Paul Mastragostino1, Alexander D Lee2, Patrick J Battaglia3. 1. Department of Graduate Education and Research Programs, Canadian Memorial Chiropractic College, Toronto, ON. 2. Clinical Faculty, Canadian Memorial Chiropractic College, Toronto, ON. 3. Radiology Department, Logan University, Chesterfield, MO.
Abstract
OBJECTIVE: To present the clinical management and comprehensive differential diagnosis of a patient with anorectal pain from a perianal abscess. CLINICAL FEATURES: A 41-year-old woman presented with pain localized to her perianal and gluteal region, accompanied by internal and external rectal pain. Prior to presentation, the patient had received a working diagnosis of levator ani syndrome. INTERVENTION AND OUTCOME: An interdisciplinary management approach was utilized. Diagnostic imaging confirmed the clinical suspicion of a perianal abscess and the patient underwent surgical drainage. SUMMARY: Anorectal pain is complex and multifactorial and a diagnosis such as an abscess should not be overlooked. This case emphasized that practitioners must be diligent in their evaluation and management of patients with anorectal pain, including recognizing situations that require further imaging and interdisciplinary management.
OBJECTIVE: To present the clinical management and comprehensive differential diagnosis of a patient with anorectal pain from a perianal abscess. CLINICAL FEATURES: A 41-year-old woman presented with pain localized to her perianal and gluteal region, accompanied by internal and external rectal pain. Prior to presentation, the patient had received a working diagnosis of levator ani syndrome. INTERVENTION AND OUTCOME: An interdisciplinary management approach was utilized. Diagnostic imaging confirmed the clinical suspicion of a perianal abscess and the patient underwent surgical drainage. SUMMARY: Anorectal pain is complex and multifactorial and a diagnosis such as an abscess should not be overlooked. This case emphasized that practitioners must be diligent in their evaluation and management of patients with anorectal pain, including recognizing situations that require further imaging and interdisciplinary management.
Authors: Richard P Billingham; John T Isler; Mark H Kimmins; Jeffery M Nelson; Jeremy Schweitzer; M Margarita Murphy Journal: Curr Probl Surg Date: 2004-07 Impact factor: 1.909