Perianal abscess — MCCQE Part 1 MCQ

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EasyAbdominal PainPerianal abscessMCCQE Part 1

A 45-year-old man has a 3-day painful erythematous fluctuant perianal swelling. Fever 38.5C. No IBD history. Most appropriate management?

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Correct answer: C — Incision and drainage under anaesthesia

Explanation lettering: B = shown as A · E = shown as B · D = shown as C · A = shown as D · C = shown as E

Perianal abscess: I&D required. Antibiotics alone insufficient. Drainage in OR for adequate exploration + assess for fistula-in-ano (present in 30-50%). Topical nitro for fissures.

Reference: Canadian Colorectal Surgery Guidelines