The aerobes most commonly implicated are Staphylococcus aureus, Streptococcus, and Escherichia coli. Other symptoms of an abscess or fistula are: Supralevator abscesses, the least common of the four major types, may form from cephalad extension of the intersphincteric abscess above the levator ani or from caudal extension of a suppurative abdominal process eg, appendicitis, diverticular disease, gynecologic sepsis into the supralevator space. The frequent sites of infection are the lung Table Anorectal abscesses are classified according to their anatomic location; the following are the most common locations see the image below:. Extrasphincteric fistula tracts can traverse in either direction from the perineal skin through the ischioanal fossa and levator ani muscle to penetrate the rectal wall. If one of these glands becomes blocked, it can become infected.
A fistula is an abnormal opening in the skin near the anus. Lohsiriwat V, Yodying H, Lohsiriwat D ; Incidence and factors influencing the development of fistula-in-ano after incision and drainage of perianal abscesses. An anal, or rectal, abscess occurs when a cavity in the anus becomes filled with pus. These can reduce the number of subsequent septic events by providing continuous drainage and preventing premature closure of the external opening. All abscesses can progress to serious generalized infections requiring lengthy hospitalizations if not treated.
Anal abscess and fistula | Bowel condition | ACPGBI
A pilonidal sinus with perianal extension can be identified by prior history or by the presence of midline pilonidal pits in the gluteal cleft cephalad to the point of the coccyx. The key to this is in defining local anatomy, allowing ongoing drainage of pus and, where possible, treating fistulae while preserving the integrity of the internal and external sphincters. Deep rectal abscesses may be caused by intestinal disorders such as Crohn disease or diverticulitis. Perianal abscess is not uncommon in small infants. Evaluation begins with a careful history as described earlier. If the fistula involves too much sphincter muscle, a two-stage procedure or more complicated repair may be necessary.
This methodologically sound, prospective study has provided strong evidence for the benefit of combined use of setons and infliximab in the management of perianal sepsis in Crohn's disease. Home Health A-Z Anal fistula. Dis Colon Rectum ; 52 2: This is achieved by ischaemia in the tissue edges inside loops allowing the seton to slowly cut through and leave scarring behind the loop. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.