An anal abscess is an infected cavity filled with pus near the anus or rectum.
An anal fistula (also called fistula-in-ano) is a small tunnel that tracks from an opening inside the anal canal to
an outside opening in the skin near the anus. An anal fistula often results from a previous or current anal abscess. As many as 50% of people with an abscess
get a fistula. However, a fistula can also occur without an abscess
Small glands just inside the anus become clogged, this may result in an infection.
When the infection is serious, this often leads to an abscess. Other causes are associated with medical diseases like. Crohn’s disease, cancer, trauma,
and radiation that increase the risk of infections and fistulas.
A patient with an abscess may have pain, redness or swelling in the area around the anal area or canal.
many experience fever and chills. Patients with fistulas have similar symptoms, as well as drainage from an opening near the anus.
A fistula is suspected if these symptoms tend to keep coming back in the same area.
Most anal abscesses or fistulas are diagnosed and managed based on clinical findings. Occasionally, imaging studies such as ultrasound,
CT scan or MRI can help in the diagnosis and management of deeper abscesses & complex fistulous tracts.
The treatment of an abscess is surgical drainage in the operation theatre under general anesthesia.
Patients who tend to get more severe infections due to diabetes or immunity problems may need to be hospitalized
Surgery is nearly always needed to treat an anal fistula. In many patients, if the fistula is not too deep, a fistulotomy is performed.
During this surgery, the fistula tract will be opened to allow healing from the bottom up. The surgery may require dividing a small portion of the sphincter muscle.
A large amount of the sphincter muscle is not divided as this could lead to problems with bowel control (fecal incontinence) in some patients.
If the fistula track does involve a large portion of the sphincter muscle, other more involved surgeries are done to treat the fistula without harming the sphincter muscle.
More difficult cases may require multiple surgeries.
Unfortunately, despite proper treatment and complete healing, an abscess or fistula can come back. If an abscess comes back,
it suggests that perhaps there is a fistula that needs to be treated. If a fistula comes back, additional surgery will likely be required to treat the problem.