Supralevator anorectal abscess

Relatively rare 2.5% of anorectal abscessess.
- perianal and buttock pain are the most common presenting complaints.
- most with this rare type of abscess have underlying pelvic inflammatory process, prior recent abdominal surgery or crohn's disease.
- can also occur in continuity with cepahalad extension of transsphincteric fistula/abscess

Treatment:
- cause determines therapy.
- transrectal or transvaginal drainage for abscess caused by pelvic sepsis
- if extension if transsphincteric abscess then manage primary trans sphincteric process

Key is to know the patients history.
- crohns or recent abdominal surgery.
- then go to or. Look for crypt abscess
- if absent the internal drainage following a seeker needle with a
Foley/malecot/t-tube in place for 24-48 hrs
- if crypt abscess found the. Drain exteriorly through a large skim incision to adequately drain the supralevator abscess component

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