Perianal abscess clinical manifestations

Written by Chen Tian Jing
Colorectal Surgery
Updated on December 13, 2024
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Perianal abscess is an acute infectious disease of the local skin, mucosa, and sphincter around the anus, characterized by certain acute clinical symptoms, most commonly pain. The onset of a perianal abscess is generally sudden, occurring within one to three days. Due to the formation of a local pus cavity, intense pain is experienced along with the red, swollen, and hot skin in the affected area. The nature of the pain is often throbbing or pecking. If the infection worsens or is not actively treated, it may also cause systemic symptoms such as fever and chills due to the pain and infection. With repeated attacks over a long term, or if the patient's physical condition is poor, further symptoms like fatigue might occur. Acute episodes of perianal abscess require prompt surgical intervention.

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Written by Chen Tian Jing
Colorectal Surgery
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Can a perianal abscess heal by itself without rupturing?

Perianal abscesses that have not ruptured generally involve two scenarios. First, the application of topical or oral antibiotics may eliminate the local abscess, but some infection foci and swelling may persist, with a possibility of recurrence later. The second scenario occurs when the abscess does not rupture, but the pus chamber further expands, leading to an increase in the area of infection and thus worsening systemic infection symptoms. Once a perianal abscess is detected, it is necessary to treat it promptly. If an early-stage typical pus chamber has not formed, antibiotics can be used for symptomatic treatment to reduce local inflammation. If a clear pus chamber has formed and is accompanied by pus, it is advisable to promptly perform an incision and drainage of the abscess, followed by a definitive surgical debridement.

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Written by Chen Tian Jing
Colorectal Surgery
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Can a perianal abscess heal by itself?

During the acute phase of a perianal abscess, there is significant local redness, swelling, heat, and pain around the anus. Generally, this condition is caused by an infection of the anal crypts, and the possibility of self-healing is very low, so the main treatment for a perianal abscess is surgery. The surgical approach usually involves incision and drainage of the perianal abscess, combined with a one-time curative surgery. If the abscess ruptures and forms an anal fistula, surgical treatment is also required. During the outbreak of a perianal abscess, due to the severe local pain, it is advisable to undergo surgery as soon as possible to prevent further spread of the abscess. Simple topical medications can only relieve the symptoms of local inflammatory infection and cannot achieve a cure.

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Written by Chen Tian Jing
Colorectal Surgery
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Which is more serious, perianal abscess or hemorrhoids?

Perianal abscesses and hemorrhoids are two different types of anorectal diseases. During the acute phase of a perianal abscess, the urgency of the condition is greater than that of hemorrhoids. If active surgical intervention and incisional drainage and debridement are not carried out for a perianal abscess, it can lead to further enlargement of the pus cavity, increasing the size of the infected wound and the focus of infection, causing more severe pain and symptoms of systemic infection in the patient. Hemorrhoids, on the other hand, can be managed with conservative medication to alleviate symptoms. Surgical treatment is considered only when there are recurrent flare-ups, severe pain, significant prolapse, and worsening bleeding.

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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.