Perianal abscess, also known as perianal rectal abscess, is an acute purulent disease with an incidence of about 3-6% of anorectal diseases. After rupture or incision and drainage of pus, anal fistula is gradually formed. The incidence is most frequent in young adults aged 20-40 years old, with more men than women.
Perianal abscesses can be divided into several conditions
Perianal abscess is a complex condition, and can be subdivided into several types depending on the site of onset.
a. Subcutaneous and submucosal abscesses
b. inter-sphincter abscesses (low or high)
c. abscesses of the colorectal fossa
d. abscesses of the pelvic rectal fossa (deep abscesses)
Perianal abscess, an easily misidentified disease
Perianal abscesses, because their symptoms are mainly abscesses, can be easily confused with other diseases. The main diseases that can be easily confused with it are the following.
1. Paranal boils
It is caused by purulent bacterial infection, with bright red burning skin and a small white head in the center, the lump is superficial, easy to collapse and converge, and will not form an anal fistula after it collapses.
2. Perianal purulent sweat gland infection
The perianal skin has multiple purulent lesions with multiple pus-flowing wounds, and the sores can be connected to each other to form subcutaneous fistulas, but the fistulas are not connected to the anal dentate line or rectum. The skin of the lesion is thickened, and there is extensive chronic inflammation and scar formation.
3.Presacral teratoma
It is characterized by smooth post-rectal mass, no obvious pressure pain, cystic feeling and lobulation. X-ray examination shows a mass in front of the sacrum pushing the rectum forward or to one side, and scattered calcified shadows such as teeth are visible.
4.Perianal powdery tumor and cyst
Before infection, the original skin color is unchanged and the lumps are soft and painless; only after infection do local symptoms of redness, swelling, heat and pain appear, and the lumps are easy to heal after rupture or excision.
5.Sacrococcygeal tuberculous abscess
Patients mostly have a history of tuberculosis with a long course of disease; bone destruction can be seen on X-ray radiographs and sinus imaging; Mycobacterium tuberculosis can be found in pus culture.
The perianal and lateral rectal tissues are lax and not easily confined to inflammation; therefore, untreated perianal abscesses are likely to cause the spread of inflammation, and deep abscesses may even spread to the abdominal cavity when the condition is serious. Clinically, it is difficult to treat diffuse inflammatory abscesses, the surgery is traumatic, and it is easy to cause incomplete removal of infection foci, easy to recur, and easy to produce problems of sequelae. This is a disease that cannot be ignored and can bring a lot of trouble and annoyance to life. Once you find a swelling and pain around the anus and other problems, you are advised to go to the hospital for examination and treatment as soon as possible so as not to delay causing more damage.