Which department should I go to for perianal abscess?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 14, 2024
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During the acute phase of a perianal abscess, patients experience significant local redness, swelling, heat, and pain around the anus. The pain is severe and in some cases, patients are unable to sit or walk normally due to the discomfort. During this acute phase, the swelling of the skin around the anus can easily be confused with skin carbuncles, leading patients to mistakenly visit a dermatologist. However, a perianal abscess is a local anal disease that requires registration with a colorectal surgery department, as it is not merely a skin carbuncle but an infection caused by an infection at the anal crypts inside the anal canal. This necessitates prompt surgical incision and drainage, and, if a fistula has formed, a fistulotomy may also be necessary.

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Written by Chen Tian Jing
Colorectal Surgery
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Precautions for Perianal Abscess

The precautions for perianal abscess mainly include those during an acute episode and post-surgical measures. If it is clearly an acute onset of a perianal abscess, it is important to seek treatment promptly. Treatment methods, besides incision and drainage, further include debridement to achieve a complete cure through surgery. Generally, simple incision and drainage only alleviate temporary pain symptoms. If not followed by definitive surgery, there is a high likelihood of developing anal fistulas, necessitating a second surgery. Post-surgical precautions for a perianal abscess primarily involve maintaining cleanliness of the local wound, changing dressings, and ensuring that the drainage from the wound remains unobstructed to prevent false healing.

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Written by Chen Tian Jing
Colorectal Surgery
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Symptoms of perianal abscess

Perianal abscess is a common acute infectious disease in proctology. When a perianal abscess occurs, the patient generally experiences severe pain in the anal area accompanied by local skin redness, increased skin temperature, and even systemic fever and fatigue symptoms due to the local abscess. During an outbreak of a perianal abscess, the abscess cavity or pus encapsulation can generally be clearly seen under perianal color ultrasound, and it is necessary to promptly carry out perianal abscess incision and drainage surgery, as well as further one-time radical surgery for the perianal abscess. If not treated actively, a perianal abscess might rupture and likely form an anal fistula, the treatment of which is also primarily surgical.

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Written by Xiao Zhi Guo
Colorectal Surgery Department
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How to treat perianal abscess?

Perianal abscesses generally have two treatment options. Initially, if the abscess is not very large and the swelling and pain are not particularly severe, conservative treatment with antibiotics can be used temporarily. If conservative treatment is ineffective and the swelling worsens, surgical treatment may be necessary. In cases of severe abscesses, incision and drainage can be considered first, followed by antibiotic treatment. Surgical definitive treatment can then be performed 3-5 days later.

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Written by Chen Tian Jing
Colorectal Surgery
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What is the best medicine to take for a perianal abscess?

Perianal abscess is a type of acute infectious disease localized around the anus, and oral medication is not necessarily the best treatment method for perianal abscesses. Rather, the best treatment for perianal abscesses is surgery. Surgical methods generally include incision and drainage procedures, as well as further definitive surgeries, because perianal abscesses are associated with infections in the anal crypts. Thus, medication alone can only relieve symptoms and cannot completely clear the infection. If treatment is solely through medication or if it is incomplete, there is a high likelihood of recurrent infections, which may even lead to the formation of anal fistulas. Once an anal fistula forms, it can only be cured through surgical procedures that involve cutting and threading.

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Written by Deng Heng
Colorectal Surgery
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Will people with perianal abscess experience weight loss?

Generally, perianal abscesses do not cause weight loss. Typically, perianal abscesses are caused by common bacteria infecting the spaces around the anus and rectum, leading to an acute purulent infection. When an abscess forms, it can cause sudden swelling and pain in the perianal area, with episodic increases in pain. However, if the abscess is caused by tuberculosis bacteria, it can lead to a chronic condition and systemic wasting diseases, which may present symptoms such as night sweats, feverish feelings, etc. Chronic diseases can cause weight loss.