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Perirectal Abscess

Perirectal Abscess is a topic covered in the 5-Minute Emergency Consult.

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Localized infection and accumulation of purulent material adjacent to anus or rectum


  • Anal crypt gland infection, with spread to adjacent areas separated by muscle and fascia:
    • Perianal:
      • Most common
      • Usually with red bulge near anus
    • Ischiorectal:
      • Large potential space
      • May become very large before diagnosed
      • Can communicate posteriorly with other side forming “horseshoe” abscess
    • Intersphincteric:
      • Contained at primary site of origin between internal and external sphincters
    • Supralevator:
      • Very deep above levator ani
      • Needs operative débridement under general anesthesia
      • Often systemic symptoms before diagnosis is made
  • Bacterial cause is typically a mix of stool pathogens:
  • Associated diseases:
    • Diabetes
    • Inflammatory bowel disease
    • Malignancy
    • Immunocompromised host

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Rosen, Peter, et al., editors. "Perirectal Abscess." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307405/all/Perirectal_Abscess.
Perirectal Abscess. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307405/all/Perirectal_Abscess. Accessed April 20, 2019.
Perirectal Abscess. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307405/all/Perirectal_Abscess
Perirectal Abscess [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 20]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307405/all/Perirectal_Abscess.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Perirectal Abscess ID - 307405 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307405/all/Perirectal_Abscess PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -