Introduction:

Patients with anal intersphincteric, perianal or ischiorectal abscess develop fistulae showing different occurrence rates and complexity. The relation between anal abscess type and the complexity of the secondary fistula has been analyzed and evaluated.

Material and methods:

This is a prospective cohort study of patients with anal abscess and a 2-month or longer follow-up after abscess drainage performed at the Service of Coloproctology, Hospital General de México “Dr. Eduardo Liceaga”. Abscess type was classified during the surgical procedure, and wound healing time, recurrence and type of fistula after drainage were evaluated. Central trend measures, frequencies and odds ratio (OR) analyses were performed.

Results:

Seventy one men and 15 women were included; 47.7% of patients were in the 31-to-46-year range. A perianal abscess was diagnosed in 66.3% of patients and an ischiorectal abscess was found in 24.4%; 37.2% of patients developed an anal fistula. OR for high transsphincteric fistula after an ischiorectal abscess was 4.3 (95% IC 0.7-25.2) and after a perianal abscess was 0.15 (95% IC 0.2-0-081).

Conclusion:

Ischiorectal abscess patients appear to be at a greater risk for developing a complex fistula; however the low risk for a secondary fistula does not justify a primary fistulotomy during abscess drainage.

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