Perianal Abscess and Fistula

What is a perianal abscess?

An abscess is a collection of pus. Perianal abscess is a collection of pus that develops in tissues around the anal canal.

What causes a perianal absess?

A perianal absess occurs as a result of cryptoglandular infection of the small anal glands in the anal canal. Bacteria lodge in these glands and become a nidus for infection that can in some circumstance spread between muscular sphincter planes and to surrounding structures. Enlargement of the abscess occurs and points towards the overlying skin. At times an perianal abscess is associated with a fistula.

What is a fistula?

A fistula is an abnormal connection between two epithelial surfaces (the lining of the anal canal and the outside anal skin). It may occur spontaneously or after drainage of a perianal abscess.

What are the symptoms of a perianal absess?

The symptoms of a perianal abscess include a constant throbbing pain in the anus, swelling and fever. The symptoms of a perianal fistula include a discharge of pus or faecal fluid that may be intermittent or constant through the external opening of the anal skin. 

How do you treat a perianal absess?

Perianal abscess is treated by examination under anaesthesia and drainage of the abscess cavity by an incision of the overlying skin. Perianal fistula is treated by examination under anaesthesia and assessment of the anatomy of the fistula tract. Once the fistula tract is identified a tailored surgical option to preserve anal sphincter function is performed.

How do you treat a fistula?

Anal fistula treatments can take a long period of time and be a difficult and frustrating condition for the patient. Healing rates are variable and often multiple operations can be required. A/Prof Terence Chua will provide a thorough explanation of the condition with a clear description of the anatomy to help you understand the situation. It is our belief that this will address all your concerns to allow us to deliver you the best surgical care that meets your expectations as we partner you on this journey to recovery.