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Difference Between Perianal Abscess and Haemorrhoid

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Lets understand few Medical Terms,

Peri means Around or near.

Abscess means Pus

Perianal abscess is Pus found around or near the anus.

Generally abscesses found in the lower rectum and anal canal are called ano-rectal abscess. They are further classified into 4 types

The Types of Ano-Rectal Abscess

  1. Perianal Abscess ( 60%)
  2. Ischio-rectal abscess (30%)
  3. Submucous abscess
  4. Pelvi-rectal abscess

Commonly found is Perianal abscess, which constitutes 60% of the cases.

Let’s get into more details about Perianal abscess,

Perianal abscess

Cause of Perianal abscess

The majority of these are caused due to acute inflammation of the anal gland.

Infection of any thrombosed external pile can also cause perianal abscess.

Organism which cause Perianal abscess

  • E-Coli (Most common)
  • Staphylococcus aureus
  • Bacteroides
  • Streptococcus
  • B Proteus

Clinical Features

Chief complaints are throbbing pain near the anus, which increases in intensity during defecation. Fever and headache may be present.

On Inspection, a lump may be seen at the anal margin or it may be felt with a finger, just below the dentate line. It is a very tender cystic lump. (Cystic means A closed, sac-like pocket filled with pus)

Treatment

Treatment should be done immediately and the abscess incised or cut and pus drained by a surgeon under antibiotic cover.

Inadequate and defective incision would lead to Anal Fistula. It is important for the patients to consult a Surgeon and not resort to quacks, which could lead to aggravation of the condition.

The surgeon would do it under General Anaesthesia and the cut would be on the most prominent building portion of the abscess and the cavity opened adequately, so that the pus is drained. The cavity is later packed and allowed to heal.

Sequelae 

If the patient decides to tolerate the pain and leave it as it is, then it could 

  1. Rupture into anal canal
  2. Rupture into exterior causing fistula-in-ano
  3. May form ischiorectal abscess

Whereas Haemorrhoids or Piles are dilated veins within the anal canal. They are divided into

  1. Internal Haemorrhoids (Piles)
  2. External Haemorrhoids

Internal Haemorrhoids are within the anal canal and not visible. It is covered with mucous membrane and is bright red or purple in color.

External Haemorrhoids are situated outside the anal orifice and are covered with skin.

If both internal and external haemorrhoids exist then it is called Intero-external Haemorrhoids.

A detailed article is wriiten and youtube videos are made on the topic of Piles which can be seen at this Channel Link Youtube.com

Table of Contents

Sources

By McortNGHH – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=49799222

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