Summary
Definition
History and exam
Key diagnostic factors
- anal fistula
- history of Crohn disease
- male sex
- perianal pain
- perianal or rectal induration
Other diagnostic factors
- perianal swelling
- low-grade fever
- tachycardia
- change in bowel habits
- rectal bleeding
- inability to urinate
Diagnostic tests
Tests to consider
- WBC count
- serum glucose
- serum electrolytes
- anal ultrasonography
- CT pelvis
- MRI pelvis
- microscopic examination and/or culture of the purulent fluid
Treatment algorithm
Contributors
Authors
Jan Rakinic, MD, FACS, FASCRS
Professor of Surgery
Chief
Section of Colorectal Surgery
Southern Illinois University School of Medicine
Springfield
IL
Disclosures
JR is an author of a reference cited in this topic.
Acknowledgements
Dr Jan Rakinic would like to gratefully acknowledge Dr C. Neal Ellis, a previous contributor to this topic.
Disclosures
CNE declares that he has no competing interests.
Peer reviewers
Mark H. Whiteford, MD
Assistant Professor of Surgery
Colon and Rectal Surgery
Gastrointestinal and Minimally Invasive Surgery Division
The Oregon Clinic
Portland
OR
Disclosures
MHW declares that he has no competing interests.
Neil Hyman, MD
Chief
Division of General Surgery
Professor of Surgery
Fletcher Allen Healthcare
Burlington
VT
Disclosures
NH declares that he has no competing interests.
Steven Brown, MBChB, FRCS, MD, BMedSci
Consultant Surgeon
Department of Colorectal Surgery
Sheffield Teaching Hospitals
Sheffield
UK
Disclosures
SB declares that he has no competing interests.
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