The prevalence, risk factors and outcome of surgical treatment of acute perianal abscess from a single Saudi hospital

Abstract

The prevalence, risk factors and outcome of surgical treatment of acute perianal abscess in a single center of Saudi Arabia Background; Perianal abscess is a common surgical emergency that is often treated by junior surgical trainees. This study aims to report the prevalence, clinical features, predisposing factors, and the outcome of surgical treatment of perianal abscess with particular attention to fistula in ano. Methods; The medical records of all consecutive patients admitted through emergency room and surgical clinics, during 2013 through 2015, of a single Saudi hospital were reviewed. The patients diagnosed with and treated for perianal abscess and fistula in ano were further reviewed for the pre-defined variables. Results; Of a total of 3618 patients, 198 (18.2%) had perianal abscess with a mean age of 35.9 years. The body mass index of the study cohort ranged from 16.5 to 39.7 with a mean of 32. As many as 141 (71%) patients had healed wounds after primary incision and drainage, while 40 (20.2%) developed recurrent perianal abscess. Anal pain was the most common complaint noted in all 198 (100%) patients, followed by fever in 99 (50%). Forty (20.2 %; 32 men and 8 women) patients developed perianal fistula in ano. Forty six (23%) patients had predisposing risk factors including diabetes mellitus, hypertension, and Crohn’s disease. Diabetes mellitus was the most common disease that was complicated by perianal abscess in both genders. Conclusion; The reported prevalence of perianal abscess poses substantial burden on health-care facilities and leads to significant comorbidities. Common health problems such as diabetes mellitus, obesity, and hypertension predispose to perianal abscess and fistula in ano. Both the recurrence of abscess and the need for readmission are preventable if disease is adequately treated during initial intervention.