As compared to most other abscesses, the perirectal abscess is a true pain in the butt. The perirectal abscess generally strikes at random without respect to hygeine, age, or most other factors. Diabetics generally get more abscesses overall, and certain diseases such as hidradenitis suppurativa and Crohn's disease can also predispose one to having this condition.

The perirectal abscess is generally caused by enteric bacteria such as Escherichia coli which breach the dermal barrier and create a pocket of infection. These abscesses can range in size from a pimple to a huge collection of purulent fluid, and can be either annoying or life-threatening. If the immune system is able to beat the infection before it passes a certain size threshold, the abscess will generally resolve itself spontaneously. If not, however, they tend to continue growing. The gold standard of treatment in these cases is incision and drainage along with antibiotics targeted toward the enteric bacteria.

Depending on the extent of the abscess, a simple I&D usually solves the problem when followed by antibiotics and Sitz baths. If the abscess has burrowed its way into the surrounding fatty tissue and muscle, it can become destructive and require surgical debridement.

The other main risks of this type of abscess are enteric septicemia and fistulization. Sepsis is immediately life-threatening and requires intravenous antibiotics and stabilization of the circulatory system, while fistulas are more of a chronic surgical issue.

Perirectal abscesses are diagnosed by the presence of:

Patients are generally very uncomfortable when attempting to sit, and often sit on the edge of the chair, tilted to one side, or not at all. Prompt medical attention should be sought if you think you may have this condition.


Based on my personal training, knowledge, and experience

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