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Updates in the Management of Anorectal Abscess and Inflammatory or Thrombotic Process

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Operative Techniques and Recent Advances in Acute Care and Emergency Surgery

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Abstract

Thrombosis and inflammation are common causes of anorectal emergencies. Anorectal suppuration can lead to live-threatening disease (Fournier Gangrene) if is not treated immediately. Formation of subsequent fistula is rare after sufficient drainage. Abscesses caused by acne inversa are in most cases chronic suppurative lesions in the anorectal region without fistulation to the anal canal. Definitive treatment consists in radical surgical excision. Thrombosis of hemorrhoidal or anal vein is very painful, but can be managed conservatively in most cases. Local excision can be considered in patient with large segmental thrombosis and short-time duration. Acute abscess may be a first clinical manifestation of pilonidal sinus. At an acute stage, only local limited drainage of the abscess should be performed. Definitive surgery should be consist in excision with primary closure by an off-midline procedure.

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Authors and Affiliations

  1. End- und Dickdarm-Zentrum Essen, Essen, Germany

    Andreas Ommer

  2. Caritas-Krankenhaus St. Josef, Regensburg, Germany

    Markus Noll & Alois Fürst

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  1. Andreas Ommer
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  2. Markus Noll
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Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Milano, Italy

    Paolo Aseni

  2. School of Medicine, University of Milano-Bicocca, Niguarda Hospital, Milan, Milano, Italy

    Luciano De Carlis

  3. Department of Cardiac Surgery, IRCCS MultiMedica, Milan, Milano, Italy

    Alessandro Mazzola

  4. Department of Cardiac Surgery, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy

    Antonino M. Grande

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Ommer, A., Noll, M., Fürst, A. (2019). Updates in the Management of Anorectal Abscess and Inflammatory or Thrombotic Process. In: Aseni, P., De Carlis, L., Mazzola, A., Grande, A.M. (eds) Operative Techniques and Recent Advances in Acute Care and Emergency Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-95114-0_42

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