When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Anorectal abscess

Ver PDF
  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 28 Nov 2025
Última actualización: 21 Dec 2022

Resumen

定义

病史和体格检查

关键诊断因素

  • anal fistula
  • history of Crohn disease
  • male sex
  • perianal pain
  • perianal or rectal induration
完整详情

其他诊断因素

  • perianal swelling
  • low-grade fever
  • tachycardia
  • change in bowel habits
  • rectal bleeding
  • inability to urinate
完整详情

危险因素

  • anal fistula
  • Crohn disease
  • male sex
  • hard stools
  • age 21 to 40 years
完整详情

诊断性检查

首要检查

  • clinical examination
  • examination under anesthetic
完整详情

需考虑的检查

  • WBC count
  • serum glucose
  • serum electrolytes
  • anal ultrasonography
  • CT pelvis
  • MRI pelvis
  • microscopic examination and/or culture of the purulent fluid
完整详情

治疗流程

急症处理

all patients

撰稿人

作者

Jan Rakinic, MD, FACS, FASCRS

Professor of Surgery

Chief

Section of Colorectal Surgery

Southern Illinois University School of Medicine

Springfield

IL

利益声明

JR is an author of a reference cited in this topic.

鸣谢

Dr Jan Rakinic would like to gratefully acknowledge Dr C. Neal Ellis, a previous contributor to this topic.

利益声明

CNE declares that he has no competing interests.

同行评议者

Mark H. Whiteford, MD

Assistant Professor of Surgery

Colon and Rectal Surgery

Gastrointestinal and Minimally Invasive Surgery Division

The Oregon Clinic

Portland

OR

利益声明

MHW declares that he has no competing interests.

Neil Hyman, MD

Chief

Division of General Surgery

Professor of Surgery

Fletcher Allen Healthcare

Burlington

VT

利益声明

NH declares that he has no competing interests.

Steven Brown, MBChB, FRCS, MD, BMedSci

Consultant Surgeon

Department of Colorectal Surgery

Sheffield Teaching Hospitals

Sheffield

UK

利益声明

SB declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Gaertner WB, Burgess PL, Davids JS, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula. Dis Colon Rectum. 2022 Aug 1;65(8):964-85.全文  摘要

Nomikos IN. Anorectal abscesses: need for accurate anatomical localization of the disease. Clin Anat. 1997;10:239-44. 摘要

Wright WF. Infectious diseases perspective of anorectal abscess and fistula-in-ano disease. Am J Med Sci. 2016 Apr;351(4):427-34. 摘要

Malik AI, Nelson RL, Tou S. Incision and drainage of perianal abscess with or without treatment of anal fistula. Cochrane Database Syst Rev. 2010 Jul 7;(7):CD006827.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Anorectal abscess images

  • 鉴别诊断

    • Anal fissure
    • Thrombosed hemorrhoid
    • Pilonidal abscess
    更多 鉴别诊断

  • 指南

    • The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of anorectal abscess, fistula-in-ano, and rectovaginal fistula
    • ACR appropriateness criteria: anorectal disease
    更多 指南
  • padlock-locked登录或订阅即可浏览 BMJ Best Practice 临床实践完整内容

内容使用需遵循免责声明