Minimal Access Surgery

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What Is It ?

A perianal abscess is an infection in the wall of the lowest part of the back passage. Pus is building under the skin causing swelling and pain. There is sometimes a connection with the back passage itself, which 'fuels' the infection since the back passage is full of bugs.

  • Stool formed in the colon or large intestine empties into the rectum and the anal canal then exits through the anus. Perianal refers to the structures around the anus (skin) and within the anal canal. The walls of the anal canal above the anus contain anal glands that secrete lubricants.
  • Stool contains waste material and many bacteria. If there is a cut or scratch in the skin around the anus or the walls of the anal canal, bacteria can enter and cause an infection. The infection then causes local swelling, irritation, tissue damage, and fluid buildup (abscess).
  • Unable to sit comfortably
  • Difficulty or pain with passing stool
  • Redness or pain around anus
  • Abscess felt around anus or within anal canal
  • Peri-rectal swelling
  • Pain may be throbbing, sharp, or dull
  • Fever may be seen in severe case
  • Bleeding or discharge if abscess is drained or accidentally ruptures.
  • In elderly there maybe no fever only lower abdominal pain
  • If the abscess ruptures and leaves a fissure that opens into the anal canal, a fistula is formed.


  • Bacteria : -
  • Staphylococcus E. coli Streptococci
  • Proteus vulgaris
  • Pseudomonas aeruginosa
  • Bacteroides
  • Usually a mixture of above

The Operation

You will have a general anaesthetic, and will be asleep for the whole operation. The pus is let out through a cut in the skin. The surgeon will also wash out the area of the infection to minimise the chances of it coming back. The wound is packed with swabs. Antibiotics are given to help the healing. You should be able to go home after one or two days. For the first week or so after the operation, the swabs are changed for clean ones about every other day.

This can be done on the ward while you are in the hospital or in the outpatients clinic or in your GP's surgery when you leave the hospital. After that you will not need any more swabs in the area and at about a month later the wound is examined to see if any more treatment is needed.

Risk Factors

  • Cuts : -
  • From food such as egg shell and fish bone Swallowed objects, such as rings, coins, paperclips
  • Penetrating Injuries : -
  • Constipation Enema Vibrators Anal sex Light bulbs Bottles Surgical injection of hemorrhoids
  • Diseases : -
  • hemorrhoids (hang out from the anus opening) Inflammatory Bowel Disease Granulomatous diseases such as Sarcoidosis Weakened immune system (body's defenses) -- cancer (specially of blood), AIDS, etc.

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