intersphincteric abscess

Hi All,

I have got a 4-5mm intersphincteric abscess which clearly shows up on an MRI scan. When i went in for surgery to cut it out, my surgeon said he couldn't find the abscess and that there isn't anything he can do to help me as he cannot feel it or find an internal opening from where the abscess is draining inside the anal canal, despite the fact he knows its exact location on the MRI scan! I was devastated when he told me this as this abscess is ruining my life. Pus continuously drains into my anal canal which means it subsequently seeps out of my ******* all day everyday, plus it is really painful. Has anyone else had any experience with anything like this? I thought it would be a routine operation to fix but my surgeon has basically said its too small to find and operate on!

Many thanks

[patient915]

Welcome to the gastroenterology community!  How long ago was the MRI done versus how long ago was the surgery done?

[roundincircles]

Hi patient915,

I had the MRI about a month before i went in to have the darn thing removed. I came out of hospital yesterday. They have basically said they don't want to go "cutting around blindly" if they can't see it, but i don't get that if they know exactly where it is on the MRI scan. I just don't know what to do now as they said it needs to form into a fistula or the abscess needs to get bigger

[roundincircles]

Hi patient915,

Thanks for your response. I had the MRI about a month before i went in to  try and have the darn thing removed. I came out of hospital yesterday. They have basically said they don't want to go "cutting around blindly" if they can't see it, but i don't get that if they know exactly where it is on the MRI scan why they don't know where to cut! I just don't know what to do now as they said it needs to form into a fistula or the abscess needs to get bigger before they can do anything which sounds absurd! Plus i dont think it will get bigger as it already drains into my anal canal so the pus already has a way out. It is just dominating my life at the moment and i desperately want it fixed. I just Cant believe we live in an age where we can do face and organ transplants, but a surgeon has told me he can't remove a tiny abscess! Any suggestions?

[patient915]

Well, that seems pretty surprising to me.  The only thing I can recommend is that you see a different surgeon.  Is the surgeon you saw specifically a colo-rectal surgeon?

[roundincircles]

Yeah he is a fully qualified colorectal surgeon. I think your are right; im going to have to find a surgeon somewhere else as this guy clearly has no clue! Im so sick and tired of incompetent medical professionals!

[patient915]

Good, I hope you get this all figured out.

[roundincircles]

Just an update: My surgeon phoned me and said that when they had a look when i was under anesthetic they found a little 'pocket' which is either from another abscess which had burst or from a previous surgery i had for a fistula about 18 months ago. He thinks its this pocket which we can see on the MRI and that the pain is from the scar tissue in the area and he said there is no abscess there at all. He has said they will be having me back in for an appointment to look at some treatment options so im not sure what he has in mind. would it be possible for scar tissue to cause pain after this kind of surgery? Thanks

[roundincircles]

Just an update: My surgeon phoned me and said that when they had a look when i was under anesthetic they found a little 'pocket' which is either from another abscess which had burst or from a previous surgery i had for a fistula about 18 months ago. He thinks its this pocket which we can see on the MRI and that the pain is from the scar tissue in the area and he said there is no abscess there at all. He has said they will be having me back in for an appointment to look at some treatment options so im not sure what he has in mind. Would it be possible for scar tissue to cause pain after this kind of surgery? i can't help but feel like they are fobbing me off! Thanks

[patient915]

Scar tissue can definitely cause pain, but I've never heard of rectal scar tissue causing pain (but it's possible).

[roundincircles]

Hmmm. Well it still feels like i have an abscess there which is why i am doubting what they are saying. I guess i'll just have to wait and see what they say on my follow up appt. Thanks for your comments.

[patient915]

No problem, keep us updated.

[roundincircles]

Oh yeah, the other thing he said was that the clear discharge i have could be caused by where i had the previous surgery on the fistula and there is a flap of skin and a pocket which is collecting sweat which causes the discharge. I didn't think the inside of your anus had sweat glands! Does this sound like he's talking rubbish?!

[patient915]

Well he might not literally mean sweat, he could just mean discharge that your body naturally collects and the pocket is creating a place for it all to accumulate.

[roundincircles]

Oh yeah, the other thing he said was that the clear discharge i have could be caused by where i had the previous surgery on the fistula and there is a flap of skin and a pocket which is collecting sweat which causes the discharge. I didn't think the inside of your anus had sweat glands! Does this sound like he's talking rubbish?! i still have small amounts of discharge and a constant nagging pain down there so im really not convinced he is talking the truth.

[patient915]

I'm not sure if he's talking rubbish or not.

[roundincircles]

Sorry about my repeat posts- Im doing this using my phone and my posts were not showing as posted even though they were. thanks for your comments. ill keep u posted.

[patient915]

Good, keep us updated.