Konstantinos Papadopoulos S, Andreas Dimopoulos, Kleoniki Kordeni, Dimitrios Filis
Deparment of General Surgery, General Hospital of Patras, Patras, Greece.
Ann Coloproctol. 2021 Jul;37(Suppl 1):S11-S14. doi: 10.3393/ac.2020.01.20. Epub 2020 Jan 31.
Supralevator abscess is a rare form of anorectal disease responsible for very rare but morbid manifestations, one of which is superior spread through fascial planes. We present a rare case of a spreading anorectal abscess in a patient who presented with only diffuse abdominal pain, and we review similar cases in the literature according to anatomical considerations, presentation, diagnostic procedures, and treatment options. We identified 7 previously reported cases of spreading anorectal abscesses. Most abscesses had a horseshoe morphology, and all patients presented or developed abdominal pain. All patients had perianal swelling and pain. Five out of 7 patients were previously mistreated. Only 2 abscesses spread through both the pre- and retroperitoneal planes. Abdominal pain is a dominant feature of extraperitoneal inflammation originating from anorectal abscesses. The absence of perianal signs is rare, and proper inspection of the patient along with the medical history can lead to quicker diagnosis and decisive treatment.
肛提肌上脓肿是一种罕见的肛肠疾病，会引发极为罕见但严重的症状，其中之一是通过筋膜平面向上蔓延。我们报告了一例罕见的肛肠脓肿扩散病例，该患者仅表现为弥漫性腹痛，并且根据解剖学因素、临床表现、诊断方法及治疗选择对文献中类似病例进行了回顾。我们确定了7例先前报道的肛肠脓肿扩散病例。大多数脓肿呈马蹄形，所有患者均出现或发展为腹痛。所有患者均有肛周肿胀和疼痛。7例患者中有5例曾接受过不当治疗。仅2例脓肿同时通过腹膜前和腹膜后平面扩散。腹痛是源自肛肠脓肿的腹膜外炎症的主要特征。肛周体征缺失的情况较为罕见，对患者进行仔细检查并结合病史可实现更快诊断和果断治疗。
