Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- anal fistula
- history of Crohn disease
- male sex
- perianal pain
- perianal or rectal induration
Outros fatores diagnósticos
- perianal swelling
- low-grade fever
- tachycardia
- change in bowel habits
- rectal bleeding
- inability to urinate
Fatores de risco
- anal fistula
- Crohn disease
- male sex
- hard stools
- age 21 to 40 years
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- clinical examination
- examination under anesthetic
Investigações a serem consideradas
- WBC count
- serum glucose
- serum electrolytes
- anal ultrasonography
- CT pelvis
- MRI pelvis
- microscopic examination and/or culture of the purulent fluid
Algoritmo de tratamento
all patients
Colaboradores
Autores
Jan Rakinic, MD, FACS, FASCRS
Professor of Surgery
Chief
Section of Colorectal Surgery
Southern Illinois University School of Medicine
Springfield
IL
Declarações
JR is an author of a reference cited in this topic.
Agradecimentos
Dr Jan Rakinic would like to gratefully acknowledge Dr C. Neal Ellis, a previous contributor to this topic.
Declarações
CNE declares that he has no competing interests.
Revisores
Mark H. Whiteford, MD
Assistant Professor of Surgery
Colon and Rectal Surgery
Gastrointestinal and Minimally Invasive Surgery Division
The Oregon Clinic
Portland
OR
Раскрытие информации
MHW declares that he has no competing interests.
Neil Hyman, MD
Chief
Division of General Surgery
Professor of Surgery
Fletcher Allen Healthcare
Burlington
VT
Раскрытие информации
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
Раскрытие информации
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.
Список литературы
Основные статьи
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.Полный текст Аннотация
Nomikos IN. Anorectal abscesses: need for accurate anatomical localization of the disease. Clin Anat. 1997;10:239-44. Аннотация
Wright WF. Infectious diseases perspective of anorectal abscess and fistula-in-ano disease. Am J Med Sci. 2016 Apr;351(4):427-34. Аннотация
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.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Anal fissure
- Thrombosed hemorrhoid
- Pilonidal abscess
Больше DifferentialsGuidelines
- 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
Больше Guidelines
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