Surgical Management of Ischiorectal Abscesses: a Retrospective Study of 111 Patients

SURGICAL MANAGEMENT OF ISCHIORECTAL ABSCESSES: A RETROSPECTIVE STUDY OF 111 PATIENTS (Abstract): Aim: To evaluate the results of surgically treated ischiorectal abscesses in our service regarding postoperative morbidity, rate of abscess recurrence, and incidence of fistulas. Methods: From January 1, 1997 through December 21, 2007, 111 cases of ischiorectal abscess were surgically treated with incision-drainage and are surgically revised. Patients included 77 men and 34 women (male/female ratio of 2.26 / 1) with a mean age of 42.2 years. One third of the population reported a history of anorectal abscess. In 8.1% of patients the abscess spread. To adjacent tissues a fistula was found in 6.3 % of patients at the time of incision and drainage All the patients were treated by intravenous antibiotic treatment. Results: There was no postoperative mortality. Localized postoperative morbidity was 5.4% and overall morbidity was 4.5%. A transphincteric fistula was present in 38.6% of patients and recurrence of abscess occurred in 12.8% on follow-up. Conclusions: Surgical treatment of ischiorectal abscesses by incision-drainage is a simple and safe technique. Nevertheless, long-term follow-up is necessary given the risk of recurrence and of transphincteric fistula requiring additional treatment.