Asian Journal of Case Reports in Surgery

All Perianal Abscesses are Not Necessarily Cryptoglandular in Origin – Beware!

Scott Arockia Singh *

Dr. Scott’s Laser Piles Fistula Center, Ananthanadarkudy, Nagercoil-629201, Tamilnadu, India.

*Author to whom correspondence should be addressed.

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Abstract

Perianal abscess is the most common abscess that arises from the anal glands in the crypts of the dentate line of anal canal mucosa. Over 90% of perianal abscess originates at the level of the dentate line where the squamocolumnar junction and 4-10 anal glands reside. Anorectal abscess due to non-cryptoglandular etiology is uncommon. We present a perianal ischiorectal abscess secondary to a ruptured prostatic abscess in a diabetic patient. Urinary tract infection in diabetes leads to prostatic abscess formation especially patients with voiding disturbances. Anorectal abscesses should be adequately assessed with symptoms, physical examination, laboratory, and imaging, and rarely underlying causes of inflammation of adjacent organs, such as the prostatic abscess, should be kept in mind. It is a rare clinical condition, only a few cases reported in the literature.

Keywords: Prostatic abscess, perianal abscess, diabetes mellitus, perianal pain, ischiorectal abscess, cryptoglandular infection, dentate line, non-cryptoglandular infection

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References

X. Ruíz, Plazas, D Alonso, Rodríguez, L Fernández, Barranco, D Muñoz, Vélez Rectoprostaticfistula: unusual presentation of a prostatic abscess Arch ESPUrol, 2011;64:59-61.

J Joseph, H Narayanan, H Babu, A Praveen, Tuberculosis of the Prostate and Seminal Vesicles, J HK Coll Radiol. 2010; 13:40-2.

S Kumar, NS Kekre, G Gopalakrishnan Diagnosis and conservative treatment of tubercular rectoprostatic fistula Ann R Coll Surg Engl, 2006;88:1-4.

SC Wen, YS Juan, CJ Wang, K Chang, MC Shih, JT Shen, et al.344-349.

YC Chee, YN Chee An unusual case of primary melioidotic prostatic abscess complicated by perianal abscess. ID cases 2018;11:51-52.

Engin G, Acunaş B, Acunaş G, Tunaci M Imaging of extrapulmonary tuberculosis. Radiographics. 2000;20:471-88.

Prostate-ano-cutaneousProstato-ano-cutaneous fistula: unusual complication of prostatic abscess; Pankaj Kumar Garg MS, niladharshankarraohadkems; 21 October 2008.

AM Elshal, A Abdelhalim, TS Barakat, AA Shaaban, A Nabeeh, and E-H Ibrahiem, Prostatic abscess: objective assessment of the treatment approach in the absence of guidelines, Arab Journal of Urology, 2019; 12(4):262- 268.

Ridgway AJ, Luk ACO, Pearce I Prostate abscess: A comprehensive review of the literature. J Clin Urol. 2019;12(6):441-448.

Kensuke Konagaya, Hiroyuki Yamamoto, Tomoyuki Suda, Yusuke Tsuda, Jun Isogai, Hiroyuki Murayama, Yoshichika Arakawa, Hidemitsu Ogino, Ruptured Emphysematous Prostatic Abscess Caused by K1-ST23 Hypervirulent Klebsiella pneumonia presenting as Brain Abscesses: A Case Report and literature Review, Trontiers in Medicine, 2022;8. DOI:10.3389/fmed. 2021.768042

Masaki Kobayashi, Hiroshi Fukushima, Keizo Kawano, Shinji Morimoto Inflammation and infection, A case of nontraumatic urethral rupture possibly induced by prostatic abscess; Urology Case Reports. July 2020;31:107763.

John Michael Nesemann, Kathy Huen, Jonathan Bergman, Extensive Prostatic Abscess in an Elderly Patient Requiring Multidisciplinary Drainage, Case Reports in Urology. 2020;2020 (4398561):6.