Perianal abscess pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

The abscess usually begins when bacteria enters through a tear in the lining of the rectum or anus. Most often, this occurs between the internal and external sphincters (intersphincteric abscess), where the perianal glands are located. As the abscess increases in size, most will follow the plane of least resistance and spread towards the surface, creating a perianal abscess. Occasionally, the infection can spread into the ishiorectal fossa or above the level of the levator muscles, creating ischiorectal and/or supralevator abscesses, respectively. Although supralevator abscesses are difficult to diagnose, perianal and ischiorectal abscesses still seem to account for the majority of the ones encountered.