Supralevator Abscess - A Diagnostic Dilemma

Abstract

Supralevator abscesses are the rarest manifestation of anorectal suppurative disease and are thought to originate from extension of ischiorectal or intersphincteric abscess. These abscesses pose a diagnostic dilemma because of their occult nature. A thorough knowledge of relevant anatomy and high index of suspicion is needed for its diagnosis. It is important to consider the possibility of supralevator abscess if a patient presents with rectal, pelvic or back pain and signs of infective process. Adequate diagnosis is done with CT scan or MRI scan. It is imperative to make sure that the supralevator abscess are adequately managed upon irst presentation. We report a case of supralevator abscess in a 33-year-old male who presented with right ischiorectal abscess. Following the initial drainage of the abscess, patient developed supralevator abscess which later extended into the anterior extraperitoneal compartment. Patient underwent multiple drainage procedures including supralevator space exploration and bilateral inguinal canal exploration to facilitate adequate drainage of abscess.