM WIDTH
•Right & left communicate with each other
through posterior spincteric space- HORSE
SHOE abscess
17. ISCHIORECTAL FOSSA- BOUNDARIES
•LATERALLY-fascia covering OBTURATOR
INTERNUS
•MEDIALLY- LEVATOR ANI & EXTERNAL
SPINCTER
•POSTERIORLY- SACROTUBEROUS
LIGAMENT & GLUTEUS MAXIMUS
•ANTERIORLY- UROGENITAL DIAPHRAGM
•BELOW- BY SKIN
18. ETIOLOGY
•Commonly it is due to extension of
lower intermuscular anal abscess
laterally through ext spincter
•Fat in fossa is more prone to infection
coz its LEAST VASCULARISED