Perianal Abscess Following Excisional Hemorrhoidectomy in an Immunocompetent Patient

Hemorrhoidal disease is the third most common outpatient gastrointestinal diagnosis affecting more than four million patients annually. The management depends on the disease severity, and the treatment options range from lifestyle modification to excisional hemorrhoidectomy. Perianal abscess is an exceedingly rare complication following hemorrhoidectomy, with immunocompromised patients the most commonly affected. The rarity of this complication may be attributed to the natural immunologic process within the reticuloendothelial apparatus of the liver. The disease presentation of perianal abscess after hemorrhoidectomy and its management is unclear in the literature. We present the case of a 44-year-old immunocompetent male with grade II and III hemorrhoidal disease who underwent excisional hemorrhoidectomy that was complicated with perianal abscesses. The patient was successfully managed with incision and drainage with antibiotics. Surgeons should maintain a high index of suspicion for any sign of pelvic sepsis or a developing perianal abscess, particularly in immunocompromised patients.