The management of anorectal abscess during pregnancy: a case report

Introduction: Perianal and perirectal abscesses are rare in pregnant women and typically cause severe, constant pain, often accompanied by purulent rectal drainage. Diagnosis can be aided by digital rectal examination and magnetic resonance imaging (MRI). This report discusses the management of a pregnant patient with an anorectal abscess, which is a rare condition during pregnancy. Case Presentation: We present a case of a 25 -year -old pregnant woman (G1P0A0) at 37-38 weeks of gestational age with a history of sepsis due to a perianal abscess before her last menstrual period. She presented to the emergency room of Dr. Soetomo General Hospital, Surabaya, with a three-day history of fever and painful anal discharge. Magnetic resonance fistulography revealed a perianal fistula measuring 33.6 mm in length and 3.7 mm in width at the six o'clock position on the right side. The obstetric evaluation showed no uterine contractions cephalic presentation, and the fetus was at a high position. Laboratory tests indicated anemia and leukocytosis. A cesarean section was performed, delivering a male infant weighing 3,305 g with Apgar scores of 8 and 9. Subsequently, the surgical team performed drainage and debridement of the abscess. Conclusion: Anorectal abscesses causing anal pain in pregnant women are uncommon. Timely clinical assessment and management are crucial to prevent adverse maternal and fetal health effects. Further prospective studies are warranted to evaluate the outcomes of different delivery methods in pregnant women with anorectal abscesses.