Rectal Abscess and Fistula: The Daily PANCE Blueprint
Which of the following is the best treatment option for a patient who presents to the hospital complaining of a tender, pruritic fluctuant perirectal mass for the past few days?
A. Hemorrhoidectomy
B. I&D of the abscess
C. IV antibiotics and fluid
D. Fistulotomy
E. Situ baths
Answer and topic summary
The answer is B. I&D of the abscess
An anal abscess is a pus-filled cavity of the perirectal area. It commonly occurs due to an infected anal crypt gland. Other causes include IBD, radiation, and malignancy. Clinical features include pain, pruritus, discomfort, rectal drainage, tenderness, and a palpable tender mass on DRE. Diagnosis is usually clinical; a CT can be obtained though if needed. Treatment is surgical incision and drainage with subsequent open wound healing. Most anal abscesses heal on their after drainage, but some will lead to a fistula (the connection between the abscess and anal canal or skin).
View blueprint lesson
Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ ⇒
