Resumo
Definition
History and exam
Key diagnostic factors
- fístula anal
- história de doença de Crohn
- sexo masculino
- dor perianal
- endurecimento perianal ou retal
Other diagnostic factors
- inchaço perianal
- febre baixa
- taquicardia
- alteração nos hábitos intestinais
- sangramento retal
- incapacidade de urinar
Risk factors
- fístula anal
- Doença de Crohn
- sexo masculino
- fezes duras
- 21 a 40 anos de idade
Diagnostic investigations
1st investigations to order
- exame clínico
- exame sob anestesia
Investigations to consider
- contagem leucocitária
- glicose sérica
- eletrólitos séricos
- ultrassonografia anal
- tomografia computadorizada (TC) da pelve
- ressonância nuclear magnética (RNM) da pelve
- exame microscópico e/ou cultura do líquido purulento
Treatment algorithm
todos os pacientes
Contributors
Authors
Jan Rakinic, MD, FACS, FASCRS
Professor of Surgery
Chief
Section of Colorectal Surgery
Southern Illinois University School of Medicine
Springfield
IL
Disclosures
JR is an author of a reference cited in this topic.
Acknowledgements
Dr Jan Rakinic would like to gratefully acknowledge Dr C. Neal Ellis, a previous contributor to this topic.
Disclosures
CNE declares that he has no competing interests.
Peer reviewers
Mark H. Whiteford, MD
Assistant Professor of Surgery
Colon and Rectal Surgery
Gastrointestinal and Minimally Invasive Surgery Division
The Oregon Clinic
Portland
OR
Disclosures
MHW declares that he has no competing interests.
Neil Hyman, MD
Chief
Division of General Surgery
Professor of Surgery
Fletcher Allen Healthcare
Burlington
VT
Disclosures
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
Disclosures
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.
References
Key articles
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.Full text Abstract
Nomikos IN. Anorectal abscesses: need for accurate anatomical localization of the disease. Clin Anat. 1997;10:239-44. Abstract
Wright WF. Infectious diseases perspective of anorectal abscess and fistula-in-ano disease. Am J Med Sci. 2016 Apr;351(4):427-34. Abstract
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.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Fissura anal
- Hemorroidas trombosadas
- Abscesso pilonidal
More 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
More Guidelines
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