What Is Perianal Abscess? Symptoms, Treatment, Surgery and Risk of Anal Fistula

Perianal abscess is an acute infectious condition characterized by sudden anal pain, swelling, redness and sometimes fever. Patients often describe difficulty sitting, night-time pain and progressive swelling. Without timely treatment, the infection may worsen and increase the likelihood of anal fistula formation. Therefore, early diagnosis and appropriate surgical management are important.

 

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Symptoms

 

 

Common symptoms include:

 

• Severe anal pain

• Swelling and tenderness

• Local redness

• Fever (may not always be present)

• Purulent discharge

• Pain when sitting or walking

 

 

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Causes

 

 

Most abscesses originate from cryptoglandular infections due to obstruction of anal glands. Other associated factors may include:

 

• Crohn’s disease

• Diabetes mellitus

• Chronic constipation

• Immunosuppression

• Prior fistula disease

 

 

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Diagnosis

 

 

Diagnosis is mainly clinical. In deep or atypical cases, imaging such as:

 

• Ultrasound

• MRI

  may be required.

 

 

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Treatment

 

 

The definitive treatment is surgical drainage. Antibiotics alone are insufficient. Drainage provides rapid pain relief by reducing local pressure and infection.

 

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Surgical Management

 

 

Drainage can be performed under local, spinal or general anesthesia. The procedure is short and same-day discharge is possible. Postoperative care focuses on hygiene, wound care and preventing constipation.

 

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Recovery

 

 

Pain typically improves within days. Discharge may continue for a short period. Sitz baths and hygiene measures are recommended.

 

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If Untreated: Risk of Anal Fistula

 

 

Delayed or untreated cases carry a higher risk of developing anal fistula. Therefore, abscesses are not conditions that should be left to “resolve on their own”.

 

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When to Seek Medical Attention

 

 

Medical evaluation is recommended when:

 

• Severe pain

• Swelling

• Fever

• Purulent discharge

• Inability to sit comfortably

  are present.

 

 

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Mini FAQ

 

 

Can a perianal abscess heal without surgery? → No, drainage is essential.

Does it always lead to a fistula? → Not always, but risk increases if untreated.

Does it recur? → If a fistula is present, recurrence is possible.

 

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Clinic Information

 

 

Op. Dr. Hakan Bayri — General Surgery & Proctology

 

We evaluate and treat anorectal conditions including hemorrhoids, fissures, fistulas, abscesses, anal warts, rectocele and incontinence.

 

Address: Kızılırmak Mah., Dumlupınar Blvd. No:9A, YDA Center, 19th Floor, Suite 747, Ankara

Phone: +90 537 022 15 42 — +90 547 530 40 40

Web: www.hakanbayri.com