Complications

Complication
Timeframe
Likelihood
short term
low

Necrotizing soft-tissue infections of the perineum (Fournier gangrene) with life-threatening sepsis may be present or develop in patients with anorectal abscesses when there is a delay in diagnosis or management.

This is more likely to occur in patients with diabetes, immunocompromise, chronic debilitation, or older age.[3][11]

Necrotizing fasciitis

variable
high

Between 30% to 70% of anorectal abscesses present with concomitant fistula, and around 30% to 50% of patients with anorectal abscesses develop an anal fistula in the months or years following drainage.[4][36][27]

If examination at the time of surgical drainage reveals an associated anal fistula, while controversial, consideration can be given to managing the fistula at the same time.[28][30][31][32] If the anal fistula is superficial and involves less than 30% of the sphincter mechanism, some surgeons feel that the anal fistula can be managed by fistulotomy.[4] 

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