Horseshoe perianal abscess

Case contributed by Dr Michael P Hartung

Presentation

Progressive rectal pain after fall 2 weeks ago. Low grade fever and mild leukocytosis.

Patient Data

Age: 55 years
Gender: Male
CT

"U" or horseshoe-shaped enhancing collection surrounding the anus, outside of the external anal sphincter and localized in the ischiorectal fossa. 

Incidental right gluteus medius lipoma. 

Case Discussion

Horseshoe perianal abscess occurring 2 weeks after a hard fall onto the buttock region. Perianal abscesses most commonly occur due to infected anal glands at the dentate line (mucocutaneous junction). However, given the history of a fall, trauma may have resulted in a mucosal injury or anal gland obstruction, leading to the abscess formation. 

The abscess is outside of the external anal sphincter and localized in the ischiorectal fossa. Treatment is incision and drainage. 

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Case information

rID: 61791
Published: 19th Jul 2018
Last edited: 19th Jul 2018
Inclusion in quiz mode: Included

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