Alternate Names: Anal abscess; Rectal abscess; Abscess - anorectal

Causes and Risks:

Infection of an anal fissure (cleft or slit), sexually transmitted infections, and blocked anal glands are causes of anorectal abscesses. Abscesses may occur in an area that is easily accessible for drainage, or higher in the rectum. Deep rectal abscesses may be caused by intestinal disorders such as Crohn’s disease or diverticulitis.

Superficial perianal abscesses are not uncommon in infants and toddlers who are still in diapers and have a history of anal fissures. The abscess often appears as a swollen, red, tender lump at the edge of the anus. The infant may be fussy from discomfort but there are generally no other associated systemic symptoms. Surgical drainage and antibiotics provide prompt relief.

Prevention:

In adults and adolescents prompt treatment or prevention of sexually transmitted diseases may prevent this cause of anorectal abscesses.

Frequent diaper changes and attention to hygiene and cleansing at diaper changes will help prevent both anal fissures and perianal abscesses in infants and toddlers.

Symptoms:

• discharge of pus from the rectum
• lump or nodule, swollen, red, tender at edge of anus
• fever
• pain in or around the anal opening
• pain associated with bowel movements
• constipation (may occur)

Signs and Tests: A rectal examination may confirm the presence of an anorectal abscess.

A proctosigmoidoscopy may be performed.

Treatment:

Abscesses are lanced and drained. Depending on the location of the abscess, the procedure may take place in an outpatient setting. If the abscess is very deep, surgery may be indicated.

Warm sitz baths may assist with localization of the abscess to permit drainage.

Pain medication and antibiotics may be indicated.

Prognosis:

The probable outcome is good with treatment. Infants and toddlers recover very quickly.

Complications:

• systemic infection
• anal fistula formation

Call your health care provider if rectal discharge or other symptoms of anorectal abscess develop.

Call your health care provider if fever, chills, or other new symptoms develop after treatment of an anorectal abscess.