Anorectal Abscess, Dr. Weyrich's Naturopathic Proctology Notebook

Overview

An anorectal abscess is an extremely painful infection that produces a pus-filled sac under the skin of the anus or mucosa of the rectum. More serious forms may be found under the muscular layer. Naturopathic, Complimentary and Alternative treatments that may be considered include:

Signs and Symptoms

Pain in the rectum or anus.
Fever and possible elevation in white blood cell count.
Swollen, warm, red induration.

Etiology

The origin of anorectal abscesses is not completely understood, but proposed causes include:

Secondary to cryptitis.
Secondary to an enlarged papilla.
Iatrogenic.

Treatment

Incision and drainage provides considerable relief from pain. Antibiotics alone are not sufficient, but may be used as an adjunct to incision and drainage.

When performing an incision and drainage, precaution must be taken to prevent the premature healing of the opening. If the surgical incision heals over to quickly, remaining infection may become entrapped and lead to a relapse. In order to promote healing from the inside out, the incision at the superficial skin level may be purposely enlarged, or else a surgical wick or drain may be inserted in the incision.

Sequelae

If left untreated, the infection may spread to the perineum or lead to septicemia. These are medical emergencies. Alternatively, the abscess may rupture and drain spontaneously.

Incision and drainage or spontaneous rupture may result in fistula formation, which requires further treatment.

ICD-9 Codes