Perirectal Abscess

This is an infection that appears as a tender red lump under the skin near the anus. It happens when the little glands in the rectum get blocked and infected. This can cause a lump that can grow large and become painful. It may drain fluid (pus) on its own and then heal and disappear.

This type of abscess happens most often in babies and children under 1 year of age.

• An abscess that does not drain by itself may need to be drained by the surgeon in clinic or the Emergency Department. This would involve making a small cut over the abscess.
• Antibiotics may be given if there is concern for an infection. The length of time your child is on antibiotics depends on the amount of drainage, redness, swelling and pain.

If the abscess continues to return, there may be an abnormal connection or tract (fistula) inside the body from the abscess towards the anal canal. This is called a fistula-in ano. The abscess will continue to return from the bacteria that fills this tract.

These may heal on their own but sometimes, a surgery called a fistulotomy is done. This involves opening the tract so it can drain more easily and heal. This is an outpatient procedure, and your child will be able to go home the same day.

For either drainage of an abscess or surgery for the fistulotomy, the wound needs to heal from the inside out. It can take 1 to 3 weeks for the wound to completely heal over depending on the size. For either treatment:

• There will be no stitches to remove.
• Bathe your child in warm, soapy water daily and after each bowel movement to keep the wound clean.
• It is OK for your child to be active as much as they can tolerate right after the procedure.

We partner with you and your child to prevent and relieve pain as completely as possible. You know your child best. No matter the level of your child’s pain, believe they are hurting and respond right away.

After a surgery your child is likely to have some pain and discomfort. Children usually only need acetaminophen (Tylenol) or ibuprofen (Motrin) once they are home. Talk with your healthcare provider first before giving any type of medicine to your child. We will work with you to create a plan that encourages coping activities to treat pain and provide support. Help your child get better, faster with good pain management.

Call us if your child has any of these warning signs:

• If your child has increasing pain.
• If your child has any increased swelling or redness at the site where the surgeon made the cut.
• If your child gets a fever of 101.5°F (38.6 °C) or higher. Sometimes children will have a low fever (under 101.5°F) after general anesthesia.

If you have questions or concerns, please call the nurse in the General Surgery Clinic at 206-987-2794. After hours or on weekends call 206-987-2000 and ask for the on-call General Surgeon to be paged.