What Is It? 

​

Anorectal abscesses and fistulas are very common conditions.

​

An anorectal abscess is pus near the anus or the rectum. These are generally painful due to pressure build off of pus underneath the skin or anorectal muscles. The skin around your anus can become hard, red, and tender to the touch. 

​

Fistula-in-ano or anorectal fistulas present as drainage from around your anus, usually blood, stool, and/or mucous. 

​

​

​

​

​

​

​

​

​

​

​

​

​

​

Causes

​

There are small glands in the anal canal that are a normal part of the anatomy. These glands secrete mucous to help lubricate stool. When the glands become clogged with stool, bacteria can form an anorectal abscess.

​

Abscesses that drain can leave a remnant tunnel behind, from the anal canal to the skin. This is called a fistula. About 30-50% of patients with an anorectal abscess end up developing an anorectal fistula.

​

Treatment

​

The treatment for an anorectal abscess is incision and drainage of the pus. Colorectal surgeons are experts in the management of the variety of abscess and fistula. Dr. Squillaro sees a high volume of patients with these quite literal "pains in the butt" and can offer solutions to these common problems. Abscesses can often be trained in our clinic the same or next day. 

 

The treatment for anorectal fistulas is almost always surgical. Fistulas have perplexed both patients and doctors for thousands of years, however their management has evolved with many successful treatments.  

 

If the fistula is not too deep, or a "simple fistula" with little to no involvement of the sphincter, a fistulotomy surgery to unroof the fistula tract is highly successful. If the fistula is "complex", or involving a significant amount of the sphincter muscle or contains multiple fistula tracts, fistula surgery is often staged with a temporary drainage procedure called seton placement. A seton is simply a a small piece of silicone that looks like spaghetti and allows the fistula tract to mature. Later, surgery to either divide the fistula tract by ligation of internal fistula (LIFT) procedure or endoanal advancement flap to cover the internal opening can be completed.

​

​

​

Reference: https://fascrs.org/patients/diseases-and-conditions/a-z/abscess-and-fistula-expanded-information

​