(Disclaimer: This article is for general use only, and the information in the following content has been processed to protect patient privacy) Abstract: An 80-year-old man with fever developed perineal and rectal downward discomfort without perianal pain symptoms, and was diagnosed with rectal abscess after completing relevant examinations. The patient recovered well, and the anal incision was completely healed after 2 months of outpatient follow-up. [Basic information] Male, 80 years old [Disease type] Rectal abscess [Consultation hospital] Hegang People’s Hospital [Consultation time] December 5, 2018 [Treatment plan] Surgical treatment (abscess incision + hose drainage + endogastric hanging) + clean enema + intravenous infusion (cefoperazone sodium sulbactam for injection + ornidazole injection) + physical cooling (warm water bath) [Treatment cycle] Inpatient treatment 14 days, postoperative outpatient incision care for 2 months 【Treatment effect】Anal swelling disappeared, urination flowed smoothly I. Initial interview The patient was 80 years old, hospitalized with high fever and temperature up to 39℃, no abnormality was found in the chest CT, blood count indicated that leukocytes and neutrophils were significantly elevated, difficulty in urination and discomfort of anal and perineal swelling occurred in the past 3 days, and the perineal swelling was still present after catheterization and was aggravated After the catheterization, she still had perineal swelling, and the tendency was worsening. After listening to the presentation of the patient’s condition, we examined the patient’s anus and found that the anal appearance was as normal, and internal finger diagnosis revealed that the anterior rectal wall was full and painful to palpation. Initially, we considered that this was a case of rectal abscess with a deep location, and then we saw pus and blood in the rectal puncture and confirmed the diagnosis of rectal abscess. Because the patient had a submucosal abscess in the anterior rectal wall and its location was deep, the local swelling and pain in the anus was not obvious, while fever, chills, discomfort in the anus and perineum and difficulty in urination were the main symptoms. Treatment The patient was diagnosed with rectal abscess and required surgery, so she was transferred to the Department of Proctology for treatment. After the patient was transferred, clean enemas were routinely performed, and during the emergency surgery, it was found that the rectal abscess had spread to the pelvic rectal space, so the patient was given an abscess incision, hose drainage, and endogastric hanging, and the pus was taken for bacterial culture during the operation, and the operation went smoothly. After the operation, the patient was given cefoperazone sodium sulbactam sodium for injection and ornidazole injection for intravenous infusion of anti-inflammatory treatment. III. Treatment effect On the 2nd postoperative day, the patient ate normally, the swelling in the anus and perineum area was significantly reduced, and the rectum was flushed with saline and the anus was cleaned and cared for after stool. On the 3rd postoperative day, the patient had a low fever and the body temperature fluctuated between 37.4℃ and 37.8℃, so the patient was given a warm water bath to physically reduce fever; on the 5th postoperative day, the body temperature was normal, the catheter was removed and the patient could urinate normally, and the blood count was rechecked during the period, and the white blood cells gradually decreased to normal, and the use of antibiotics was stopped after 7 days; on the 10th postoperative day, the anorectal glue tube was removed to drain the anus, and the glue band in the rectum fell off in 14 days after hospitalization, and the traumatic granulation The patient was discharged with fresh and good growth. The patient was discharged from the hospital after 2 months of outpatient incision care without any complications and without abscess recurrence or postoperative anal fistula. We are glad that the patient’s condition gradually recovered, and advised the patient’s parents to pay attention to warmth in daily life and add clothes in time with the weather; pay attention to monitoring the patient’s body temperature, and seek medical consultation for symptomatic treatment if the body temperature is too high; after the patient’s discharge, before the incision is completely healed, clean the anal area in time after the patient’s bowel movement to avoid infection; the diet should be rich in nutrition and also easy to digest, such as pigeon soup, fish meat, etc. Spicy and stimulating foods should be prohibited. V. Personal insight The patient was an elderly male with fever as the first symptom, and his family visited him promptly. Although initially treated in the respiratory department, as his condition changed, he eventually promptly asked for a consultation in the anorectal department and was diagnosed with rectal abscess, which prevented the disease from deteriorating and not progressing to the stage of necrotizing fasciitis and septicemia, and was eventually treated surgically and obtained good treatment results. The patient and her family trusted the doctor and cooperated with him unconditionally in the treatment process, and were able to follow the doctor’s orders after discharge, achieving a successful outcome.