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Michael Buckmire, MD, FACS, FASCRS

WHAT IS AN ANAL ABSCESS OR FISTULA?
An anal abscess is an infected cavity filled with pus found near the anus or rectum. Ninety percent of
abscesses are the result of an acute infection in the internal glands of the anus. Occasionally, bacteria,
fecal material or foreign matter can clog an anal gland and tunnel into the tissue around the anus or
rectum, where it may then collect in a cavity called an abscess.
An anal fistula (also commonly called fistula-in-ano) is frequently the result of a previous or current anal
abscess. This occurs in up to 50% of patients with abscesses. Normal anatomy includes small glands
just inside the anus. The fistula is the tunnel that forms under the skin and connects the clogged
infected glands to an abscess. A fistula can be present with or without an abscess and may connect just
to the skin of the buttocks near the anal opening.

CLASSIFICATION
Anal abscesses are classified by their location in relation to the structures comprising and surrounding
the anus and rectum: perianal, ischioanal, intersphincteric and supralevator. The perianal area is the
most frequent and the supralevator the least. If any of these particular types of abscess spreads partially
circumferentially around the anus or the rectum, it is termed a horseshoe abscess.

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