Perirectal Abscess, ,

Study objective: To review clinical features of perirectal abscesses and to determine appropriate management. Design: Retrospective analysis of medical records. Setting: Urban teaching hospital. Participants: Ninety-two patients with the discharge diagnosis of perirectal abscess over a 4-year period. Results: Perirectal pain was the most common presenting symptom, being present in 98.9% of cases. External perianal and digital rectal examination identified an abscess in 94.6% of patients. A variety of aerobic and anaerobic bacteria from skin, bowel, and, rarely, vagina were identified as causative agents, with mixed infections common. The major complications of perirectal abscesses included formation of extensive abscesses and urine retention. Abscess resolution occurred in all patients after adequate drainage. Antibiotics appeared to be useful only as adjunct therapy. Conclusion: Effective management of perirectal abscess involves early, adequate drainage, with antibiotics in an adjunct role.