S3-Leitlinie: Analabszess : AWMF-Registriernummer: 088/005

Translated title of the contribution: S3 guidelines: Anal abscess : on of Scientific Medical Societies registration number: 088/005

A. Ommer, A. Herold, E. Berg, S. Farke, A. Fürst, F. Hetzer, A. Köhler, S. Post, R. Ruppert, M. Sailer, T. Schiedeck, B. Strittmatter, B. H. Lenhard, W. Bader, J. E. Gschwend, H. Krammer, E. Stange

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: Anal abscesses are relatively frequent and most common in young men. Methods: A systematic review of the literature has been undertaken. Results: The origin of the abscess is usually the proctodeal gland in the intersphincteric space. There are different types of abscesses: intersphincteric, ischioanal and supralevatory abscesses. Anamnesis and clinical examination are sufficient to indicate surgery. Further examinations such as endosonography or magnetic resonance tomography (MRT) should be considered in recurrent or supralevatory abscesses. The timing of surgical intervention depends on clinical symptoms, whereas the acute abscess is an emergency indication. Surgery is the primary therapy approach for anal abscess. Surgical access (transrectal or perianal) depends on the localization of the abscess. The aim of surgery is to broadly drain the infection and protect anal sphincter structures. The wound should be rinsed regularly (showering with clear water). Treatment with local antiseptics carries the risk of zytotoxicity. Antibiotic treatment is necessary only in selected cases. Any attempt to locate a fistula intraoperatively should be undertaken with great care; proven evidence of a fistula is not mandatory. Although the risk of recurrent abscess or secondary fistula is low, these may be caused by insufficient drainage. The primary fistulotomy of superficial fistulas should only be performed by an experienced surgeon. In the case of ambiguous findings or high fistulas, treatment should be carried out in a second surgical procedure. Conclusion: For the first time in Germany, this clinical S3 guideline provides instructions for the diagnosis and treatment of anal abscesses based on a systematic review of the literature.

Translated title of the contributionS3 guidelines: Anal abscess : on of Scientific Medical Societies registration number: 088/005
Original languageGerman
Pages (from-to)378-392
Number of pages15
JournalColoproctology
Volume33
Issue number6
DOIs
StatePublished - Dec 2011
Externally publishedYes

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