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An anal, or rectal, abscess occurs when a cavity in the anus becomes filled with pus. It causes extreme pain, fatigue, rectal discharge, and fever. If the fistula is simple and involving minimal sphincter muscle, a fistulotomy may be performed. This procedure involves unroofing the fistula tunnel, connecting the internal opening within the anal canal to the external opening and creating a groove that will heal from the inside out. minor surgery may be performed in the healthcare professionals office or in the emergency department using local anesthesia (an injection in the infected area), and possibly iv sedation. Most patients are referred to a surgeon for treatment of perirectal abscesses because the abscess may involve additional structures or require more debridement that may not be apparent until it is surgically. Anal abscess and fistula (1mb) what is an anal abscess? An anal abscess is a cavity filled with pus found near the back passage (anus). It is a common condition with over 10,000 admissions per year. Anorectal abscess (also known as an analrectal abscess, or perianalperirectal abscess) is an abscess adjacent to the anus. Most cases of perianal abscesses are sporadic, though there are certain situations which elevate the risk for developing the disease, such as diabetes mellitus, crohns disease, chronic corticosteroid treatment and others. Ischiorectal, inter- and intrasphincteric abscesses have been described. This usually involves cutting a small portion of the anal sphincter muscle to open the passage, joining the external and internal opening, and converting the passage into a groove that will then heal from the inside out. Most fistula surgery can be performed on an outpatient basis. But you may have some mild pain in your anal area from the incision for several days after the surgery. Most people can go back to work or their normal routine 1 or 2 days after surgery. It will probably take about 2 to 3 weeks for your abscess to completely heal.