Clinical and microbiological analysis of adult perianal abscess

Liu, Chien‐Kuo; Liu, Chang-Pan; Leung, Ching-Hsiang; Sun, Fang‐Ju

doi:10.1016/j.jmii.2011.01.024

Cited by 39 publications

(33 citation statements)

References 20 publications

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“…Literature has shown that about 40% patients develop a fistula in ano after primary incision and drainage of perianal abscess (15)(18). As perianal abscess frequently co-exists with fistula in ano, failure to identify and treat the internal opening at the time of primary operation may result in chronic fistulation 1 …”

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confidence: 99%

The prevalence, risk factors and outcome of surgical treatment of acute perianal abscess from a single Saudi hospital

Elhassan¹,

Guraya²,

Almaramhy³

2017

J Res Educ Indian Med - ISSN 0970-7700

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Background-Perianal abscess is a common surgical emergency that is often treated by junior surgical trainees. This study aims to report the prevalence, clinical features, predisposing factors, andthe outcome of surgical treatment of perianal abscess with particular attention to fistula in ano. Methods-The medical records of all consecutive patients admitted through emergency room and surgical clinics, from 2013 to 2015,in a single Saudi hospital were reviewed. The records of patients diagnosed with and treated for perianal abscess and fistula in ano were further reviewed for the pre-defined variables. Results-From a total of 3618 patients, 198 (18.2%) had perianal abscess with a mean age of 35.9 years. The body mass index of the study cohort ranged from 16.5 to 39.7 with a mean of 32. As many as141 (71%)patients had healed wounds after primary incision and drainage while 40 (20.2%) developed recurrent perianal abscess. Anal pain was the most common complaint noted in all 198 (100%) patients, followed by fever in 99 (50%). Forty (20.2 %; 32 men and 8 women) patients developed perianal fistula in ano. Forty six (23%) patients had predisposing risk factors including diabetes mellitus, hypertension, and Crohn's disease. Diabetes mellitus was the most common disease that was complicated by perianal abscess in both genders. Conclusion-The reported prevalence of perianal abscess and the outcome of surgical treatment is in accordance with the published data. Common health problems such as diabetes mellitus, obesity, and hypertension predispose to perianal abscess and fistula in ano. Both the recurrence of abscess and the need for readmission are preventable if disease is adequately treated during initial intervention.

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confidence: 99%

The prevalence, risk factors and outcome of surgical treatment of acute perianal abscess from a single Saudi hospital

Elhassan¹,

Guraya²,

Almaramhy³

2017

J Res Educ Indian Med - ISSN 0970-7700

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“…Infections may occur in various foci, such as mucosa, catheters, and respiratory and gastrointestinal tracts [6], which may subsequently result in bacteremia during the period of severe neutropenia. Perianal or rectal abscesses are uncommon in immunocompetent subjects [2] but they may occasionally occur in leukemia or other neutropenic patients [2,7,8,9,10]. In patients with acute leukemia receiving chemotherapy, the incidence of perianal abscess is 5-9% [1,11,12,13].…”

Section: Discussionmentioning

confidence: 99%

“…Microbiology profiles differ among various studies [1,14]. Surgical interventions should be advised in most immunocompetent patients with a perianal abscess [2,3,4]. Surgical treatment for leukemia patients with a perianal abscess has been reported [12,15,16].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Features and Recurrence Pattern of Perianal Abscess in Patients with Acute Myeloid Leukemia

Chang

Kuo²,

Tang³

et al. 2017

Acta Haematol

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Introduction: Perianal abscess may develop during neutropenia periods in patients with acute myeloid leukemia (AML). The standard of care for perianal abscess in AML is unclear. Methods: We retrospectively collected patient data in our institute from 2009 to 2012. Results: Two hundred ninety-two patients with AML were analyzed. In total, 1,051 chemotherapy sessions were administered. Twenty-three patients experienced perianal abscess. Patients with perianal abscess were younger than those without (44 vs. 60 years, p < 0.0001). Perianal abscess developed in various phases of treatment and in the stem cell transplantation period. Twelve recurrences developed in 6 patients. Patients with a prior perianal abscess have a 10-fold risk of developing a subsequent abscess following further chemotherapy. The microbiology profile revealed that most pathogens were derived from the intestinal tracts, which was similar to the findings of previous studies. The 28-day mortality was 14.3% and the direct cause of death was not perianal abscess in any case. Surgical interventions had no impact on recurrence or survival. Conclusion: In patients with AML, perianal abscess results from gastrointestinal tract pathogens. Many patients do not require surgical interventions. The mortality is low but recurrence is common following subsequent chemotherapies. Therefore, awareness of recurrence is important for the timely management of perianal abscess in AML.

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“…Its development may be favored by anti-inflammatory medications and diabetes. The microbial flora is of fecal origin, often with mixed bacteria, mostly Escherichia coli or Klebsiella pneumoniae (the latter especially in diabetics) [4]. Antibiotic treatment alone without adequate drainage is ineffective.…”

Section: Treatment Of the Abscessmentioning

confidence: 99%

Treatment of anal fistula and abscess

Pigot¹

2015

Journal of Visceral Surgery

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The glands of Hermann and Desfosses, located in the thickness of the anal canal, drain into the canal at the dentate line. Infection of these anal glands is responsible for the formation of abscesses and/or fistulas. When this presents as an abscess, emergency drainage of the infected cavity is required. At the stage of fistula, treatment has two sometimes conflicting objectives: effective drainage and preservation of continence. These two opposing constraints explain the existence of two therapeutic concepts. On one hand the laying-open of the fistulous tract (fistulotomy) in one or several operative sessions remains the treatment of choice because of its high cure rates. On the other hand surgical closure with tract ligation or obturation with biological components preserves sphincter function but suffers from a higher failure rate.

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Clinical and microbiological analysis of adult perianal abscess

Cited by 39 publications

References 20 publications

The prevalence, risk factors and outcome of surgical treatment of acute perianal abscess from a single Saudi hospital

The prevalence, risk factors and outcome of surgical treatment of acute perianal abscess from a single Saudi hospital

Clinical Features and Recurrence Pattern of Perianal Abscess in Patients with Acute Myeloid Leukemia

Treatment of anal fistula and abscess

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