Early symptoms of perianal abscess

Written by Chen Tian Jing
Colorectal Surgery
Updated on March 25, 2025
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When perianal abscesses occur, there are usually significant triggers, most commonly seen after acute diarrhea or when a patient's immunity has recently declined. In the early stages of a perianal abscess, there are sudden symptoms of localized swelling and pain around the anus, accompanied by a sensation of heaviness. As the local abscess cavity enlarges and the infection worsens, the patient may also experience general weakness, fever, and even a decrease in appetite. During the acute phase of a perianal abscess, due to severe local pain, patients are unable to carry on with normal life activities, including sitting and walking. The pain may further involve pelvic muscles and nerves, leading to difficulties with defecation and urinary retention.

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Written by Chen Tian Jing
Colorectal Surgery
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Does a perianal abscess require hospitalization?

Perianal abscess is a common acute onset disease in proctology. If surgery is performed for a perianal abscess, it is recommended that the patient be hospitalized. Hospitalization observation is mainly for the local wound, to prevent recurrence and infection, and to ensure early proper wound dressing and drainage work, laying a good foundation for granulation growth post-surgery. The general hospitalization duration is about one week to ten days. In some cases, where the symptoms are severe or the abscess cavity is large, the hospital stay may extend to 20 days. During hospitalization, it is necessary for a professional proctologist to disinfect and change dressings of the local wound, and it is important to wash with saline water after each bowel movement.

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Written by Yu Xu Chao
Colorectal Surgery
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Differences between minimally invasive surgery and traditional surgery for perianal abscess

In clinical practice, perianal abscesses are primarily due to infection and inflammation of the anal glands, which then leads to the formation of red and swollen masses around the anus, causing pain and swelling near the anus. If not treated surgically in a timely manner, it can lead to necrotizing fasciitis or anal fistulas. Minimally invasive surgery for perianal abscesses mainly aims to minimize damage to the anal sphincter during the procedure. Techniques such as loop drainage can be employed to preserve it, whereas traditional surgery generally involves larger incisions, but provides better drainage and has a lower recurrence rate post-operatively. However, leakage or moisture in the anal area can occur after traditional surgery. For minimally invasive surgery for perianal abscesses, there is a relatively higher recurrence rate since the drainage may not be as effective. However, the integrity of the anus post-surgery is better preserved and incidents of leakage are less frequent. The choice of surgical method should still be based on the severity of the perianal abscess.

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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.

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Written by Chen Tian Jing
Colorectal Surgery
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How many days is the hospital stay for perianal abscess surgery?

After surgery for a perianal abscess, due to the presence of a local wound and the significant discharge from the wound in the early postoperative period, combined with the potential fall of ligatures or elastic bands at the area, a hospital stay of approximately two weeks is required. For severe cases or those with deeper abscess cavities, a hospital stay of three weeks or even a month might be necessary. The main purpose of the hospital stay post-surgery is to monitor for any major bleeding from the wound, and to facilitate dressing changes. Postoperative dressing changes for a perianal abscess wound are crucial for recovery, as only thorough daily disinfection and dressing changes can ensure uniform granulation and growth of local tissues, prevent the enclosure of pus within the local cavity leading to pseudohealing or reinfection, and thus affect the treatment outcome of the surgery. Approximately one month after surgery, regular follow-up visits are required to monitor the healing of the local wound.

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Written by Yu Xu Chao
Colorectal Surgery
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Can a perianal abscess burst on its own after it forms pus?

After an anal abscess becomes purulent, one should not attempt to rupture it on their own. If purulence occurs, it is advised to perform local disinfection under a doctor's supervision, followed by incision and drainage or pus aspiration to prevent further infection. Attempting to rupture it on your own can easily lead to further aggravation of the local infection. After an anal abscess becomes purulent, the choice of incision location is crucial; once cut, it is necessary to maintain unobstructed drainage to avoid subsequent infection or even necrotizing fasciitis. In clinical practice regarding anal abscesses, it is advised to visit a colorectal surgery department at a hospital as soon as the abscess is detected, to undergo procedures such as incision and drainage or radical surgery of the anal abscess to avoid the later development of anal fistulas or necrotizing fasciitis. Post-surgery, medications such as red oil gauze strips, anal cleansing solutions, and aureomycin ointment are recommended for dressing changes.