Perianal abscess

Case contributed by Dr Prashant Mudgal


Elderly patient presented with pain and perianal pustule.

Patient Data

Age: 63 years
Gender: Male

Extensive loculated fluid collection encircling the rectosigmoid and anal canal with surrounding inflammation suggestive of an anorectal abscess.

The abscess is extending from supralevator regions bilaterally to intersphincteric region. A complex fistulous tract is advancing from the left intersphincteric abscess to the subcutaneous region on the left side at 4-5 o'clock position in relation to the anal opening, less than 5 mm from the skin surface suggestive of an impending fistula.

The abscess is causing significant rectal and anal luminal compromise.

Case Discussion

An anorectal abscess arises from the epithelium of anal canal, from there infection can spread to intersphincteric space, ischiorectal fossa and supralevator space.

This is a case of an extensive perianal abscess with impending fistula formation and supralevator and intersphincteric extension with involvement of the left ischiorectal fossa.

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Case information

rID: 39783
Published: 20th Sep 2015
Last edited: 14th Aug 2019
Tag: pm
Inclusion in quiz mode: Included

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