A SIMPLE METHOD FOR THE MANAGEMENT OF ANORECTAL ABSCESS

Abstract

All patients referred to the University Department of Surgery in Wellington with anorectal abscess were managed by simple de Pezzer drainage. The catheter used was between 3-5 mm in diameter and was inserted when possible under local anaesthetic. Ninety-seven patients have presented with anorectal abscess. After exclusion of those patients with intersphincteric abscess, 91 have been managed in this way with a male:female ratio of 2.8:1. A perianal abscess was present in 76 patients. General anesthesia was necessary in 18 patients and 16 of these patients were admitted to hospital. Twelve patients were admitted for underlying medical problems. One patient had Crohn''s disease. Over half of the patients had symptoms which had lasted for 4 days or less and 22 patients had antibiotics prescribed by their local practitioners. There was no past history of anorectal sepsis in 75 patients. Sixty-two of the catheters were removed in less than 15 days. Of the patients who were drained under local anaesthetic only eight said that the pain was so intolerable that they would opt for a general anaesthetic in the future. Thirty-five patients returned to their normal activities or work within 5 days and 68 were back at work 14 days after drainage. One abscess was inadequately drained. Twenty-two patients developed fistulae within the follow-up period. It is suggested that this simple technique is safe and reliable, is well tolerated by patients, results in minimal hospitalization and an early return to work.