Perianal abscess still leaking after 2.5 months

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My father had Perianal abscess drained through surgery about 2.5 months ago. His wound is stil leaking clear water with no foul smell. He has been in constant touch with the doctor. Recently, the doctor had put him on one week medication (antibiotic) which stopped the leaking and he was sitting on a ring cushion. But on his last visit to the doc, he advised to start sitting on all surfaces without the cushion and also stopped the medication. The wound has now again started leaking clear fluid, the doctor says it's fine and suggested do all the normal activities for a month or two. It's not fistula as per the doctor and he doesn't have any symptoms of fistula as well. 

Q: 

1. Since the wound is still discharging liquid therefore he's feeling very upset and wondering what should he do as the doctor has stopped the medication/sitz baths/ etc? 

2. Also, when the liquid touches his body he feels inflammation like feeling even though there is no inflammation. What is this? 

3. Can he use water to wash it everytime he changes the gauze? 

4. Is the clear liquid dangerous? 

5. When will the leaking stop? 

6. Can he still sit on the ring cushion even though the doc advised not to? It pains a bit when he sits without it and liquid comes out. 

Thanks in advance!

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6 Replies

  • Posted

    I am so sorry that your Dad is going through this. How does his doctor know it’s not a fistula? And is his doctor a general surgeon or colo-rectal surgeon? My fistula (that Showed up about 2 months after having an abscess drained) never drained foul smelling liquid- just a clear-ish discharge. When I realized I had a fistula, my doctor said he didn’t want to put me on antibiotics as they could temporary close the fistula tract and make it more difficult to find in surgery. Just something to consider?

    I’m not sure to answers to your questions, but I would imagine sitz baths would still be great!

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    • Posted

      Thanks for the reply. Yeah, I feel sorry for him too as he's extremely upset due to it. 

      The doctor physically examined him and said it's not fistula. His doctor is a general surgeon as far as I know (though I could be wrong, I'll confirm with him). Seeing what you said about about your fistula with no foul smelling liquid and clear discharge it's possible that he's developing one too (on top of that the doc advising him to stop taking medication ... may be the doc knows something he hasn't told my dad or want to tell him yet as he's very down and a bit scared). My dad was thinking about getting a 2nd opinion from another doc, I think I'll tell him to do that now.

      Again, thanks for the reply and great info. 

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    • Posted

      When my doctor examined me, he could tell that the opening “communicated” with the anus. However, I do think it sometimes requires some type of imaging to confirm. Or sometimes even exploratory surgery. Maybe someone else could chime in with their experience! 

      If it’s not a fistula, does your Dad have any other underlying health conditions that may prevent or slow the abscess cavity from healing? Crohns, etc?

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    • Posted

      Agreed, sometimes it requires an electronic examination to determine such things and physical doesn't really tell it.

      My dad is really healthy for his age (66). Extremely fit with lots of energy. He definitely doesn't have Crohns.

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    • Posted

      So doc has recommended a fistula surgery with lay open technique after ordering a Fistulogram. He still doesn't have any infection or typical symptoms of Fistula. He's very worried as the first surgery and its after effects really scared him. I'm attaching his Fistulogram report, can anyone tell whether its a straightforward fistula or a complicated one? Thanks in advance!

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  • Posted

    Mike, That sounds superficial (cutaneous) just below the skin.

    That's good, should be easy to solve.

    Good luck to your father and all the best! hope you resolve this soon.

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