Diligent sigmoidoscopy is necessary to find the perianal abscess outlet. Pus should be sent for culture of both routine gut and skin organisms, and additionally, acid fast bacilli. Specimens of the abscess should be sent for histopathological examination.
If the abscess is caught early then treatment with oral antibiotics may abort the infection. If the abscess has become established then it requires drainage and curettage. This is performed under general anaesthesia. The patient may stay in hospital for 3-7 days and be off work for 1-4 weeks.
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