Perirectal abscesses are usually caused by an infection in an anal gland or the surrounding lym-phoid tissue. Lesions that can lead to anorectal abscesses and fistulas can be caused by infections of the anal fissure; infections through the anal gland; ruptured anal hematoma; prolapsed thrombosed internal hemorrhoids; and septic lesions in the pelvis, such as acute salpingitis,

82 Anorectal Abscess and Fistula acute appendicitis, and diverticulitis. Ulcerative colitis and Crohn's disease are systemic illnesses that can cause abscesses, and people who are immunosuppresssed are more susceptible to abscesses. Patients who are at high risk are diabetics, those who engage in receptive anal sex, and those with inflammatory bowel disease and immunosuppression. Other causes include constipation, chronic diarrhea, syphilis, tuberculosis, radiation exposure, and HIV infection.

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