Anal abscess

The symptoms of perianal abscess begin with the sensation of a small hard lump or mass around the anus, followed by increased pain, redness, swelling, and heat, a feeling of heaviness and discomfort, restlessness, inability to sleep at night, constipation, difficulty urinating, or tenesmus and other rectal irritative symptoms. This is subsequently accompanied by systemic symptoms such as general malaise, mental fatigue and weakness, elevated body temperature, loss of appetite, chills, and high fever, which are systemic toxic symptoms. 1. Subcutaneous perianal abscess is an abscess formed beneath the skin around the anus, with local redness, swelling, heat, and pain. If pus has formed, there is a distinct local fluctuation, while systemic symptoms are generally not obvious. 2. Ischiorectal fossa abscess is an abscess formed in the ischiorectal fossa, with an area of infection that is more extensive and deeper than a subcutaneous abscess. Initially, there is only anal discomfort or slight pain, gradually accompanied by fever, chills, headache, and loss of appetite, followed by more severe local symptoms such as burning or throbbing anal pain, which is aggravated by defecation, coughing, and walking. Digital rectal examination can palpate fullness on the affected side, with obvious tenderness and fluctuation. 3. Pelvirectal space abscess is located above the levator ani muscle and below the peritoneum. This type of abscess is deep and hidden, with local symptoms not very obvious, sometimes only a feeling of rectal descent. However, systemic symptoms are more severe. Digital rectal examination reveals infiltration, induration, tenderness, bulging, and fluctuation on the rectal wall of the affected side. 4. Retrorectal space abscess has main symptoms similar to those of pelvirectal space abscess. There is obvious bearing-down sensation in the rectum and dull pain in the sacrococcygeal region. It may radiate to the lower limbs, and there is obvious deep tenderness between the coccyx and the anus. Digital examination reveals tenderness, bulging, and fluctuation on the posterior rectal wall. In addition, according to the nature of the pathogenic bacteria of perianal abscess, it can be divided into: 1. Acute suppurative abscess, mostly caused by staphylococcus, streptococcus, and Escherichia coli infection. 2. Chronic suppurative abscess, mostly caused by Mycobacterium tuberculosis infection.