Abscess, periproctitic K62.8

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Anal abscess; Perianal abscess; Periproctitic abscess

Definition
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Abscess in the anal region.

Etiopathogenesis
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Mostly a consequence of an intersphincteric microabscess, which always starts with an intraanal infection. Spreading of the microabscess over given cleft spaces or in the lymphatic system.

Localization
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Perianal, ischiorectal, pelvirectal.

Clinical features
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Defecation pain, pressure or spontaneous pain, inflammatory redness or swelling.

Complication(s)
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Anal fistula.

Therapy
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Remember! In the presence of fistulas, rule out Crohn's disease or tuberculosis.

Operative therapie
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  • Surgical removal with a T-shaped or oval incision up to the primary focus while protecting the anal sphincter to avoid incontinence (puborectal loop) or an anal fistula.
  • Smaller subcutaneous and submucous abscesses are incised and evacuated under local anaesthetic.
  • Open and drain larger abscesses broadly: oval, star-shaped, diamond-shaped or T-shaped partial resection of the abscess cover under general anaesthesia, followed by careful deep curettage. Avoid a via falsa!
  • In the presence of a recognizable fistula tract: primary splitting and tamponade insertion, healing of the wound per secundam.

Aftercare
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  • 1-2 dressing changes/day with antiseptic ointment (e.g. Braunovidone, Betaisodona ointment), wound gauze and sitz baths (e.g. Betaisodona perineal antiseptic), preparation of partial baths and compresses with antiseptic solutions such as potassium permanganate solution (light pink). Wound cleansing irrigations with polihexanide (Serasept, Prontoderm) or Ringer's lactate solution, see also wound treatment.
  • Initially antiseptic ointment dressings, in case of a clean wound bed, healing-promoting measures.

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020