Perianal Abscess

Symptoms

Pain is usually the most obvious symptom. The more superficial abscess may also start as a swelling that is painful when touched. The area may also feel warm to touch. This pain is persistent and may be worse when passing motion.

Some patients are so fearful of the pain that they avoid passing motion when they have an abscess. For some of the deep abscesses, pain may be the only symptom. Although an abscess is due to an infection, fever may not always be present. Some of the abscesses are very deep seated and pain may be the only symptom.

In some cases, the skin over the abscess may break and pus (and sometimes a bit of blood) may discharge. The pain and swelling would usually improve after the pus is discharged, but you should still see your doctor to ensure that all the pus is cleaned out. If the pus is not properly cleared, the abscess can recur in the near future.

Some people confuse the swelling with haemorrhoids (piles).

Diagnosis

Most of the time, it is fairly easy to diagnose an abscess just by looking at it and touching it.

In some of the rare deep abscesses, it might require either ultrasound, CT scan or even MRI for an accurate diagnosis.

Treatment

Some of the very small and early abscesses may be treated with antibiotics and use of a needle and syringe to suck out most of the pus.

Most abscesses require incision and drainage. This is a minor colorectal surgery in which the skin over the abscess is cut open and the pus is washed out. The skin cut is not stitched back, and the open wound requires daily cleaning to ensure that no remnant pus stays behind.