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Session: ePoster Monitor 2-Benign Anorectal Disease and Pelvic Floor

eP467 - Retrospective Analysis of Patients with Anorectal Abscess in a Community Hospital

Sunday, June 2, 2024
4:00 PM – 4:05 PM ET, USA
Location: Baltimore Convention Center, Room 318-320

    ePoster Presenter(s)

  • Sebastian Valdivieso, MD

    Resident
    Harlem Hospital
    Harlem Hospital
    New York, NY, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • Shamon Gumbs, MD (he/him/his)

    Resident Physician
    Harlem Hospital
    New York, NY, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • MP

    Maria Paez, MD

    Resident
    Harlem Hospital
    New York, New York, United States

    Disclosure information not submitted.

  • MG

    Maria Guevara-Kissel, MD

    Resident
    Harlem Hospital
    New York, New York, United States

    Disclosure information not submitted.

  • IC

    Ikechi Chime, MD

    Resident
    Harlem Hospital
    New York, New York, United States

    Disclosure information not submitted.

  • BD

    Brian Donaldson, MD, FACS

    Chairman of Surgery
    Harlem Hospital
    New York, New York, United States

    Disclosure information not submitted.

Purpose/Background: Anorectal abscess is a common disease that presents to the general and colorectal surgeon, as well as to the emergency department (ED). Source control is the main treatment of anorectal abscess. Current literature is deficient on information regarding the incidence and factors associated with this infection in underserved populations. We aim to identify and report the clinical and demographic parameters from an Inner-City Hospital.Methods/Interventions: A retrospective review of adult patients diagnosed with anorectal abscess in the ED from our institution from May 2022 to August 2023 was performed, age < 18 years old were excluded. Analysis was performed with Stata.Results/Outcomes: A total of 121 patients were included, 75.21% males, 24.79% females, mean age was 40 years, majority were African American 66.94%, 22.31% Hispanic. 23.14% presented with tachycardia, and 6.61% had fever upon initial presentation. 19.01% had a past medical history of HIV, 15.70% HTN, and 8.26 % DM. 25.62% were admitted to the hospital, mean length of stay was 3.48 days(1-14). 75.21% underwent incision and drainage(I&D), from those who underwent I&D 79.12% had the procedure done in the ED, vs. 25.27.% patients in the Operating room. Mean WBC on presentation was 12.1(SD 5.24), lactic acid 1.32(SD0.53). 50.41% % of patients underwent a diagnostic imaging test in the emergency department. 57.85% had a CBC collected. 34.71% had a culture obtained from the wound. Only 32.23% of patients presented for a follow up visit, mean number of follow up visits was 2.19(SD 1.89).Conclusion/

Discussion: Few data for anorectal infection exists for the underserved and minority population in the United States. Although treatment might be straight forward with drainage and antimicrobials, there is still a risk of fistula formation, worsening sepsis, and recurrence.
This review shows that this cohort usually undergoes a high number of diagnostics tests including imaging, microbiology, and laboratory bloodwork. Thus, increasing costs and radiation exposure. At the same time, only three quarters underwent I&D and one quarter of patients were admitted to the ward for further care. Interestingly only one third of the patients presented to their follow up visits, showing the poor treatment compliance, therefore resulting in lower detection of complications. A more in-depth analysis to the barriers affecting treatment compliance is warranted in this population.