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Blisters around the anus - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Infections
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   hi, I've had an abcess removed near anus, but more towards middle of bum, now it has healed but every 2 weeks, it seems to blister, become raised like a sac forms over the incision wound part and it pops either on its own and blood comes out or white discharge, its been a year since the day surgery, my surgeon cant really understand why its not fully healing, it could be lots of moisture he says, but it pops than is soar for 2-3 days than clears up and its fine than returns etc...any ideas?? I'm going to see a dermatologist in a week to see if he can figure out why the skin isnt healing, ca you help me
Doctor :   Hi
User :   hi
User :   hello can you help
Doctor :   Pls. give me few secs. to go through your query .
User :   im not worried but its been a year and this should be healing?? k thx
Doctor :   Ok, May I ask you a few questions pertaining to your problem ?
User :   yes
Doctor :   May I know your age please ?
User :   31
Doctor :   Ok, May I know if you have any long standing disease ?
User :   nothing
Doctor :   like diabetes ?
User :   no diseases
User :   no
Doctor :   Ok, That is good.
User :   just want to know if this is normal?
Doctor :   Usually blisters around anus do not heal very fast and tale lots of time to heal.
May I know the exact size of the usual blister and where exactly ?
Doctor :   Is it in the anal canal or just on the anal mucosa externally.
User :   im guessing now 1 cm
User :   external 2 inches from anus
User :   i can touch it
User :   and see it
Doctor :   Has the surgeon called it
Perianal abcess ?
User :   no its not on anus at all
User :   no he hasnt
User :   but reading on line it sounds like thats what is was
User :   before it was removed
Doctor :   Ok
Doctor :   May I know if you have any GIT disorder ?
Doctor :   like frequent diarrhoea ?
Doctor :   etc . ?
User :   no
User :   I poo once a day or every 2
Doctor :   Ok
User :   any idea why the wound isnt healling?
Doctor :   Usually I shall give you the states in which perianal abcess doesnt heal : Doctor :   And as I am not physically able to examine you , I shall cite the different conditions : Doctor :   1. Immunocompromised state
Doctor :   2. Crohn's disease
Doctor :   3. Ulcerative colitis
Doctor :   4. Diabetes
Doctor :   5.Pregnancy
User :   k 2 and 3 and 4 I have no symptons of as far as I know
User :   not 5 as I am a male
Doctor :   Yes,
User :   whats 1?
User :   mean
Doctor :   Scenarios like HIV infection where the immuniy levels are very low .
User :   like for a wound to do that why??? thats what I want to know
User :   k not me, I seem pretty healthy, Im 5-11 175lbs
Doctor :   Ok.
User :   why wont it heal? its puzzling me
Doctor :   There are 3 different peri anal abcesses ?
Doctor :   Which one of it has he described ?
User :   neither
User :   to me it has been called just an abcess
Doctor :   Treatment of ischiorectal, intersphincteric, and supralevator abscesses is different and all 3 have a chance to infect the each other and form an abcesss again and also anal fistula .
User :   he saw it 2 weeks ago and said there was some granulation on the skin and thats it
User :   what I have doesnt sound like those 3 at all
User :   at least I dont think
Doctor :   Ok.
Doctor :   By what you have mentioned I suspect it is it and the surgery if not done properly is a great underlying factor for recurrence.
Doctor :   Has he done on a day care surgery basis ?
User :   yes day
Doctor :   A potential complication of anorectal abscess drainage is the formation of fistulous tracts.The type of organism cultured from an anorectal abscess is an important predictor of fistula formation following surgical incision and drainage. Underlying anal fistulas are present in 40% of abscess cultures that are positive for intestinal bacteria; however, cultures growing Staphylococcus species are associated with perianal skin infections and typically indicate that there is no subsequent risk that anal fistulas will develop.
Doctor :   Location and etiology determine the drainage technique to be used for supralevator abscesses. Failure to manage supralevator abscesses with consideration of the primary etiology may result in iatrogenic fistula formation. Evaluation with MRI or CT scanning can exclude intra-abdominal or pelvic pathology as possible sources.
Doctor :   Usually improper management causes it srecurrence most of the times
Doctor :   i would advise a better surgeon.
Doctor :   or a gastroenteric surgeon
Doctor :   and specialist proctologist.
Doctor :   Thank you for ocnsulting me
Doctor :   take care
Doctor :   bye for now
User :   thats why
User :   you think he cut me wrong?
Doctor :   HI
User :   hi
Doctor :   Uusally the drainage in a anal or peri anal abcess is a very difficult part.
User :   so it didnt drain all
Doctor :   It has to be done with utmost care and also personal hygeine plays an important role.
User :   I keep it clean big time
Doctor :   The development of one abscess does not mean that another cannot occur. In general, if you maintain local hygiene, the chances of developing a perianal abscess are low.
Doctor :   Ok.
Doctor :   That is good.
User :   i dont want it to return
User :   but it not fully healing means what??
User :   should I see another surgeon perhaps go to the hospital
User :   im not in pain
User :   just worried
Doctor :   After the abscess heals, the abcess will need its own proper drainage. If you healed completely after the first surgery, you probably had an abscess, and probably it did not heal. However, if it did not heal completely after the first operation, perhaps you have had a fistula all along. If you have a fistula, then there will be a small residual discharge after this operation as well. You will need treatment for fistula.
User :   how do I know if I have fistula
User :   is this why the blister is forming??
Doctor :   It has to be examined by a proctoscope or colonoscope by a proctologist
User :   symptonm?
User :   symptoms of it
Doctor :   Ok
User :   cuz I feel fine
Doctor :   Anal fistulae can present with many different symptoms: Pain ;
Discharge - either bloody or purulent;
Pruritus ani - itching.
User :   none
User :   no issues down there
User :   just the part where I was cut
Doctor :   Ok.
Doctor :   Can you let m e know the exact notes of the procedure that the surgeon has done ?
User :   he froze me
User :   cut the abcess out
User :   size of penny
User :   it drained and I went back to see him in 2 weeks it healed fast
Doctor :   And I strongly feel you need to go to a super specialist - a proctologist for this.
Doctor :   Ok.
User :   really?
User :   is this not normal to do this
User :   blister??
Doctor :   Yes it is very normal, and most of the abcess around anus frequently recur
User :   so to have it blister, how long will it take to go away
Doctor :   I have to tell you that it needs a three pronged approach
Doctor :   1. Medical treatment with very strong anti-biotics
Doctor :   both orally and locally
Doctor :   2. Proper drainage and surgical correction and repair
Doctor :   3. Treatment of any underlying complicating factors like other abcesses or fissure or fistula.
User :   and your saying its nomral for the cut to blister like it is and than go back down
User :   ok I will go back and see my family doctor to get rechecked again...
Doctor :   Ok.That would be better.
User :   im scared now
Doctor :   No, there is nothing to be scared
User :   well I am, I thought I was getting better
Doctor :   just need to go to the right surgeon or proctologist.
User :   how do I see a proctolosit
User :   just call or I need to be referred
User :   how?
Doctor :   You can go directly.
User :   ok thanks
Doctor :   Thank you for ocnsulting me
Doctor :   take care
Doctor :   bye for now
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